HIV and Disability
Common challenges and prospective in
Ethiopia
A round-table discussion with media and
journalists
29 of April, 2010, Addis Ababa, Ethiopia
Belete Hiruy, Handicap International,
Ethiopia
Monitoring and Evaluation officer
Organized and presented by
&
Internews
Universal Symbol to HIV and disability
Concepts and definition of
disability
•Models of disability (charity, medical, social,
human rights)
•Definition of disability
Types of disability
commonly
•blind,
•deaf,
• intellectual disability,
•physical disability and
•multiple disability
Disability continues…..
•Figures - world health organization (WHO)
10% of a given population are people with
disability.
•May shoot as high as 18% in developing
countries such as Ethiopia
•Nearly 7.5 people are with disabilities in
Ethiopia, and 650 million people worldwide .
Background on HIV
Concepts and definition of HIV
•HIV
•AIDS - is a cluster of medical condition often
referred to as opportunistic infection
•Socio-economic implicational - oftentimes
targets 15-49 age population, most
productive and sexually active portion of a
society
HIV continues………
•Fact - HIV targets People with disabilities too
•people living with HIV/AIDS (PLWHA) is
about 1.32 million (45% male and 55%
female) 6th AIDS in Ethiopia report, HAPCO
•There were 134,450 (368 per day) AIDSrelated deaths
HIV continues…….
•People living with HIV usually suffers from
stigma and decimation due to poor and
perceived misperception
• PwDs with HIV do suffers from DOUBLE
discrimination (because of their disability +
HIV status)
HIV and people with disabilities
Facts
•No HIV campaigns in Ethiopia have been
found disability inclusive or friendly
•Though PwDs are equally vulnerable to HIV as
other population, if not greater
•AIDS patients at later stage oftentimes
develops disability (the link b/n HIV and
disability)
Key disability issues
•Accessibility (infrastructure and information)
•disabling environment (due to the nature of
the environment and other social-economic
situation of a given society )
•Poverty (makes a vicious circle with disability
leading the one to another)
•Health care (attitude and awareness of health
professionals, facilities, and priorities,
disability tailored service e.g. Physiotherapy
and rehabilitation)
Key disability continues……..
•
•
•
•
•
•
•
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HIV and AIDS (vulnerability)
Gender inequality
Employment
community attitude and perception
(wordings/terminologies matters)
National and regional Guidelines and strategies
Disability movement
Education (97% of PwDs are illiterate)
Poor community awareness what disability is and
related discrimination
Are PwDs are vulnerable to HIV?
Yes because
•HIV risk behaviors including unsafe sexual
practice, and injection of drug use
•Sexual violence among women with disability is
high in schools, institution, community, hospitals
•There is misperception or a myth in a community
that PwDs are not vulnerable to HIV but the fact is
they are equally or highly vulnerable to the virus
(world bank Global survey on HIV and AIDS)
Vulnerability continues…….
• Access to HIV prevention awareness and
information services is very low for multiple
reasons (inaccessibility, illiteracy,
discrimination)
• Their sexual activity and desire is not well
recognized (reproductive health and sexuality)
• Exposed and subject to sexual and related
violence (Handicap International, Yeka sub city legal
right empowerment)
Common barriers in reaching PwDs
with HIV service includes but not
limited to..
•No specific and clear understanding on the real
vulnerability and situation of PwDs
• IEC/BCC materials are not accessible (media, print,
workshop, trainings)
•VCT centers are neither accessible nor promoted among
PwDs (confidentiality, communication barrier,
infrastructure accessibility, )
•High illiteracy and economic dependency of PwDs (97%
of CwD, accounts 1/3 of the total 72 million children out
of school equals to 24 million) are out of school) Helander,
1998
Barriers continues……
• Families and communities misperception that
they don’t need such service and kept behind
doors
• Service providers consider it is difficult to work
with PwDs or think need to design a special types
of service to them which apparently appears
costly
• HIV/AIDS service providers lack technical skill on
mainstreaming disability in their HIV prevention
program
Barriers continues…….
•PwDs themselves are not well empowered
•Usually labeled as second priority
•Organization of and for with disabilities are
very limited in No. and their..
• organization capacity is not that tough and
competent to promote and lobby on issues of
disability
Barriers continues…….
• Linkage b/n HIV and disability organization is
very poor (alienated and disbursed actions
rather than coordination and exchange
focused)
• Policies and guidelines are not in place
promoting disability in the HIV initiative which
is the basis
Facts about OVC + disability
•OVC due to HIV from families and or parents
with disability the disadvantage is Double +
• Children with disabilities are suffering a lot
whom account 4-5% of the general OVC due
to HIV and AIDS.
•OVC + HIV positive + disability + female =
quadruple discrimination/burden
The common barriers can be
summarized
•Community barriers (stigma and discrimination,
attitude and perception on disability)
•Environmental barriers (the built environment,
approach and strategies)
•Communication barriers (media, print, brail, sign
languages, simple and plain pictures and
messages)
•HIV service providers (professionals, facilities)
•Policy and guidelines
Is it possible to include Disability in the
HIV programs? Yes but need to consider
the following points
•Conduct a nationwide and large scale
assessment or survey on HIV and disability
•Work with organization of/for with disability
•Mainstream Disability in the existing HIV and
AIDS programs
•Capacity building of stakeholders and health
professionals on Disability
How to include continues…..
•Import other countries prior experience
and adapt to Ethiopia context
•Enhance coordination and networking of
HIV and disability service providers
•Design strategies and means how to best
fit in order to realize the set goals
How to include
continues……….
•Monitor and evaluate the progress and
made amendments where required
•Capitalization and scaling of best practices
•Promote skill and experience sharing
among the major HIV and disability actors
•Priorities and
consider women with
disabilities as special target group
What if not included?
•All efforts and endeavors in the fighting of HIV and
AIDS will never be fully realized since 10% of the
total population have been left out
•The Virus will keep spreading despite hard
workings and investment
•Equity and equality of all citizens is not in place
•Loss and jeopardize the social and economic gains
the country would have been secured from people
with disabilities (~7.5 million people)
What can media and journalists
do in this regard?
•Media is the main rout taking quite imperative
informations and messages to and from the
community
•Is bridge between two or more parties
•So that may talk about Disability and HIV
•Work closely with organization of/for with
disability
•Identify gaps on these area and made it
public/bring it into attention
Journalist continues……
•Mainstream disability in their routine program
separated or in the package e.g. drama, literatures,
interviews, live phone discussion
•Write articles, commentaries, citing facts and
figures
•Keep it visible and consistent rather than making it
only fashion of the day (flourish-diminish)
•Build journalists’ capacity on disability issues on
reporting and making features or sessions (because
wording and naming are sensitive) Inter-news is a
good start & e.g
Journalist continues…..
•Invite PwDs to take part in your sessions and
programs however you are not talking about
disability issues
•Monitor and evaluate your performance and
made amendments where and when
required
•Put PwDs in the centre (in the hub)
Question and Discussion