Disability and HIV in Africa: Breaking the barriers to sexual health care

Rohleder, Poul

doi:10.1177/1359105316628738

Cited by 9 publications

(3 citation statements)

References 48 publications

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“…Consistent with other research (e.g., [63]), this study has identified some powerful barriers impeding access to HIV information and services for persons with disabilities. In particular, this study has clearly identified some risky attitudes towards and among persons with disabilities and has illustrated ways in which stigma exacerbates the limited access to and utilisation of services.…”

Section: Attitudinal Barrierssupporting

confidence: 88%

“Even the fowl has feelings”: access to HIV information and services among persons with disabilities in Ghana, Uganda, and Zambia

Schenk

Tun

Sheehy

et al. 2018

Disability and Rehabilitation

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Background: Persons with disabilities have often been overlooked in the context of HIV and AIDS risk prevention and service provision. This paper explores access to and use of HIV information and services among persons with disabilities. Methods: We conducted a multi-country qualitative research study at urban and rural sites in Uganda, Zambia, and Ghana: three countries selected to exemplify different stages of the HIV response to persons with disabilities. We conducted key informant interviews with government officials and service providers, and focus group discussions with persons with disabilities and caregivers. Research methods were designed to promote active, meaningful participation from persons with disabilities, under the guidance of local stakeholder advisors. Results: Persons with disabilities emphatically challenged the common assumption that persons with disabilities are not sexually active, pointing out that this assumption denies their rights andby denying their circumstancesleaves them vulnerable to abuse. Among persons with disabilities, knowledge about HIV was limited and attitudes towards HIV services were frequently based upon misinformation and stigmatising cultural beliefs; associated with illiteracy especially in rural areas, and rendering people with intellectual and developmental disability especially vulnerable. Multiple overlapping layers of stigma towards persons with disabilities (including internalised self-stigma and stigma associated with gender and abuse) have compounded each other to contribute to social isolation and impediments to accessing HIV information and services. Participants suggested approaches to HIV education outreach that emphasise the importance of sharing responsibility, promoting peer leadership, and increasing the active, visible participation of persons with disabilities in intervention activities, in order to make sure that accurate information reflecting the vulnerabilities of persons with disabilities is accessible to people of all levels of education. Fundamental change to improve the skills and attitudes of healthcare providers and raise their sensitivity towards persons with disabilities (including recognising multiple layers of stigma) will be critical to the ability of HIV service organisations to implement programs that are accessible to and inclusive of persons with disabilities. Discussion: We suggest practical steps towards improving HIV service accessibility and utilisation for persons with disabilities, particularly emphasising the power of community responsibility and support; including acknowledging compounded stigma, addressing attitudinal barriers, promoting participatory responses, building political will and generating high-quality evidence to drive the continuing response. Conclusions: HIV service providers and rehabilitation professionals alike must recognise the two-way relationship between HIV and disability, and their multiple overlapping vulnerabilities and stigmas. Persons with disabilities demand recognition through practical steps ...

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Section: Attitudinal Barrierssupporting

confidence: 88%

“Even the fowl has feelings”: access to HIV information and services among persons with disabilities in Ghana, Uganda, and Zambia

Schenk

Tun

Sheehy

et al. 2018

Disability and Rehabilitation

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“…The differences in the study findings could be due to variations in the study population, time, and measurement of the outcome variables. These findings imply the urgent need to demystify the general assumption that PwDs do not have sex [ 65 ] which negatively impacts their sexual behaviour and use of SRH services increasing their risk of STIs, including HIV and AIDS [ 37 ]. Nonetheless, the prevalence of self-reported STIs in this study could be due to underreporting and social desirability biases.…”

Section: Discussionmentioning

confidence: 99%

Sexual lives and reproductive health outcomes among persons with disabilities: a mixed-methods study in two districts of Ghana

Seidu,

Malau-Aduli,

McBain-Rigg

et al. 2024

Reprod Health

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Introduction People with disabilities (PwDs) constitute a large and diverse group within the global population, however, their sexual and reproductive health (SRH) needs are often neglected, particularly in low-and middle-income countries. This may result in adverse outcomes, such as sexually transmitted infections (STIs), unintended pregnancies, and experience of interpersonal violence (IV). This study aimed to assess the factors that influence the sexual lives of PwDs in two districts of Ghana. Methods A sequential explanatory mixed-methods study design was used to collect data from PwDs. Quantitative data were obtained from 402 respondents using a pretested questionnaire, and qualitative data gathered from 37 participants using in-depth interviews. The quantitative data were analysed using descriptive and inferential statistics, while the qualitative data were analysed using inductive thematic analysis. Results Most PwDs (91%) reported that they have ever had sex, which was associated with age, disability severity, and household size. The prevalence of poor SRH status, STIs, unintended pregnancy, pregnancy termination, and unsafe abortion were 10.5%, 5.7%, 6.4%, 21.6%, and 36.9% respectively. These outcomes were influenced by education, income, health insurance subscription, and proximity to a health facility. The prevalence of IV was 65%, which was related to disability type and severity. The qualitative data revealed five main themes: curiosity to engage in sexual activities, feelings of despair and insecurity with abled partners, preference for sexual relationships with other PwDs, IV and its perpetrators, and adverse SRH outcomes. Conclusion The study findings indicate that most adult PwDs have ever had sex and they face various challenges in their sexual lives. They experience multiple forms of abuse and neglect from different perpetrators at different levels of society, which have negative impacts on their well-being. There is a need for comprehensive and inclusive interventions that address the SRH needs of PwDs, as well as the underlying social and structural factors that contribute to their vulnerability. Further research is recommended to explore the perspectives of stakeholders on how to improve the SRH outcomes of PwDs.

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“…al. 2014;Löfgren-Mårtenson 2004;McKenzie and Swartz 2011;Pinquart and Pfeiffer 2012;Rohleder 2017). Thus WHO (2015) report clearly highlighted the dangers of stigma and unpleasurable sexual encounters as violating the right to sexual health which must be all inclusive.…”

Section: A D I 236mentioning

confidence: 99%

Beyond Asexualization: Narratives of Sexual Objectification of Persons with Albinism in Nigeria

Ikuomola¹

2019

eap

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Often overemphasised, in most sexuality studies, is that persons with disability, especially women, face experiences of asexualization rather than sexualisation. Similarly overemphasised is the faulty monolithic assumption that economic deprivation is the causal factor in the objectification of persons with disability. This has unintentionally created an expectation that objectifying environments are the inevitable and immutable default to economic distress. This is often not the case within the socio-cultural space of persons with albinism (PWA) in Southern Nigeria, where their presence is obvious. As a departure, this study examined the sexual objectification of PWA in Nigeria. It was discovered that at some points in the life course of PWA, most especially among the women with the development and aging of their body, objectification added to mental health risks such as withdrawal syndrome, isolation and indolence. The study concludes that cultural attitudes not only creates and threatens PWA sexed and gendered body confidence in relationships but also for them to be labelled and misconstrued as sexually inactive.

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Disability and HIV in Africa: Breaking the barriers to sexual health care

Cited by 9 publications

References 48 publications

“Even the fowl has feelings”: access to HIV information and services among persons with disabilities in Ghana, Uganda, and Zambia

“Even the fowl has feelings”: access to HIV information and services among persons with disabilities in Ghana, Uganda, and Zambia

Sexual lives and reproductive health outcomes among persons with disabilities: a mixed-methods study in two districts of Ghana

Beyond Asexualization: Narratives of Sexual Objectification of Persons with Albinism in Nigeria

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