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"We are also dying of AIDS” : barriers to HIV services and treatment for persons with disabilities in Zambia

CHOPRA, Rashmi
July 2014

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This report documents the obstacles faced by people with disabilities in both the community and healthcare settings. These include pervasive stigma and discrimination, lack of access to inclusive HIV prevention education, obstacles to accessing voluntary testing and HIV treatment, and lack of appropriate support for adherence to antiretroviral treatment. The report also describes the sexual and intimate partner violence women and girls with disabilities face, and the need for the government and international donors to do more to ensure inclusive and accessible HIV services

 

Note : Accessible and easy read versions are available from the link above

Disabling sexualities: Exploring the impact of the intersection of HIV, disability and gender on the sexualities of women in Zambia

WICKENDEN, Anna
NIXON, Stephanie
YOSHIDA, Karen K
2013

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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.

Disability in national strategic plans on HIV and AIDS : a review on the national response to the interrelations of disability and HIV in eastern and southern Africa|Final report

GRANT, Kitty
STRODE, Ann
HANNASS-HANCOCK, Jill
December 2009

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This report examines national AIDS and HIV strategic plans (NSPs) in eastern and southern Africa and includes findings, discussions and best practice examples on the integration of disability throughout the countries. "Generally, the findings of the report show that less than 50% of the countries in Eastern and Southern Africa recognise disability as an issue of concern, or specifically recognise the vulnerability of people with disabilities to HIV and AIDS within their NSPs. Furthermore, it found that even where countries have recognised disability as an issue, there is limited specific guidance within the NSP on HIV-related service provision to meet the needs of people with disabilities. Only one country, South Africa, showed extensive integration of disability into the various focus areas of its NSP." The report concludes with recommendations and provides detailed appendices of national reports for each country surveyed

Our future : sexuality and life skills education for young people. Grades 6 - 7

INTERNATIONAL HIV/AIDS ALLIANCE
March 2007

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To help support young people, the Government of Zambia has a comprehensive strategy for sexual and reproductive health and HIV education in and out of school. This is the first in a series of three books which focus on young people of different ages. Each book contains learning activities and illustrations, which engage young people in understanding themselves and their world. They reflect on the virtues and skills needed to develop caring and loving relationships, make good decisions, solve problems and seek help. The topics and activities are designed to fit into the national curriculum or to be used in extra curricula activities in or out of school. The books are accompanied by a Teachers’ Guide

Tell me more : children's rights and sexuality in the context of HIV/AIDS in Africa

THOMSEN, Sarah C
2007

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This report explores the strategies that children have developed for dealing with sexuality and relationships in the face of HIV and AIDS; and provides stakeholders with a coherent rights and youth-oriented knowledge base for the development of a sexual and reproductive health agenda for advocacy. It gives an overview of sexual rights with a focus on children’s rights, including their access to sexual and reproductive health information, as endorsed by relevant international conventions and policies. It also looks at the concept of sexuality and the sexual development of children. The report includes a summary of children’s reflections on issues of sexuality and their coping mechanisms for preventing the transmission of HIV and AIDS. Based on these findings, the report makes recommendations for effective responses that would support children’s existing coping mechanisms and enhance their ability to protect themselves

Getting started! : running a junior farmer field and life school|Empowering orphans and vulnerable children living in a world with HIV and AIDS

WIEGERS, Esther
HILL, Catherine
COLBERT, Patricia
2007

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This manual was developed from the experiences of a number of communities and organisations in southern and eastern Africa in creating Junior Farmer Field and Life Schools as a response to the growing number of orphans and vulnerable children. For many reasons these children more likely than other orphans to be at risk from malnutrition, disease, abuse, stigmatisation and sexual exploitation. The risk of sexual exploitation is particularly significant for those left alone to cope with poverty and who are forced to adopt adult roles and ensure food for the rest of the family. As parents and family members become ill, children take on greater domestic, agricultural and income generating responsibilities. HIV and AIDS has a particular impact on girls who are left to care for ailing parents, or who have to become the heads of households upon the death of caregivers. Also, as many parents are dying at a young age orphaned children are growing up without the necessary knowledge and skills for their future livelihood

Our future : sexuality and life skills education for young people. Grades 4-5

INTERNATIONAL HIV/AIDS ALLIANCE
December 2006

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To help support young people, the Government of Zambia has a comprehensive strategy for sexual and reproductive health and HIV education in and out of school. This is the first in a series of three books which focus on young people of different ages. Each book contains learning activities and illustrations, which engage young people in understanding themselves and their world. They reflect on the virtues and skills needed to develop caring and loving relationships, make good decisions, solve problems and seek help. The topics and activities are designed to fit into the national curriculum or to be used in extra curricula activities in or out of school. The books are accompanied by a Teachers’ Guide

Community action and the test of time : learning from community experiences and perceptions|Case studies of mobilization and capacity building to benefit vulnerable children in Malawi and Zambia

DONAHUE, Jill
MWEWA, Louis
December 2006

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This case study review seeks to identify lessons learned from community experiences and perceptions of community mobilisations initiatives in Malawi and Zambia, particularly the sense of ownership generated and where that has been able to sustain activities to benefit especially vulnerable children. It would be of interest policy makers and programme designers

Empowering communities to respond to HIV/AIDS|Ndola demonstration project on maternal and child health : operations research final report

HORIZONS
August 2003

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This is the report of an evaluation study into the feasibility, acceptability and implications of improving infant feeding counselling and introducing voluntary counselling and testing into a low-resource ante-natal care/mother and child health clinic setting, where women did not at the time have access to short-course antiretrovirals to reduce vertical transmission

Information and communication technologies and poverty reduction in Sub Saharan Africa : a learning study (synthesis)

GERSTER, Richard
ZIMMERMAN, Sonja
2003

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A report of the learning study carried out as part of the Building Digital Opportunities (BDO) programme.The study focuses on mapping the experiences of BDO partners with ICTs and poverty reduction in order to enable BDO partners to improve their understanding of the role of ICTs in poverty reduction and play a pro-poor role in multilateral forums like the World Summit on the Information Society (WSIS). It draws on research into the use of information and communication technology in Mali, Uganda and Zambia, and examines progress in fulfilling BDO's global objective to ensure that such technology contributes to the achievement of the 8 Millenium Development Goals and 17 Millenium Development Targets

Disentangling HIV and AIDS stigma in Ethiopia, Tanzania and Zambia

NYBLADE, Laura
et al
2003

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This report explores the causes, manifestations and consequences of HIV and AIDS related stigma in sub-Saharan Africa. Based on a study in Ethiopia, Tanzania and Zambia, it acknowledges stigma as complex, caused by incomplete knowledge, fears of death and disease and sexual transmission. Stigma is also influenced by socio-economic status, age and gender. The report also discusses in detail how people living with HIV react to stigma, and also how they and their families/ friends develop strategies to cope with stigma. Recommendations include the need to provide safe spaces to discuss the values and beliefs about sex, morality and death, find a common language to talk about stigma and ensure a contextually appropriate and ethically responsible role for people living with HIV

Ndola demonstration project : a midterm analysis of lessons learned

HORIZONS PROGRAM
November 2002

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This report summarises baseline and midterm findings of an intervention pilot study conducted in Ndola District, Zambia. The aim of the research was to investigate how integrating services for the prevention of mother-to-child transmission (PMCT) of HIV into low-resource maternal and child health (MCH) and antenatal care (ANC) settings influences women’s ability to make and implement informed decisions about HIV. The intervention strengthened routine services and introduced HIV voluntary counselling and testing and PMCT counselling and services into the MCH/ANC setting. Exclusive breast feeding was promoted for all mothers with infants below 6 months old

Mainstreaming HIV/AIDS : a conceptual framework and implementing principles

JOINT UNITED NATIONS PROGRAMME ON HIV/AIDS (UNAIDS)
Deutsche Gesellschaft für Technische Zusammenarbeit GmbH (GTZ)
et al
June 2002

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This document explores the current understanding of mainstreaming, and examples of relevant experience. It provides a set of basic principles designed to enable those working at the different levels and aspects of HIV/AIDS policy and practice to begin using mainstreaming processes to expand and accelerate responses to HIV/AIDS

Edutainment for development and sexual health [whole issue]

2002

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This issue of Sexual Health Exchange includes articles on performance art / theatre for development projects in 12 countries. The diverse projects described tend to focus on social change as well as behaviour change communications, and range from peer education projects to edu-clowns to mass-media soap operas

Mainstreaming HIV/AIDS : looking beyond awareness

WILKINS, Marissa
VASANI, Dolar
2002

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The social and environmental circumstances that lead vulnerable people to have unprotected sex, exposing them to infections, have to be resolved through addressing the causes of poverty, gender discrimination, and the use of sex as a commodity. This book addresses the impact of HIV without prejudice, by taking a human rights stance. It is useful for trainers, programme planners, policy-makers and CBR programmes

Care for orphans, children affected by HIV/AIDS and other vulnerable children : a strategic framework

FAMILY HEALTH INTERNATIONAL (FHI)
2001

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Family Health International's strategic framework for setting priorities and taking the necessary steps to develop responsive care and support programmes for orphans, children affected by AIDS and other vulnerable children. Describes projects in three countries responding to the needs of vulnerable children. Designed to assist national and local planners, implementers and donors in setting priorities

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