Limited accessibility to HIV services for persons with disabilities living with HIV in Ghana, Uganda and Zambia
Identifieur interne : 000050 ( Pmc/Curation ); précédent : 000049; suivant : 000051Limited accessibility to HIV services for persons with disabilities living with HIV in Ghana, Uganda and Zambia
Auteurs : Waimar Tun [États-Unis] ; Jerry Okal [Kenya] ; Katie Schenk [États-Unis] ; Selina Esantsi [Ghana] ; Felix Mutale [Zambie] ; Rita Kusi Kyeremaa [Ghana] ; Edson Ngirabakunzi [Ouganda] ; Hilary Asiah [Ghana] ; Charlotte Mcclain-Nhlapo [États-Unis] ; Grimond Moono [Zambie]Source :
- Journal of the International AIDS Society [ 1758-2652 ] ; 2016.
Abstract
Knowledge about experiences in accessing HIV services among persons with disabilities who are living with HIV in sub-Saharan Africa is limited. Although HIV transmission among persons with disabilities in Africa is increasingly acknowledged, there is a need to bring to life the experiences and voices from persons with disabilities living with HIV to raise awareness of programme implementers and policy makers about their barriers in accessing HIV services. This paper explores how the barriers faced by persons with disabilities living with HIV impede their ability to access HIV-related services and manage their disease.
We conducted focus group discussions with 76 persons (41 females; 35 males) with physical, visual and/or hearing impairments who were living with HIV in Ghana, Uganda and Zambia (2012–2013). We explored challenges and facilitators at different levels (individual, psychosocial and structural) of access to HIV services. Transcripts were analyzed using a framework analysis approach.
Persons with disabilities living with HIV encountered a wide variety of challenges in accessing HIV services. Delays in testing for HIV were common, with most waiting until they were sick to be tested. Reasons for delayed testing included challenges in getting to the health facilities, lack of information about HIV and testing, and HIV- and disability-related stigma. Barriers to HIV-related services, including care and treatment, at health facilities included lack of disability-friendly educational materials and sign interpreters, stigmatizing treatment by providers and other patients, lack of skills to provide tailored services to persons with disabilities living with HIV and physically inaccessible infrastructure, all of which make it extremely difficult for persons with disabilities to initiate and adhere to HIV treatment. Accessibility challenges were greater for women than men due to gender-related roles. Challenges were similar across the three countries. Favourable experiences in accessing HIV services were reported in Uganda and Zambia, where disability-tailored services were offered by non-governmental organizations and government facilities (Uganda only).
Persons with disabilities living with HIV encounter many challenges in accessing HIV testing and continued care and treatment services. Changes are needed at every level to ensure accessibility of HIV services for persons with disabilities.
Url:
DOI: 10.7448/IAS.19.5.20829
PubMed: 27443266
PubMed Central: 4956734
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<front><div type="abstract" xml:lang="en"><sec id="st1"><title>Introduction</title>
<p>Knowledge about experiences in accessing HIV services among persons with disabilities who are living with HIV in sub-Saharan Africa is limited. Although HIV transmission among persons with disabilities in Africa is increasingly acknowledged, there is a need to bring to life the experiences and voices from persons with disabilities living with HIV to raise awareness of programme implementers and policy makers about their barriers in accessing HIV services. This paper explores how the barriers faced by persons with disabilities living with HIV impede their ability to access HIV-related services and manage their disease.</p>
</sec>
<sec id="st2"><title>Methods</title>
<p>We conducted focus group discussions with 76 persons (41 females; 35 males) with physical, visual and/or hearing impairments who were living with HIV in Ghana, Uganda and Zambia (2012–2013). We explored challenges and facilitators at different levels (individual, psychosocial and structural) of access to HIV services. Transcripts were analyzed using a framework analysis approach.</p>
</sec>
<sec id="st3"><title>Results</title>
<p>Persons with disabilities living with HIV encountered a wide variety of challenges in accessing HIV services. Delays in testing for HIV were common, with most waiting until they were sick to be tested. Reasons for delayed testing included challenges in getting to the health facilities, lack of information about HIV and testing, and HIV- and disability-related stigma. Barriers to HIV-related services, including care and treatment, at health facilities included lack of disability-friendly educational materials and sign interpreters, stigmatizing treatment by providers and other patients, lack of skills to provide tailored services to persons with disabilities living with HIV and physically inaccessible infrastructure, all of which make it extremely difficult for persons with disabilities to initiate and adhere to HIV treatment. Accessibility challenges were greater for women than men due to gender-related roles. Challenges were similar across the three countries. Favourable experiences in accessing HIV services were reported in Uganda and Zambia, where disability-tailored services were offered by non-governmental organizations and government facilities (Uganda only).</p>
</sec>
<sec id="st4"><title>Conclusions</title>
<p>Persons with disabilities living with HIV encounter many challenges in accessing HIV testing and continued care and treatment services. Changes are needed at every level to ensure accessibility of HIV services for persons with disabilities.</p>
</sec>
</div>
</front>
<back><div1 type="bibliography"><listBibl><biblStruct></biblStruct>
<biblStruct><analytic><author><name sortKey="Rohleder, P" uniqKey="Rohleder P">P Rohleder</name>
</author>
<author><name sortKey="Braathen, Sh" uniqKey="Braathen S">SH Braathen</name>
</author>
<author><name sortKey="Swartz, L" uniqKey="Swartz L">L Swartz</name>
</author>
<author><name sortKey="Eide, Ah" uniqKey="Eide A">AH Eide</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Rohleder, P" uniqKey="Rohleder P">P Rohleder</name>
</author>
<author><name sortKey="Eide, Ah" uniqKey="Eide A">AH Eide</name>
</author>
<author><name sortKey="Swartz, L" uniqKey="Swartz L">L Swartz</name>
</author>
<author><name sortKey="Ranchod, C" uniqKey="Ranchod C">C Ranchod</name>
</author>
<author><name sortKey="Schneider, M" uniqKey="Schneider M">M Schneider</name>
</author>
<author><name sortKey="Schur, C" uniqKey="Schur C">C Schur</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Hanass Hancock, J" uniqKey="Hanass Hancock J">J Hanass-Hancock</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Hanass Hancock, J" uniqKey="Hanass Hancock J">J Hanass-Hancock</name>
</author>
<author><name sortKey="Nixon, Sa" uniqKey="Nixon S">SA Nixon</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Touko, A" uniqKey="Touko A">A Touko</name>
</author>
<author><name sortKey="Mboua, Cp" uniqKey="Mboua C">CP Mboua</name>
</author>
<author><name sortKey="Tohmuntain, Pm" uniqKey="Tohmuntain P">PM Tohmuntain</name>
</author>
<author><name sortKey="Perrot, Ab" uniqKey="Perrot A">AB Perrot</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Olaleye, Ao" uniqKey="Olaleye A">AO Olaleye</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Aderemi, Tj" uniqKey="Aderemi T">TJ Aderemi</name>
</author>
<author><name sortKey="Pillay, Bj" uniqKey="Pillay B">BJ Pillay</name>
</author>
<author><name sortKey="Esterhuizen, Tm" uniqKey="Esterhuizen T">TM Esterhuizen</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Groce, Ne" uniqKey="Groce N">NE Groce</name>
</author>
<author><name sortKey="Yousafzai, Ak" uniqKey="Yousafzai A">AK Yousafzai</name>
</author>
<author><name sortKey="Van Der Maas, F" uniqKey="Van Der Maas F">F van der Maas</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Kvam, Mh" uniqKey="Kvam M">MH Kvam</name>
</author>
<author><name sortKey="Braathen, Sh" uniqKey="Braathen S">SH Braathen</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Philander, Jh" uniqKey="Philander J">JH Philander</name>
</author>
<author><name sortKey="Swartz, L" uniqKey="Swartz L">L Swartz</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="De Beaudrap, P" uniqKey="De Beaudrap P">P De Beaudrap</name>
</author>
<author><name sortKey="Mac Seing, M" uniqKey="Mac Seing M">M Mac-Seing</name>
</author>
<author><name sortKey="Pasquier, E" uniqKey="Pasquier E">E Pasquier</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Trani, Jf" uniqKey="Trani J">JF Trani</name>
</author>
<author><name sortKey="Browne, J" uniqKey="Browne J">J Browne</name>
</author>
<author><name sortKey="Kett, M" uniqKey="Kett M">M Kett</name>
</author>
<author><name sortKey="Bah, O" uniqKey="Bah O">O Bah</name>
</author>
<author><name sortKey="Morlai, T" uniqKey="Morlai T">T Morlai</name>
</author>
<author><name sortKey="Bailey, N" uniqKey="Bailey N">N Bailey</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Yousafzai, Ak" uniqKey="Yousafzai A">AK Yousafzai</name>
</author>
<author><name sortKey="Edwards, K" uniqKey="Edwards K">K Edwards</name>
</author>
<author><name sortKey="D Allesandro, C" uniqKey="D Allesandro C">C D'Allesandro</name>
</author>
<author><name sortKey="Lindstrom, L" uniqKey="Lindstrom L">L Lindström</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Nixon, Sa" uniqKey="Nixon S">SA Nixon</name>
</author>
<author><name sortKey="Cameron, C" uniqKey="Cameron C">C Cameron</name>
</author>
<author><name sortKey="Hanass Hancock, J" uniqKey="Hanass Hancock J">J Hanass-Hancock</name>
</author>
<author><name sortKey="Simwaba, P" uniqKey="Simwaba P">P Simwaba</name>
</author>
<author><name sortKey="Solomon, Pe" uniqKey="Solomon P">PE Solomon</name>
</author>
<author><name sortKey="Bond, Va" uniqKey="Bond V">VA Bond</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Chireshe, R" uniqKey="Chireshe R">R Chireshe</name>
</author>
<author><name sortKey="Rutondoki, En" uniqKey="Rutondoki E">EN Rutondoki</name>
</author>
<author><name sortKey="Ojwang, P" uniqKey="Ojwang P">P Ojwang</name>
</author>
</analytic>
</biblStruct>
<biblStruct></biblStruct>
<biblStruct><analytic><author><name sortKey="Parsons, Ja" uniqKey="Parsons J">JA Parsons</name>
</author>
<author><name sortKey="Bond, Va" uniqKey="Bond V">VA Bond</name>
</author>
<author><name sortKey="Nixon, Sa" uniqKey="Nixon S">SA Nixon</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Hanass Hancock, J" uniqKey="Hanass Hancock J">J Hanass-Hancock</name>
</author>
<author><name sortKey="Strode, A" uniqKey="Strode A">A Strode</name>
</author>
<author><name sortKey="Grant, C" uniqKey="Grant C">C Grant</name>
</author>
</analytic>
</biblStruct>
<biblStruct></biblStruct>
<biblStruct></biblStruct>
<biblStruct></biblStruct>
<biblStruct><analytic><author><name sortKey="Corbin, J" uniqKey="Corbin J">J Corbin</name>
</author>
<author><name sortKey="Strauss, A" uniqKey="Strauss A">A Strauss</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Green, J" uniqKey="Green J">J Green</name>
</author>
<author><name sortKey="Thorogood, N" uniqKey="Thorogood N">N Thorogood</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Richie, J" uniqKey="Richie J">J Richie</name>
</author>
<author><name sortKey="Spencer, L" uniqKey="Spencer L">L Spencer</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Schenk, K" uniqKey="Schenk K">K Schenk</name>
</author>
<author><name sortKey="Tun, W" uniqKey="Tun W">W Tun</name>
</author>
<author><name sortKey="Sheehy, M" uniqKey="Sheehy M">M Sheehy</name>
</author>
<author><name sortKey="Okal, J" uniqKey="Okal J">J Okal</name>
</author>
<author><name sortKey="Kuffour, E" uniqKey="Kuffour E">E Kuffour</name>
</author>
<author><name sortKey="Moono, G" uniqKey="Moono G">G Moono</name>
</author>
</analytic>
</biblStruct>
<biblStruct></biblStruct>
<biblStruct><analytic><author><name sortKey="Merrick, J" uniqKey="Merrick J">J Merrick</name>
</author>
<author><name sortKey="Talnir, R" uniqKey="Talnir R">R Talnir</name>
</author>
<author><name sortKey="Gross, S" uniqKey="Gross S">S Gross</name>
</author>
<author><name sortKey="Chemtob, D" uniqKey="Chemtob D">D Chemtob</name>
</author>
<author><name sortKey="Aspler, S" uniqKey="Aspler S">S Aspler</name>
</author>
<author><name sortKey="Kandel, I" uniqKey="Kandel I">I Kandel</name>
</author>
</analytic>
</biblStruct>
<biblStruct></biblStruct>
</listBibl>
</div1>
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<publisher><publisher-name>International AIDS Society</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">27443266</article-id>
<article-id pub-id-type="pmc">4956734</article-id>
<article-id pub-id-type="publisher-id">20829</article-id>
<article-id pub-id-type="doi">10.7448/IAS.19.5.20829</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Limited accessibility to HIV services for persons with disabilities living with HIV in Ghana, Uganda and Zambia</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Tun</surname>
<given-names>Waimar</given-names>
</name>
<xref ref-type="corresp" rid="cor1">§</xref>
<xref ref-type="aff" rid="AF0001">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Okal</surname>
<given-names>Jerry</given-names>
</name>
<xref ref-type="aff" rid="AF0002">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Schenk</surname>
<given-names>Katie</given-names>
</name>
<xref ref-type="aff" rid="AF0003">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Esantsi</surname>
<given-names>Selina</given-names>
</name>
<xref ref-type="aff" rid="AF0004">4</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Mutale</surname>
<given-names>Felix</given-names>
</name>
<xref ref-type="aff" rid="AF0005">5</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Kyeremaa</surname>
<given-names>Rita Kusi</given-names>
</name>
<xref ref-type="aff" rid="AF0006">6</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Ngirabakunzi</surname>
<given-names>Edson</given-names>
</name>
<xref ref-type="aff" rid="AF0007">7</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Asiah</surname>
<given-names>Hilary</given-names>
</name>
<xref ref-type="aff" rid="AF0004">4</xref>
</contrib>
<contrib contrib-type="author"><name><surname>McClain-Nhlapo</surname>
<given-names>Charlotte</given-names>
</name>
<xref ref-type="aff" rid="AF0008">8</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Moono</surname>
<given-names>Grimond</given-names>
</name>
<xref ref-type="aff" rid="AF0009">9</xref>
</contrib>
</contrib-group>
<aff id="AF0001"><label>1</label>
HIV and AIDS Program, Population Council, Washington, DC, USA</aff>
<aff id="AF0002"><label>2</label>
HIV and AIDS Program, Population Council, Nairobi, Kenya</aff>
<aff id="AF0003"><label>3</label>
Department of Global and Community Health, George Mason University, Fairfax, VA, USA</aff>
<aff id="AF0004"><label>4</label>
Reproductive Health Program, Population Council, Accra, Ghana</aff>
<aff id="AF0005"><label>5</label>
Development Consultant, Formerly with Zambia Agency for Persons with Disabilities, Lusaka, Zambia</aff>
<aff id="AF0006"><label>6</label>
Ghana Federation of Disability Organisations, Accra, Ghana</aff>
<aff id="AF0007"><label>7</label>
National Union of Disabled Persons of Uganda, Kampala, Uganda</aff>
<aff id="AF0008"><label>8</label>
The World Bank, Washington, DC, USA</aff>
<aff id="AF0009"><label>9</label>
HIV and AIDS Program, Population Council, Lusaka, Zambia</aff>
<author-notes><corresp id="cor1"><label>§</label>
<bold>Corresponding author:</bold>
Waimar Tun, HIV and AIDS Program, Population Council, 4301 Connecticut Avenue, NW, Suite 280, Washington, DC 20008, USA. Tel: +1-202-237-9400. (<email xlink:href="wtun@popcouncil.org">wtun@popcouncil.org</email>
)</corresp>
</author-notes>
<pub-date pub-type="epub"><day>20</day>
<month>7</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="collection"><year>2016</year>
</pub-date>
<volume>19</volume>
<issue>5Suppl 4</issue>
<elocation-id content-type="doi">20829</elocation-id>
<history><date date-type="received"><day>23</day>
<month>11</month>
<year>2015</year>
</date>
<date date-type="rev-recd"><day>01</day>
<month>4</month>
<year>2016</year>
</date>
<date date-type="accepted"><day>02</day>
<month>5</month>
<year>2016</year>
</date>
</history>
<permissions><copyright-statement>© 2016 Tun W et al; licensee International AIDS Society</copyright-statement>
<copyright-year>2016</copyright-year>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/3.0/"><license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution 3.0 Unported (CC BY 3.0) License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
</license>
</permissions>
<abstract><sec id="st1"><title>Introduction</title>
<p>Knowledge about experiences in accessing HIV services among persons with disabilities who are living with HIV in sub-Saharan Africa is limited. Although HIV transmission among persons with disabilities in Africa is increasingly acknowledged, there is a need to bring to life the experiences and voices from persons with disabilities living with HIV to raise awareness of programme implementers and policy makers about their barriers in accessing HIV services. This paper explores how the barriers faced by persons with disabilities living with HIV impede their ability to access HIV-related services and manage their disease.</p>
</sec>
<sec id="st2"><title>Methods</title>
<p>We conducted focus group discussions with 76 persons (41 females; 35 males) with physical, visual and/or hearing impairments who were living with HIV in Ghana, Uganda and Zambia (2012–2013). We explored challenges and facilitators at different levels (individual, psychosocial and structural) of access to HIV services. Transcripts were analyzed using a framework analysis approach.</p>
</sec>
<sec id="st3"><title>Results</title>
<p>Persons with disabilities living with HIV encountered a wide variety of challenges in accessing HIV services. Delays in testing for HIV were common, with most waiting until they were sick to be tested. Reasons for delayed testing included challenges in getting to the health facilities, lack of information about HIV and testing, and HIV- and disability-related stigma. Barriers to HIV-related services, including care and treatment, at health facilities included lack of disability-friendly educational materials and sign interpreters, stigmatizing treatment by providers and other patients, lack of skills to provide tailored services to persons with disabilities living with HIV and physically inaccessible infrastructure, all of which make it extremely difficult for persons with disabilities to initiate and adhere to HIV treatment. Accessibility challenges were greater for women than men due to gender-related roles. Challenges were similar across the three countries. Favourable experiences in accessing HIV services were reported in Uganda and Zambia, where disability-tailored services were offered by non-governmental organizations and government facilities (Uganda only).</p>
</sec>
<sec id="st4"><title>Conclusions</title>
<p>Persons with disabilities living with HIV encounter many challenges in accessing HIV testing and continued care and treatment services. Changes are needed at every level to ensure accessibility of HIV services for persons with disabilities.</p>
</sec>
</abstract>
<kwd-group><kwd>disability</kwd>
<kwd>persons with disabilities</kwd>
<kwd>PLHIV</kwd>
<kwd>HIV positive</kwd>
<kwd>accessibility</kwd>
</kwd-group>
</article-meta>
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