The COVID-19 pandemic and the associated containment measures have resulted in a mental health crisis globally. Marginalised populations have been disproportionately affected during the pandemic with an aggravation of existing inequalities, and this has increased the risks to their mental health. The LGBTIQ+ population is among those marginalised whose lives have been rendered even more precarious than before by the pandemic. This paper explores some of the main risks to the mental health of LGBTIQ+ people in India, the advice being given to them by mental health professionals and activists, and need for queer revisionings of uncertainty, the concept of a future and individualism.
Here you can find all documents in one zipfile that relate to the disability-confident employers’ toolkit: a unique portfolio of practical guides, checklists, case studies and resources that make it easier for any business to be disability confident.
This brief is part of a series on leaving no one behind in the context of COVID-19 and the world of work. It provides an overview of specific groups that risk being left behind: people with disabilities, indigenous and tribal peoples, people living with HIV, and migrant workers.
A Health Stigma and Discrimination Framework is proposed, which is a global, crosscutting framework based on theory, research, and practice. It's application to a range of health conditions, including leprosy, epilepsy, mental health, cancer, HIV, and obesity/overweight is demonstrated. How stigma is related to race, gender, sexual orientation, class, and occupation intersects with health-related stigmas is discussed. How the framework can be used to enhance research, programming, and policy efforts is examined.
BMC Med 17, 31 (2019)
This paper includes four studies which seek to better understand the situation by HIV-related situation of disabled men and women living in West Africa.
Using epidemiological investigation, qualitative interviews and collections of testimonies, these studies offer insight into the vulnerability of people with disabilities in the area of sexual health
Background: Persons with disabilities have often been overlooked in the context of HIV and AIDS risk prevention and service provision. This paper explores access to and use of HIV information and services among persons with disabilities.
Methods: We conducted a multi-country qualitative research study at urban and rural sites in Uganda, Zambia, and Ghana: three countries selected to exemplify different stages of the HIV response to persons with disabilities. We conducted key informant interviews with government officials and service providers, and focus group discussions with persons with disabilities and caregivers. Research methods were designed to promote active, meaningful participation from persons with disabilities, under the guidance of local stakeholder advisors.
Results: Persons with disabilities emphatically challenged the common assumption that persons with disabilities are not sexually active, pointing out that this assumption denies their rights and – by denying their circumstances – leaves them vulnerable to abuse. Among persons with disabilities, knowledge about HIV was limited and attitudes towards HIV services were frequently based upon misinformation and stigmatising cultural beliefs; associated with illiteracy especially in rural areas, and rendering people with intellectual and developmental disability especially vulnerable. Multiple overlapping layers of stigma towards persons with disabilities (including internalised self-stigma and stigma associated with gender and abuse) have compounded each other to contribute to social isolation and impediments to accessing HIV information and services. Participants suggested approaches to HIV education outreach that emphasise the importance of sharing responsibility, promoting peer leadership, and increasing the active, visible participation of persons with disabilities in intervention activities, in order to make sure that accurate information reflecting the vulnerabilities of persons with disabilities is accessible to people of all levels of education. Fundamental change to improve the skills and attitudes of healthcare providers and raise their sensitivity towards persons with disabilities (including recognising multiple layers of stigma) will be critical to the ability of HIV service organisations to implement programs that are accessible to and inclusive of persons with disabilities.
Discussion: We suggest practical steps towards improving HIV service accessibility and utilisation for persons with disabilities, particularly emphasising the power of community responsibility and support; including acknowledging compounded stigma, addressing attitudinal barriers, promoting participatory responses, building political will and generating high-quality evidence to drive the continuing response.
Conclusions: HIV service providers and rehabilitation professionals alike must recognise the two-way relationship between HIV and disability, and their multiple overlapping vulnerabilities and stigmas. Persons with disabilities demand recognition through practical steps to improve HIV service accessibility and utilisation in a manner that recognises their vulnerability and facilitates retention in care and adherence to treatment. In order to promote lasting change, interventions must look beyond the service delivery context and take into account the living circumstances of individuals and communities affected by HIV and disability.
This guidance is designed for UNICEF field staff – including humanitarian field officers, coordinators, specialist and advisors – as well as UNICEF’s partners and others involved in humanitarian work. It provides practical tips and offers entry points for making sure that humanitarian action takes children with disabilities into account. There are 5 other associated guidelines.
impact of emergiencies on health of children and adolescents with disabilities
why children and adolescents with disabilities are excluded health and HIV/AIDS interventions
frameworks and approaches
response and early recovery
recovery and reconstruction
This article advocates for the development and implementation of a model of care to guide rehabilitation of people living with HIV in South Africa. The paper begins by presenting the emerging evidence of rehabilitation in the context of HIV, and goes on to identify appropriate steps to develop a model of care based on this that would be applicable to South Africa
African Journal of Disability 4(1), Art. #137
In this paper, the researchers develop a needs-based home-based rehabilitation programme for people living with HIV in order to improve their quality of life and functional ability. The study aims to provide rehabilitation professionals and researchers with evidence that can be utilised to improve existing rehabilitation interventions for people living with HIV.
The paper outlines a randomised control trial to test the programme, to be conducted at a public hospital in KwaZulu-Natal, South Africa. The trial will assess the participants’ quality of life, perceived level of disability, functional ability and endurance
Purpose: The aim of the study was to examine whether there are any significant differences in demographic characteristics and health-related Quality of Life (QoL) among people living with HIV (PLWH) at shelter homes and drop-in centres in Malaysia.
Method: 117 PLWH were recruited by using the purposive sampling method. Data were collected through a questionnaire survey.
Results: Significant differences were found between PLWH at shelter homes and drop-in centres, in their demographic characteristics and in the 3 factors in the HIV/AIDS-Targeted Quality of Life Instruments (HAT-QoL) – namely, overall function, health worries, and provider trust.
Conclusion: Due to the differences in characteristics and QoL among PLWH in these two settings, different approaches are suggested to assist PLWH from shelter homes and drop-in centres.
Background: Disability grants in South Africa increased from 600 000 in 2000 to almost 1.3 million in 2004. This rise can be attributed to the HIV/ AIDS epidemic, South Africa’s high rate of unemployment and possibly an increased awareness of constitutional rights. The Western Cape, which has a disability prevalence of 3.8%, has also experienced an influx of applications. The study was conducted at Bishop Lavis Community Health Centre (BLCHC) in the Cape Town Metropole, Western Cape.
The primary aim of this study was to establish the profile of adults applying for disability grants at Bishop Lavis. The secondary aim was the determination of the degree of activity limitation and participation restriction by means of the International Classification of Functioning, Disability and Health (ICF) shortlist of activity and participation domains.
Methods: A descriptive study was conducted with emphasis on identifying and quantifying the relevant factors. The population studied included all prospective adult (18–59-year-old females and 18–64-year-old males) disability grant applicants in Bishop Lavis over a two-month period (April–May 2007). A structured, self-compiled questionnaire was administered during face-to-face interviews with applicants. The questionnaire included the demographic details of the applicants, disability/chronic illness/condition, educational level and social/living conditions. The second part of the questionnaire was based on the ICF shortlist of activity and participation.
Results: There were 69 respondents over the period of data collection. Of the 69 applicants who participated in the study, 45 (65%) received a temporary disability grant, 6 (8%) received a permanent grant and 18 (26%) applications were rejected. The results demonstrated that most applicants were females over the age of 50, were poorly educated with chronic medical conditions and were living in formal accommodation with good basic services but with minimal or no disposable income. The ICF questionnaire responses showed that the majority of respondents had no difficulty in most domains, except for the general tasks and demands (multiple tasks), mobility (lifting and carrying, fine hand use and walking) and domestic tasks domains, which showed high percentages of severe to complete difficulty. However, further statistical analysis showed no association between degree of difficulty in the above domains and eventual outcome of type of grant received.
Conclusions: This study confirmed that unemployment and a lack of income are the factors influencing patients to seek assistance in the form of disability grants. Most applicants had a chronic medical condition and reported functional restrictions but only received a temporary grant. This may be an indication that most patients require further evaluation before a final decision can be made. There is a need for a standardised, objective assessment tool for disability grant applications. A campaign to educate patients about disability grants could save patients and hospital medical services time and money.
Background: Women with a disability are often characterised as a homogenous social group consigned to a cultural stereotype with assumptions of dependence, asexuality and gender neutrality. Furthermore, there is a void of research about the experience of people with disabilities following diagnosis with HIV. Little is known about how HIV diagnosis intersects with disability and gender and how it shapes the experiences of intimacy and gender roles of those negotiating this intersection.
Objective: The objective of this study was to explore how HIV, disability and gender shape the perspectives of HIV-positive women with disabilities regarding intimacy and gender roles.
Methods: Twelve women in Lusaka, Zambia were recruited for in-depth semi-structured interviews to explore their experiences of having a disability and living with HIV. Interviews were conducted in English, Bemba, Nyanja and Zambian sign language. Descriptive and thematic analyses were conducted, followed by in-depth gender analyses of data relating to intimacy and gender roles.
Results: Data analysis led to the identification of two main themes: the impact of HIV diagnosis on intimate relationships amongst the participants; and the disruption and renegotiation of gender roles. These findings demonstrate the loss of intimacy (often decided by the participants) and changes in women’s gender roles (infrequently decided by them).
Conclusions: The narrow approaches to sexuality and HIV that reinforce misconceptions and stereotypes need to change. In their place should be inclusive and disability and sex-positive approaches that are informed by the diverse realities of women’s lives. Further research is needed to develop stronger evidence of the impact of HIV and disability on gender roles and sexuality.
Purpose: By exploring the level of knowledge about HIV/AIDS and attitudes towards persons with HIV/AIDS among deaf people in Ghana, this article aims to identify and correct possible gaps in awareness.
Method: A participatory sexual and reproductive health (SRH) needs assessment was conducted, targetting deaf people who were fluent in the Ghanaian Sign Language (GSL). The study design was a two-phase, sequential, mixed methods approach. Three focus groups assisted in the development of a survey, which was then implemented for needs assessment data collection. The 179 study participants consisted of 26 focus group participants, 152 survey respondents and 1 key informant. Of the focus group participants, 7 were executives of Ghana National Association of the Deaf (GNAD), 10 were adult males, and nine were adult females. Apart from the key informant, all the participants were deaf persons.
Results: The study indicated that many respondents still had misconceptions about HIV/AIDS and had difficulty identifying preventive methods, but their attitudes towards persons with HIV/AIDS was generally positive.
Conclusion: More attention needs to be paid to the requirements of the deaf community and to designing HIV/AIDS programmes and services that are deaf-friendly and accessible.
"The report describes developments affecting legal environments related to people living with HIV and most-at-risk populations. It provides examples of human rights based approaches, and sets out an agenda for action relating to advocacy, community mobilisation, law reform and law enforcement"
"The nature of discrimination against people living with HIV and with AIDS ('PLHA') is rooted in deeper stigmatisation than discrimination against other groups. Reasons for this include the association of HIV/AIDS with behaviours that may be considered socially unacceptable by many people. To combat such discrimination, HIV is deemed to be a 'disability' under the Equality Act 2010. Whilst this protection has been welcomed by various activists and policy groups within the field, it will be argued that the decision to classify HIV as a disability is an inadequate response to the unique and multi-faceted discrimination faced by PLHA. To achieve this this article will examine the history of the virus; current epidemiology within the UK; the extent to which HIV accords with traditional models of disability and the definition employed by the Equality Act 2010; and finally, the manner in which HIV is socially constructed and how this has compounded discrimination against PLHA"
5 Web JCLI
This guide provides practical information for programme level staff in organisations responding to HIV, helping them to define good practice for the meaningful involvement of people living with HIV in programmes and organisations and strategies for developing their capacity
This is an introduction to a supplement of nine articles on family-centred services for children affected by HIV and AIDS
This article puts forward the view that unless health and social services for children affected by HIV and AIDS are family-centred and include non-traditional families, rather than being directed towards individuals, they become piecemeal
Rather than prevention of mother to child transmission of HIV programmes focusing on biomedical interventions during the perinatal period, this article argues that they should address the health needs of the whole family
This article advocates the need for a family-centred model of care to address the many needs of people with HIV and other household members, following a systematic review of family-centred HIV care programmes
Source e-bulletin on Disability and Inclusion