HIV and Disability

HIV and Disability Common challenges and prospective in Ethiopia A round-table discussion with media and journalists 29 of April, 2010, Addis Ababa, Ethiopia BeleteHiruy, 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 650million 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) AIDS-related 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…….. • 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

HIV and Disability