Office on Disability
HIV and Disability - A Companion to Chapter 13 of Health People 2010
OFFICE ON DISABILITY
The Office on Disability (OD) was created by the Secretary of the U.S. Department of Health and Human Services in October 2002. The OD acts as the focal point for programs, policies, and initiatives designed to tear down barriers that prevent the 54 million Americans with disabilities from fully participating in an inclusive community life.
PURPOSE OF THE COMPANION DOCUMENT TO HEALTHY PEOPLE 2010
Eliminating health disparities is a key goal of Healthy People 2010. Persons with disabilities are represented in 207 of the 467 Healthy People 2010 objectives, and data on persons with disabilities are available for only 88 of these 207. Each companion document describes the particular challenges to health promotion and disease prevention affecting persons with disabilities in focus areas addressed in Healthy People 2010. The importance of including persons with disabilities in research is also stressed.
HEALTHY PEOPLE 2010 GOAL
Prevent human immunodeficiency virus (HIV) infection and its related illness and death.
The Centers for Disease Control and Prevention (CDC) report that HIV/AIDS has been identified in virtually every racial and ethnic population, every age group, every socioeconomic group, and in every state in the United States.
HIV is not transmitted by casual contact. Transmission requires a direct exchange of body fluids, most commonly during sexual activity or the sharing of needles among drug users. Blood, blood products, breast milk, semen, and vaginal secretions may all carry HIV. Transmission may also occur from mother to baby during pregnancy or at birth. Despite concerns, saliva, tears, urine, feces, and sweat do not appear to transmit the virus.
Many individuals who may be at risk are unaware that they are infected as a result of delays in accessing counseling, testing, and care. If they continue to engage in risky behaviors, they are also putting others at risk.
Persons with disabilities are at risk for HIV infection and AIDS
According to the CDC’s National Prevention Information Network, individuals with disability are assumed to be at little or no risk for HIV infection therefore, have not typically been included in HIV/AIDS outreach efforts.
It is incorrectly assumed that persons with disabilities are not sexually active, are unlikely to use intravenous drugs and alcohol, and are at low risk for abuse or violence. Individuals with disability are at equal or increased risk of exposure to risk factors for HIV and AIDS.
- Persons with disabilities are as likely as their peers without disabilities to be sexually active and to use drugs and alcohol.
- Homosexuality and bisexuality appear to occur at the same rate among individuals with and without disabilities.
- Persons with disabilities are more likely than persons without disabilities to be victims of violence or rape. Further, they are less likely to obtain police intervention, legal protection, or prophylactic care.
How common is HIV infection and AIDS in the disabled population?
Little data are available on the prevalence of HIV infection among persons with disabilities other than anecdotal reports. However, special characteristics of this population suggest that the rate of infection with HIV could be as high as the rate found within the United States population as a whole.
- At the end of 2003, the CDC estimated that 405,926 people were living with AIDS in the U.S. This includes an estimated 1,998 children.
- While all persons with disability are at risk for HIV infection, subgroups within the disabled population are at an increased risk. Most notably this includes women, members of ethnic and minority communities, adolescents, and those living in institutions.
HIV/AIDS education, prevention, and treatment services are not accessible
Existing health care and wellness systems are not sufficiently responsive to the needs of persons with disabilities. As a result, access to education, prevention, screening, diagnosis, treatment, and services for HIV/AIDS and other sexually transmitted diseases can be limited, incomplete, or misdirected.
HIV/AIDS materials are often inaccessible to persons with disabilities.
- Health promotion materials may be written at too high a reading level for a person with an intellectual disability. According to the Center of Disease Control National Prevention Information Network and the World Bank Organization, the global literacy rate for adults with disability is as low as 3%. For women with disability, the global literacy rate may be as low as 1%.
- Materials also might be unavailable in formats accessible to persons with visual impairments (e.g., Braille or interactive technology).
- HIV/AIDS educational and prevention literature, videos, presentations, and materials found in print media, on television, and on the World Wide Web primarily show images of persons without disabilities, sending the inaccurate message that persons with disabilities are not at risk.
Clinics and services are often inaccessible to those with physical disabilities.
- Transportation issues and sheer distance complicate access to specialized treatment centers for persons with disabilities.
- Once at a health care facility, other potential physical barriers arise. Frequently, treatment centers do not have adaptive equipment that can meet the needs of individuals with disabilities, including changing rooms with narrow doorways and examination tables too high or too flat for comfort. More than discomfort, the result might well be an incomplete, potentially inaccurate, examination.
- Cultural insensitivity by health care and health promotion providers may prevent persons with disabilities from seeking education, testing, and care.
- Effective communication may be frustrated as a result of limited availability of assistive supports, such as interpreters for persons who are deaf or hard of hearing.
- Because health care and health promotion providers alike often focus solely on a person’s disability rather than on the full range of health and wellness needs, they may fail to communicate HIV/AIDS messages that are given routinely to persons without disabilities.
- Persons with disabilities need access to HIV/AIDS materials that are culturally sensitive, linguistically accessible, and inclusive in order to meet their prevention needs.
- Persons with disabilities should be included in research and data statistics.
To Learn More…
CDC Home, HIV/AIDS Information
English, Espanol: 1-800-CDC-INFO (1-800-232-4636)
CDC National Prevention Information Network (NPIN)
CDC National STD and AIDS Hotline
Espanol: 1-800-344-SIDA (1-800-344-7432)
National Center for HIV, STD and TB Prevention
Public Inquiries: 1-800-311-3435
Voice Information System available 24-hours a day
U.S. Department of Health and Human Services
Office of HIV/AIDS Policy
Centers for Disease Control and Prevention (CDC). HIV/AIDS Surveillance Report 10(2), 1998.
CDC National Prevention Information Network. http://www.cdcnpin.org.