National Strategic Framework on HIV DHAT Regional Meeting on Disability, HIV and AIDS Jill Hanass-Hancock (HEARD)

John Meletse Film “Stepping into the Unknown” “You are given a beautiful cocktail of tablets, and no one explains what they are for and how they would help me” John Meletse Film “Stepping into the Unknown” www.heard.org.za

HIV-Prevalence of at Risk Populations in South Africa Source: South African National HIV Prevalence, Incidence, Behaviour and Communication Survey, 2008:

Disability and Mental Health in the NSPs of Southern and Eastern Africa Table 2: Emerging responses within NSPs in Eastern and Southern Africa NSP fails to recognise disability as an issue in any way NSPs do not specifically indentify disability as an issue but nevertheless include some reference to disability within the Response NSP identifies disability as an issue but fails to operationalise this concern issue and takes selective steps to operationalise this concern issue and takes extensive steps to operationalise the issue Report based on the UNCRPD and the UNAIDS HIV and Human Rights guidelines Identification of disability as a key issue in the situational analysis Inclusion of principles relevant to people with disabilities within the NSP Creating a framework for the involvement of people with disabilities in responses to HIV and AIDS Protecting the rights of people with disabilities Providing HIV-related prevention, treatment, care and support services for people with disabilities Monitoring and evaluating the impact of HIV on people with disabilities Evaluating the overall inclusion of disability within NSPs

Agencies Developed in the National Strategic Framework Government NAC Sectors NGO or DPO Sectors UNAIDS Sectors NSP and Ops Plan

Basic Structure of previous NSPs Situation Analysis 2. National Framework for the Response to HIV Priority Areas Key Priority Area 1: Prevention Key Priority Area 2: Treatment Care and Support Key Priority Area 3: Research, Monitoring and Surveillance Key Priority Area 4: Human Rights and Access to Justice Some have more The sector plan is very focused on access and human rights issues. It is however relatively silent of issues faced by people with intelelctual and mental disabilities/disorders. It recognises “HIV as a cause of disability” but does not look into services for PLHIV who are developing disabilities

Recommendations for Priority Area 1 and 2 People with mental health problems or intellectual disabilities PLHIV who develop mental health problems or neuro-cognitive disorders People who care for PLHIV especially young carers Access to health services and education disability specific sex education simplified HIV information psychological support for people with intellectual disabilities in rape cases integration of mental health issues in training of health care staff Use and adopt screening tools: SF12 HTQ CES D PRIME – MD ADLs Rehabilitation clinics and hospitals HBC and CBR adaptation in the workplace Support and care apply CRPD concepts of universal access and reasonable accommodation for people with disabilities Work placement adjustments for PLHIV care support grants SF12 (non-clinical administration / cross-cultural evaluation) HTQ - Harvard Trauma Questionnaire (non-clinical administration / cross-cultural evaluation) CES D - Centre for Epidemiological Studies Depression Scale (non-clinical administration / cross-cultural evaluation) PRIME-MD (depression, anxiety, alcohol (non-clinical administration / Botswana) ADLs – Activity of Daily Living (non-clinical administration / Botswana) BAVLT – verbal learning and memory (non-clinical administration / Botswana) Digit Symbol Coding - speed of processing (non-clinical administration / Botswana) Colour Trail I and II – executive functions (non-clinical administration / Botswana) Grooved Pegboard - fine motor function (non-clinical administration / Botswana) GHQ - General Health Questionnaire SRQ - Self Reporting Questionnaire SAMISS - Substance Abuse and Mental Illness Symptom Screener

Universal Design and reasonable accommodation

HIV information for deaf youth NAM 2009

Sign language for health care providers NAM 2009

“Good and Bad Touch” Rebecca Johns 2007

THANK YOU For more information visit the HEARD disability and HIV resource centre www.heard.org.za/african-leadership/disability Or the Good Practise Collection at: www.heard.org.za/african-leadership/disability/resources