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Disability and HIV: Critical Intersections

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Disability in the Global South

Abstract

The relationship between HIV and disability is complex, but critical, because disabled people are vulnerable to HIV infection, while people living with HIV are at high risk of impairment. But this relationship remains largely unexplored in disability studies, epidemiology, global health, development and associated fields, and disability issues have been largely neglected in global and national HIV policy responses. The continuing lack of data on HIV prevalence among disabled people globally obscures their specific needs and requirements in accessing HIV prevention, treatment, care and support services. This chapter discusses conceptualisations of disability, bodies and health identities. We then examine disabled people’ vulnerability to HIV, including violence, stigma and access to sexual health and HIV prevention and treatment programmes. We focus on the relationship between disability and HIV in Sub-Saharan Africa, the continent that has been most affected by the HIV epidemic to date, and examine recent policy initiatives by disabled people’s organisations and networks of people living with HIV to tackle discrimination to advance their claim for the right to health in the differing local and national contexts of Ghana and Uganda.

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Notes

  1. 1.

    Although the frequently used PLHA acronym includes both ‘HIV’ and ‘AIDS’, UNAIDS terminology guideline s (<CitationRef CitationID="CR44" >2011</Citation Ref>) propose use of the term that is most specific and appropriate in the context to avoid confusion between HIV (a virus) and AIDS (a clinical syndrome). People living with HIV and the HIV epidemic are the preferred terms and AIDS should be used only when referring to a person with a clinical diagnosis of AIDS or to national policy responses. We have therefore used the acronym ‘PLHIV’ throughout this chapter.

  2. 2.

    We recognise the contested, complex notion of ‘vulnerability’ within disability studies (Burghardt <CitationRef CitationID="CR7" >2013</Citation Ref>). While being categorised as ‘vulnerable’ may have social and practical consequences in terms of being regarded as having high support needs that should be met through the provision of services, support and other resources, it may also serve to construct particular groups as passive recipients of service provision and deny their agency.

  3. 3.

    The CRPD understanding of disability includes people those with long-term physical, mental, intellectual or sensory impairments which hinder their full, effective and equal participation with others in society.

  4. 4.

    Interviews were conducted in 2012 as part of Yaw Adjei-Amoako’s doctoral research on disability and inclusive development in Ghana, funded by The Felix Trust. The links between disability, HIV and access to healthcare were not an explicit focus of the research, although several disabled participants discussed barriers to accessing healthcare and a small proportion of the sample (3 of the 26 disabled people) identified as having ‘autoimmune conditions’.

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Authors and Affiliations

  1. Department of Geography and Environmental Science, University of Reading, Reading, UK

    Ruth Evans & Yaw Adjei-Amoako

  2. Hope Development Initiative, Kampala, Uganda

    Agnes Atim

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  1. Ruth Evans
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  2. Yaw Adjei-Amoako
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  3. Agnes Atim
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Correspondence to Ruth Evans .

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Editors and Affiliations

  1. Centre for Global Disability Research, The Critical Institute, Attard, Malta

    Shaun Grech

  2. Institute for Culture and Society, Western Sydney University, New South Wales, Australia

    Karen Soldatic

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Evans, R., Adjei-Amoako, Y., Atim, A. (2016). Disability and HIV: Critical Intersections. In: Grech, S., Soldatic, K. (eds) Disability in the Global South. International Perspectives on Social Policy, Administration, and Practice. Springer, Cham. https://doi.org/10.1007/978-3-319-42488-0_22

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