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Disability, Poverty and HIV and AIDS

By Irene Banda

HIV and AIDS are no strange words; in fact they are the center of formal and informal discussions in society, the focus of a number of workshops on a daily basis. AIDS generates conflicting feelings among us. It is bringing us face to face with the reality of love, sex unfaithfulness, disease, loss and death. The disease is destroying relationships, families' organizations and governments.

HIV is a major Socio-economic issue that is affecting each and every one of us in one way or the other. It is a major development concern in the developing world, recent studies by development NGOs have indicated that the millennium goals might never be achieved if HIV/AIDS is not addressed. In Zimbabwe the epidemic has reached proportions the significance of which cannot be overemphasized. In fact, the latest estimates indicate that over 2500 people die of HIV-related illnesses every week Social consequences are revealed through family systems being dissolved and restructured, and increase in number of orphans and prostitution and crime as alternative means of obtaining income. This increases the risk of infection. The situation is not different among ZPHCA members; in fact it is even worse because the members find themselves trying to cope with both disability and HIV.

The most extreme consequences are revealed at the household level. Women (who make up 99% of ZPHCA membership) in particular bear the brunt of this pandemic because they are usually the main caregivers, often left to do so in isolation with the men either abandoning them or working for an income. Unfavorable economic conditions and the turmoil associated with HIV/AIDS profoundly destabilize the living conditions and coping mechanisms of HIV/AIDS-affected households, for whom social and financial expenses become increasingly burdensome. Families in which one or more members is HIV-positive or have AIDS and have someone with a disability are likely to experience a reduction in income and productivity precisely as their spending patterns change to care for the sick in addition to the disabled.

Major interventions around HIV/AIDS prevention, care, support and mitigation have been done, but little or none has targeted the disabled people as a special category. This is so because Aids Service Organizations (ASOs) do no consider Disability as their issue. They also believe that the Disable do not have a sex life. One might ask why the disabled do not seek to benefit from these services: they are unable to access these services, for several reasons:  

Unfortunately the disabled including ZPHCA members have not been spared from this scourge and as it has among its membership people who are affected and infected by HIV/AIDS, unfortunately the majority are very poor and this affects the performance of the organization. To date major campaigns and interventions have been planned and implemented to address information, awareness, prevention and care of the infected and affected. However, the degree to which these programs involve or target people with disabilities and their families who are in our case mostly single mothers are very minimal or none.

Women and children who make up the majority of our members are at highest risk to infection as they may not and in certain societies they can not protect themselves due to a number of cultural social, religious economic and environmental factors.

On the other hand Disability and HIV/AIDS are surrounded by a lot of myths and misconceptions: stigma and discrimination. Therefore it is important that all HIV/Aids programs and interventions mainstream disability and gender

Given the above background ZPHCA thought of developing an HIV and AIDS and DISABILITY Project to try and address this gap in HIV campaigns. The first activity undertaken was a rapid assessment survey. The survey did bring to light a number of interesting and critical issues that needs to be addressed. A summary of the findings and recommendations is as below.

Executive summary of the DPO report

The rapid assessment was commissioned by ZPHCA to assess the vulnerability, impact and coping mechanisms of parents of disabled children on HIV&AIDS and suggest strategies for developing a HIV and AIDS program for ZPHCA. The study used participatory methodologies of inquiry and involved 60% of ZPHCA membership from the Bulawayo branch sampling both male and female parents and guardians.

Among the many findings, the study found out that many parents of the disabled children were vulnerable and affected by HIV & AIDS. In homes of disabled children where one or two parents have AIDS, the quality of care for the disabled child is highly compromised especially if the person living with AIDS is the mother. In such insistences, there is also double stigma and discrimination of parents of disabled children and at times the whole family is stigmatized for the disabled child and AIDS.

The study found out that having a disabled child increases vulnerability to STI/ HIV infection as all parents go out with other sexual partners to prove who was the source of the disabled child. In the process there is a high turnover of sexual partners to parents of disabled children leading to serial partners in a short period of time increasing the risk to infection

The study further found out that, having a disabled child in a home influences family planning behaviors and practices as parents hurry to produce another child to check whether it will also be disabled child. In some families they hurry to get another child to play with the disabled child as the community around would not allow their children to play with a disabled child, thus compromising the health of the parents and the child.

Equally important, is the time requirements to care for the disabled child, the female parent gets highly occupied with caring for the disabled child that leaves no time for her to participate in programs that can help prevent HIV&AIDS infection in the home.

Other findings related to the above critical issues are,

In conclusion, the study revealed that, the parents of the disabled children are at a higher risk of infection to STI/HIV and the risk increases as the parents try to cope with having a disabled child, therefore, a disabled child in a family act as one of the pre-disposing factors to the parents infection and when an infection happens in a home, the quality of care for the very disabled child is compromised causing a vicious cycle of disability and HIV & AIDS at house hold level.

The study recommends that, a target specific interventions should designed and implemented for the parents of disabled children to address issues of HIV & AIDS and disability, empowerment & gender issues and sexual reproductive health.

Executive summary of the DPO report

The rapid assessment was commissioned by ICD to assess the vulnerability, impact and coping mechanisms of disabled people on HIV&AIDS and suggest strategies for developing a HIV and AIDS program for Disabled people"s organizations (DPOs) partner to ICD. The study used participatory methodologies of inquiry and involved 22 respondents; 15 females and 7 males representing; King George, Muscular Dystrophy Associations of Zimbabwe, Jairos Jiri and National council of the disabled people of Zimbabwe (NCDPZ) and association of disabled people (ASSOD).

Among the many findings, the study found out that disabled people like any other people were vulnerable and affected by HIV & AIDS. The disabled people perceived themselves to be at higher risk of HIV infection due to disability regardless of the awareness levels.

The disabled people’s social exclusion from the mainstream HIV/AIDS services make the situation worse, for example, the VCT services don’t offer counseling in sign language, information, education and communication materials on HIV and AIDS are not offered in brail for the visually impaired and those physically handicapped depend on their sexual partners to put on condoms, all these situations increase their vulnerability to infection. Importantly, most disable people were not aware of the reproductive health rights a factor that puts them at risk of infection, confirming their exclusion from the reproductive health programs.

Myths and misconceptions; The study revealed that a lot of myths and misconceptions around HIV and disability increases the vulnerability of the disabled people, for example the belief that sex with a disabled person cleanses of HIV and AIDS.

The study revealed that, there were high levels of stigmatization and discrimination by the community, being stigmatized and discriminated due to both HIV and AIDS status and disability. However, the disabled people too, stigmatize each other over HIV and AIDS status and there are also elements of self-stigmatization and discrimination by the disabled people themselves.

The study found out that, there was limited access to HIV & AIDS information and utilization of services like VCT, HBC and OVC by people with disabilities mainly because of the nature of disability, location of the facilities and attitudes of the service providers.

In conclusion, the study revealed that, the people with disabilities are at a higher risk of infection to STI/HIV and AIDS due to exclusion from mainstream HIV interventions. The situation is further exacerbated by lack of policy framework on disability and HIV and AIDS.

The study recommends that a target specific interventions should designed and implemented for people with disabilities to address issues of HIV & AIDS, empowerment & gender issues and sexual reproductive health.


2005-08-19 00:00:00

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