TOWARDS AN AIDS-FREE GENERATION Promoting community-based strategies for and with children and adolescents with disabilities

Children and adolescents of the largest minority The World Health Organization estimates are close to a billion persons with disabilities around the world (15% of the total world population) WHO, 2011 UNICEF and UNESCO estimate between million children aged 0 to 18 are living with disabilities in the world (UNESCO, 2001; UNICEF 2011).

Children and adolescents of the largest majority Eighty per cent of these children and young people live in the poorest countries of the world and have the least access to education. (UNDP, 2006) Many suffer from severe social stigma and are very vulnerable to violence and sexual abuse. (UNICEF, 2005)

Invisibility and marginalization How is it possible that such a large proportion of adolescents and youth remain cut off from the efforts undertaken around the world for the prevention of HIV and STDs and the promotion of sexual and reproductive health?

Adolescents with disabilities and sexuality There is a mistaken belief that young people with disabilities are not sexually active and not at risk of contracting sexually transmitted infections. Disability does not affect sexual desire. However, it may affect motor, communication and self-care skills, levels of maturity, and self-image. All of this may pose challenges in the building of self- esteem and relating to other people.

Children and Adolescents Children with disabilities face barriers that condition their possibilities for personal development as well as the development of intimate relationships in the future. Limited autonomy (both within the family and at school or institutions). Paternalistic treatment reinforces stereotypes and creates low expectations for their social participation. Stigma, lack of information, and negative social attitudes continue to be the main barriers : – by “infantilizing” them. – by limiting their opportunities for exchange with peers. – by contributing to poor self-image and low self-esteem and self-confidence.

Exposure to Risk Factors – and lack of access to protective interventions Greater poverty Less education Barriers to access to health services Less access to information Communication barriers Friendships and romantic relationships Risk of violence and sexual abuse The situation of adolescent and young girls with disabilities (particularly adolescent and young girls with disabilities)

Principles for a family- and community-based response for AIDS-free generation PRINCIPLE 1: ACCESS Access to the physical environment. Access to information PRINCIPLE 2: GOOD COMMUNICATION & APPROPIATE TREATEMENT PRINCIPLE 3: PARTICIPATION

How was the methodology tested HIV prevention workshops were conducted in partnership with Disabled People’s Organizations in Uruguay. - Three groups of teenagers: Hearing impairments Visual impairments Down syndrome - A group of parents of children with Developmental Disabilities

Examples of materials developed by adolescents with disabilities and community-based organizations Facilitators in local institutions were identified and trained. Games and other resources were used to introduce the topics and integrate the methodology for adapting/designing HIV awareness and information materials. In all cases it was the first time the children and adolescents involved had come into contact with the topic. The goal for each group was to come out with a single prototype of resources that could be used by their organizations to reach their peers.

Examples of materials developed by adolescents with disabilities and community-based organizations The whole process was highly participative and respectful of adolescents' ways of talking about the topics. Examples of these workshop outcomes are: A video for deaf teenagers on safe and responsible sex (in sign language) Powerpoint presentation for educators of children with Down syndrome A game for computers and cell phones accessible to blind teens on HIV testing An awareness campaign for parents of children with Down syndrome (poster)

THANK YOU! Rosangela Berman Bieler Chief, Disability Section Program Division UNICEF Three United Nations Plaza, Room 452, New York, NY Tel: Fax: – web site: