There is a view that people with disabilities don’t have sex. This is wrong and comes from prejudice. But it means that sexual health services often don’t cater for people with disabilities.
HIV and people with disabilities
- In sub-Saharan Africa, women with disabilities are 2.2 times more likely to acquire HIV than women without disabilities, and this figure is 1.5 for men.
- People with disabilities are 10% less likely to know their HIV status and be on treatment than people without disabilities.
- But people with disabilities are often left out of HIV programmes. And most programmes for people with disabilities do not cover sexual health.
More than one billion people have a disability (a physical, mental, intellectual or sensory issue). The term ‘people with disabilities’ describes many different types of people with many different disabilities and needs.
People with disabilities are at risk of HIV for many reasons. They are often excluded from education, employment and healthcare. They are also vulnerable to sexual violence and abuse.
Women and girls with disabilities are particularly at risk of HIV. People's age, type of disability, location, education level, sexual orientation and gender identity also affect their HIV risk.
Why are people with disabilities at higher risk of HIV?
Some people with disabilities might not be able to go to a service (for example, because it does not have wheelchair access or because they cannot use public transport to get there). Or they may not be able to understand the information because it is not in the right format (such as sign language or Braille). People with disabilities may need someone to go with them to a service. But they may feel uncomfortable to ask, or the person they ask may be unwilling to take them.
Many young people with disabilities do not go to school, so they miss out on sex education if it is provided. Even if they are in school, young people with disabilities are often excluded from sex education lessons because of communication barriers and discriminatory views about sex and disability.
This affects people with disabilities in lots of ways. It may mean they are treated badly by healthcare providers when they try to access healthcare, so they cannot access the services they need. Discrimination also means people with disabilities do not have the same work opportunities as others. So they may engage in sex work, exchange sex for things like food or housing, or be sexually exploited.
Women and girls are particularly vulnerable to this, especially to sexual violence. They may also be unable to make decisions in relationships, like whether to use condoms. Some people with disabilities find communication difficult, which stops them reporting abuse.
How can HIV services meet the needs of people with disabilities?
Involve people with disabilities in the design and delivery of HIV information and services.
It’s important to understand and cater for the different needs of people with disabilities, rather than thinking of them as one group.
Provide condoms and accessible HIV information and other services like HIV testing in places that people with disabilities go so they can easily access them.
To reduce prejudice, train healthcare staff about the rights and needs of people with disabilities.
Support people with disabilities to recognise abuse and understand how to report it. This will help people bring about change for themselves and for others.
This includes providing support and training to get people with disabilities into work or school, and working with families, partners and the wider community to stop discrimination, abuse and violence.
Collect evidence about the sexual health needs of people with disabilities to help improve policies and programmes.
What systemic changes could reduce people with disabilities’ risk of HIV?
The belief that people with disabilities are inferior to others is wrong, and it does a lot of damage. Addressing this would help people with disabilities receive the support and services they need.
Adapting health facilities, schools and workplaces to include people with disabilities would help disabled people claim their right to health, education and employment. This reduces their vulnerability to HIV.
Enabling people with disabilities to take up leadership roles and make decisions about the things that affect their lives is essential for change.
The needs of people with disabilities should be included in all national programmes and policies that affect people’s health and wellbeing, with a particular focus on women and girls with disabilities.
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