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with disabilities sidelined in global HIV and AIDS fund intervention
– once again
Majonga, National Association of Societies for the Care of the Handicapped
September 25, 2013
As has become
the norm in mainstream national interventions, disability has been
sidelined once again in the Global fund 2014 -2016 round to combat
HIV and AIDS, tuberculosis and malaria, cementing a disability-exclusion
trend that started in 2002 with the inception of the Global Fund
intervention in Zimbabwe.
Director of the National Association of Societies for the Care of
the Handicapped, (NASCOH), Farai Mukuta, says that despite NASCOH
winning the Auxillia Chimusoro award in 2007 for advocating for
HIV and AIDS as an issue of real concern among people with disabilities
(PWDs), the prevailing view in society is that PWDs are not sexually
active and do not warrant inclusion in HIV and AIDS interventions.
Consequently, there have been no there have been no deliberate efforts
to address the issue of AIDS among people with disabilities and
to incorporate them within the rubric of the national response.
is an erroneous assumption in society that people with disabilities
are not sexually active. On the contrary, people with disabilities
are just as sexually active as the rest of the society and the lack
of provision of HIV and AIDS information in disability-friendly
formats makes them even more vulnerable to the pandemic. It is unfortunate
that they continue to be systematically excluded in national HIV
and AIDS interventions,” he said. .
and HIV and AIDS situation analysis commissioned by NASCOH in 2003
revealed that people with disabilities are particularly vulnerable
to AIDS due to their low literacy levels, little access to health
care, high vulnerability to sexual abuse, lack of information on
AIDS especially for the visually impaired and hearing impaired,
and consequent lack of inclusion in AIDS intervention programmes.
Stigma, fear and ignorance results in the majority of PWDs refraining
from accessing available services such as VTC, Antiretroviral therapy,
home based care and counseling. Such is the impact of stigma, discrimination
and social exclusion among people with disabilities that those who
contract HIV go to extra lengths to hide their status, for fear
of compounding this stigma, discrimination and social exclusion.
The peculiar situation of people with disabilities calls for urgent,
target-specific interventions aimed at mitigating the impact of
AIDS in the disability sector.
Just as people
with disabilities are a forgotten and invisible group in society,
they are also forgotten in planning for HIV/AIDS programmes. In
the majority of cases, people have found it convenient to wink at
the issue of AIDS among people with disabilities, to find solace
in the erroneous assumption that PWDs do not engage in sexual activity,
or to just regard the problem as inconsequential. The reality, however,
is that disabled people are just as sexually active as the rest
of the society and are even more at risk of infection because of
the obvious barriers that they encounter in accessing vital information
on HIV/AIDS, not to mention access to health care. In addition to
the attendant factors that have been documented by research as heightening
or ameliorating the prevalence of HIV/AIDS in any society, on a
general level, the prevalence of AIDS among people with disabilities
is further compounded by the following special considerations, again
documented by research:
and visually impaired people registered lower scores on the HIV/AIDS
Knowledge Index than hearing people, thus indicating low levels
of awareness of AIDS issues.
- The incidence
of alcohol abuse within the hearing impaired community is estimated
to be at 35% compared to 12-14% incidence among the general population.
- It is estimated
that 1 in 7 hearing-impaired persons has substance abuse problems,
compared with 1 in 10 in the hearing population.
- People with
serious mental illnesses have a lower level of self-efficacy where
taking protective measures is concerned. This observation obtains
even where knowledge and awareness of AIDS issues is present.
- People with
learning disabilities have difficulties in negotiating safe sex.
Incidences of homosexuality are also noticeably higher among this
- A strong
connection between increased risk taking behaviour and risk of
contracting HIV has been documented among adolescents hospitalised
for emotional behaviour.
and adherence to TB medication is very low for the mentally ill,
- Access to
information and treatment, and issues of social status has been
noted to be issues of real concern for women with disabilities.
issue of HIV and AIDS has been addressed comprehensively in the
wider society in Zimbabwe, as evidenced by the reported fall of
the country’s HIV and AIDS prevalence rate from 26% in 2000,
18.1% in 2005, and 15% in 2011, this success story does not, regrettably,
include people with disabilities (PWDs), who have been systematically
sidelined from all HIV and AIDS intervention programmes in the country,
on the erroneous assumption that they are not sexually active. AIDS
constitutes nature’s greatest threat to mankind, and any intervention
that fails into account a sizeable proportion of the country’s
population (1 950 000 people or 15% of Zimbabwe’s total),
is ineffectual and falls short of the mark. Fundamentally, it can
be likened to
pouring water into a bucket riddled with holes at the bottom, as
it ignores the potentially devastating effects occasioned by the
crucial dynamics of sexual interaction between PWDs and the able
bodied populace and among PWDs themselves.
The social exclusion
of PWDs is not limited to the HIV and AIDS arena, but extends to
the Millennium Development Goals (MDGs). Although the MDGs are an
international blueprint for development that hold a lot of scope
for committing governments to “making the right to development
a reality for everyone and to freeing the entire human race from
want”, disability is not mentioned in any of the 8 MDGs, the
18 targets set for achieving these goals and the 48 indicators for
measuring the achievement of these targets, effectively leaving
out people with disabilities out of the development loop. By excluding
a large part of society, the MDGs have ensured that PWDs are mostly
unable to benefit from the achievements made in attaining the MDGs,
including in the area of HIV and AIDS impact mitigation.
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