In response to reports that women with disabilities are not being adequately served by HIV/AIDS prevention or treatment campaigns, AIDS-Free World is placing disability rights high among the priorities on our advocacy agenda.

We feel there is an increasing need for the broader AIDS and women’s rights communities to better address and incorporate the rights and needs of people with disabilities into their work. To that end we have begun with a year-long research and advocacy project that will delve into the intersection of AIDS and disability in women’s lives.

We embark on this project acknowledging that it is new territory for us. Our work begins with many questions, and will be guided throughout the year as we build partnerships with disability rights organizations within Africa and around the world. We hope that our process of exploring the overlap of AIDS and disability will instigate discussion and debate and will encourage others from the broader AIDS, women’s rights, and social justice communities who aren’t yet fully engaged in the issues of disability rights to begin or expand their work in this area.

What We Know

In a recent global survey of disability advocates, 87 percent of the organizations surveyed reported that HIV/AIDS is of immediate concern to the disabled populations that they serve.¹ Although few studies have been conducted and almost no hard data exists, individuals with disabilities are anecdotally estimated to be at twice the risk of contracting HIV/AIDS. Advocates report that once infected, people with disabilities often have little or no access to treatment or care.

We can safely assume that, as with most issues, pervasive gender inequality compounds these problems for women. Throughout the world there is an increasing feminization of the AIDS pandemic. In addition, women are affected severely and disproportionately by physical and mental disabilities.² They comprise 74 percent of disabled people in low and middle-income countries, and worldwide they receive only 20 percent of the rehabilitation.³ Women are more likely than men to become disabled during their lives, often because they have fewer resources, receive less medical attention when ill, and are less likely than men to get preventative care and immunizations.⁴ The United Nations reports that the “combination of male preference in many cultures and the universal devaluation of disability can be deadly for disabled females.”⁵

Within the AIDS context, women with disabilities are frequently and wrongly assumed to be non-sexual, and are thus excluded from, marginalized or invisible in HIV policies, advocacy and funding. Yet they display behavioral risk patterns for HIV that are the same as those of the general population.⁶ They are also up to three times more likely to be victims of sexual abuse and rape.⁷ In addition, women with disabilities may lack adequate legal protection and they are often unaware of their existing legal rights. High illiteracy rates serve as a major barrier, with the global literacy rate for women with disabilities as low as 1 per cent.⁸ The tragic and unnecessary result is that some women with disabilities who are HIV-positive arrive at clinics just days before death; many others simply die without diagnosis or any form of treatment. 

Questions Raised

Legal rights vs. Community Stigma

Although some countries have progressive national legislation regarding the rights of people with disabilities, local laws and customs may prevent effective implementation and enforcement. The stigma around disability is often an enormous obstacle, sometimes causing parents to lock their children in the home and never send them to school. Progressive disability legislation thus becomes irrelevant in the face of such severe community stigma. What are ways to ensure that laws are adopted and enforced? What are mechanisms that can allow people to move from what is legally stated to actual implementation at the grassroots level?

Classifying AIDS as a disability

One of many compelling issues arising in our introduction to disability rights is how to address the differences between those who are disabled by AIDS versus those with pre-existing disabilities who later contract AIDS. Dr. Nora Groce at the Yale School of Public Health reports that there is a considerable amount of literature on the disabling consequences of AIDS, yet there has been nearly no mention of the impact of the AIDS epidemic on people with a pre-existing disabling condition. She explains that the latter population faces unique challenges when coping with HIV/AIDS and accessing treatment, care or support. For example, those who are disabled by AIDS have not grown up with a disability and thus everything is framed differently – they have likely been supported up until that time and have family and social support networks in place that those with pre-existing disabilities may be missing. And even on an individual level, having been born into the mainstream rather than the margins, they are likely to have a very different take on life. Yet for those with pre-existing disabilities to then contract AIDS often means their situation just gets worse — often they are punished for having the "nerve" to be sexually active and may lose whatever little social support they may have had initially.

In addition, Dr. Groce explains that even general support systems are not in place for those with pre-existing disabilities. For example, in South Africa those that are disabled by AIDS are entitled to some economic support, even though it is small. But in order to receive this support they must show their birth certificates, which those with pre-existing disabilities may not have — children born with a disability are often not given birth certificates because it is assumed they will die, or will have no need for documentation since they will not be attending school.

This also raises the question of resources — how to measure what resources are or are not going to those with pre-existing disabilities. While classifying AIDS as a disability can bring important and much-needed support to those suffering from the disabling consequences of AIDS, there is the danger that it also takes away what little funding or support there may be for those with pre-existing disabilities. Are there ways that the specific financial and social needs of those with pre-existing disabilities can be better met?

We welcome thoughts and feedback as we move forward with this project. Please send them to This e-mail address is being protected from spam bots, you need JavaScript enabled to view it .

1. Nora E. Groce, HIV/AIDS and Disability: Capturing Hidden Voices – The World Bank/Yale Global Survey on HIV/AIDS (Washington, DC: The World Bank, 2004).
2. Women and Girls with Disabilities, Human Rights Watch Report. Available at http://hrw.org/women/disabled.html.
3. Ibid.
4. Ibid.
5. United Nations Enable website, International Norms and Standards Relating to Disability, Rights of Women with Disabilities. Available at www.un.org/esa/socdev/enable/comp504.htm .
6. Nora E. Groce, HIV/AIDS and Individuals with Disability, HEALTH AND HUMAN RIGHTS, Vol. 8, No. 2 (2005).
7. Ibid.
8. Ibid.

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