Research-based Initiatives on the Interactions between HIV and Disability: Evidence linked to Operationalisation Dr Toyin Aderemi Symposium – Disability and HIV in Africa: Leadership, Capacity and Strategies ICASA December 2013

“We learnt also from the skills building workshop on the inclusion of disability in national strategic plans that despite the ratification of the CRPD many countries have not addressed the issues of this group which accounts for 15% of the world’s population…We were told to tell you that universal access, zero infections, zero AIDS-related death and zero discrimination cannot be achieved without including the world’s largest minority: the disabled” Volderine Hacket (Leadership and Accountability Programme Rapporteur Report, XIX IAC, Washington, 2012). Available from:

Disability and HIV in East and Southern Africa Hanass-Hancock, Regondi, & Naidoo, 2013

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

Interrelationship of Disability, Mental Health and HIV People with disabilities PLHIV who develop disabilities People who care for PLHIV especially young carers People who care for PLHIV especially young carers increased risky behaviour increased risk of sexual abuse and less access to justice negative attitudes from health care staff access problems influences adherence increased risky behaviour increased risk of sexual abuse and less access to justice negative attitudes from health care staff access problems influences adherence mental health disorders e.g. depression, schizophrenia, anxiety, substance abuse impairments such as e.g. reduced neuro-cognitive functioning, blindness, deafness, skin problems, digestive problems … episodic disabilities mental health disorders e.g. depression, schizophrenia, anxiety, substance abuse impairments such as e.g. reduced neuro-cognitive functioning, blindness, deafness, skin problems, digestive problems … episodic disabilities AIDS-related activity limitation is associated with increased child caregiving tasks, less school attendance, food insecurity and poor educational outcomes AIDS-related activity limitation is associated with increased child caregiving tasks, less school attendance, food insecurity and poor educational outcomes

HIV, Disability and Caregiving in Southern Africa Hanass-Hancock & Casale, In Press

Currently Discussed Approaches People with disabilities PLHIV who develop HIV-related disabilities People who care for PLHIV especially young carers People who care for PLHIV especially young carers Access to health services and education Disability-specific sexuality and HIV education Accessible HIV information Psychological support for people with intellectual disabilities in abuse cases Integration of mental health and disability into training of healthcare staff Inclusion of disability in NSPs Access to health services and education Disability-specific sexuality and HIV education Accessible HIV information Psychological support for people with intellectual disabilities in abuse cases Integration of mental health and disability into training of healthcare staff Inclusion of disability in NSPs Screening and rehabilitation Mental health screening and diagnostic Interpersonal therapy (IPT), cognitive behavior therapy (CBT), medication Rehabilitation Change in ART Clinics/hospitals screening HBC, CBR, block therapy Adaptation at work Screening and rehabilitation Mental health screening and diagnostic Interpersonal therapy (IPT), cognitive behavior therapy (CBT), medication Rehabilitation Change in ART Clinics/hospitals screening HBC, CBR, block therapy Adaptation at work Support and care CRPD concepts of universal access and reasonable accommodation for people with disabilities Work placement adjustments for PLHIV Care support grants Psycho-social support New CBR guidelines Support and care CRPD concepts of universal access and reasonable accommodation for people with disabilities Work placement adjustments for PLHIV Care support grants Psycho-social support New CBR guidelines CBR – Community-based rehabilitation HBC – Home-based care NSPs – National strategic plans for HIV response CBR – Community-based rehabilitation HBC – Home-based care NSPs – National strategic plans for HIV response

Next steps Operationalisation of available evidence by: HIV programmers Development partners Governments Disabled people’s organisations Service providers (e.g., health, protection, legal) More research to address current gaps in knowledge Improved collaborations between researchers and other stakeholders e.g., implementers, policymakers, service providers, service users

Acknowledgement Dr Jill Hanass-Hancock for invaluable contents/inputs and guidance

Thank You!