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Disabled at greater risk of HIV infection
Tafi Murinzi, Inter Press Service (IPS)
May 24, 2005

http://www.ipsnews.net/africa/interna.asp?idnews=28800

BULAWAYO - 'Do you think I can go for an HIV test and be accepted?" Zitha scoffs at the suggestion.

Disabled, and also a single mother, the 44-year-old swears her fear of discrimination is no idle assumption. Rather, it is based on her experience at a test centre she visited last year. ''The attitude was horrible,'' she says.

Such fear of condemnation and disapproval is rooted in society's tendency to scowl at evidence of the disabled person's sexuality. Its effect renders disclosure largely unthinkable for those who may test HIV positive.

''So they just die quietly in their homes without being noticed,'' says Annie Malinga, coordinator of the 400-member Zimbabwe Women with Disabilities in Development (ZWIDE).

HIV/AIDS, according to a collaborative global survey by the World Bank and Yale University, is a significant and almost unrecognised problem among the world's 600 million-odd individuals who live with physical, sensory, intellectual, or mental health disabilities.

Eighty percent are in the developing world, including countries like Zimbabwe, which are badly affected by HIV/AIDS. More than 10 percent, or about 1.4 million people, in the Southern African country have some form of disability.

The 57-nation study, whose findings were released last year, says while all individuals with disabilities are at risk of HIV infection, subgroups within the disabled population face a greater risk. These are mostly women, members of ethnic and minority communities, adolescents and those who live in institutions.

The fact that disabled people are more likely to have received little or no education and to be out of employment places them among the world's poorest, most stigmatised and most marginalised.

While the disabled are at also greater risk of violence or rape, they are less likely to obtain police intervention, legal protection or health care.

Poverty and social sanctions against marrying a disabled person mean that disabled women, in particular, are likely to become involved in a series of unstable relationships. They are often targeted by abusers who assume they are non-sexual and therefore safe.

''It's not really love; able-bodied men want to experiment on us,'' Zitha says. ''When they're done they go back to their own society and you are dumped just like that.''

Where the disabled suffer from AIDS the effect is often called a ''double impact''. HIV status adds to the existing stigmatisation brought by a disability. For women, AIDS may triple the stigmatisation.

''You are disadvantaged first as a woman, stigmatised as a disabled woman and then you are stigmatised as a woman with HIV and AIDS,'' Malinga says.

Even where they choose to face up to HIV, disabled women have difficulty in accessing services. ''You find that the testing centres are miles away, and the buses themselves are not accessible for someone on a wheelchair,'' she says. The female condom, too, is unsuitable for women with certain forms of disability.

Due to the special needs of the disabled, making information available to them is often the biggest challenge for AIDS service organisations, including the country's National AIDS Council.

But the commitments, and resources, are often short. ''They think disabled people are not sexually active and hence not vulnerable, so they leave us out of their programmes,'' says Chrispen Manyuke of the Federation of Disabled Persons of Zimbabwe.

The most effective intervention, he adds, is to allocate funds and allow individual disability organisations to run their own programmes.

Visually-impaired Clemence Mupasi says there is presently very little literature in Braille, even among school children where HIV/AIDS is now part of the national curriculum from forth grade upwards.

''We rely on the radio, but when you read it's different from listening; you get to understand better,'' he says.

A major concern is the disinclination to involve the disable in policy planning, even on matters that affect them. ''There is a tendency of not listening to what a disabled person is saying,'' Malinga says.

But official policy is all for ''mainstreaming'' people with disabilities. ''Whatever we plan, we need to think of the cross-section of our society and not think for them,'' says Mkhululi Nceda-Moyo, a government psychologist who works with children with special needs.

What activists have so far failed to do in highlighting the disabled person's exclusion from AIDS programmes could be left to political lobbyists. But in Zimbabwe the disability lobby appears at it weakest.

It seems political and social problems in the last five years have relegated disability issues to the periphery. There is presently no disabled person in parliament; neither did the country have a disabled legislator in the last five years.

"What we need is a disabled member of parliament from each of the 10 national provinces," Manyuke says.

Even then, the country has a plethora of organisations looking after the needs of the disabled. Yet it appears very few are focusing on vulnerability to HIV/AIDS.

''Ultimately if you look at most of them they are trying to look into the material needs of their members but they've forgotten that they cannot ignore health and some social issues,'' says Boniface Hlabano of the Matabeleland AIDS Council (MAC), an AIDS service non-governmental organisation (NGO) based in the country's southern region.

MAC has just launched a three-year programme meant to highlight, and address, the disabled person's susceptibility to HIV/AIDS. Its implementation follows results of a survey conducted by the organisation which showed that the disabled have largely been left out of existing awareness programmes.

MAC intends to develop a model on how to lessen the likelihood of the disabled getting the virus. ''At the end of the day we want inclusion and active participation,'' Hlabano says.

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