142nd APHA Annual Meeting and Exposition

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Disability and HIV/AIDS status influences actual and perceived household behaviors and access and utilization of health and education services in Chongwe, Zambia

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014

Kathryn Fleming , International Development, Evaluation and Research Program, American Institutes for Research, Washington, DC
Jonas Ngulube , Consultant, Zambia
Jerome Mindes , American Institutes for Research
With limited data available on HIV/AIDS prevalence within populations of persons with disabilities (PWD), and no firm data on disability prevalence in Zambia, the WHO estimates 10% of the population has a disability (1.3 million Zambians) with 14.3% HIV/AIDS prevalence. Despite limited research, it's believed that barriers and discrimination faced by PWD, and especially women with disabilities, reinforce the drivers of HIV/AIDS and poverty in ways that influence and even exacerbate vulnerability and HIV/AIDS incidence.  PWD are invisible in most societies without comprehensive access to services-health and education. Households balancing PWD and PLWHA needs are forces to make extreme choices when determining who receives healthcare, education, food and nutrition. Pilot study in Chongwe, Zambia using mixed methods to understand the use, availability and prioritization of services for PWD and PLWHA within their households from 235 randomly sampled HIV/AIDS-affected households.


  • 92 people self-identified as a PWD in 35% of HIV/AIDS-affected households
  • 88% of PWD wanted access to additional health and education services, many did not feel these were available to them
  • 56% of PWD sought care and support from government sources, while 22% did not seek care or know services existed
  • Almost half of PWD were not involved in age-appropriate educational or economic opportunities

 Next steps:

  • Drivers of HIV/AIDS and poverty in these households are self-reinforcing
  • Research for greater understanding and data on PWD and PLWHA needs and services
  • Inclusion of PWD in HIV/AIDS prevention education, VCT/ART, care, support
  • Inclusion of disabled persons organizations in program design, research, HIV/AIDS services

Learning Areas:

Advocacy for health and health education
Program planning
Public health or related public policy

Learning Objectives:
Discuss dual drivers of vulnerability when living with HIV/AIDS and disability Describe vulnerabilities of persons with disabilities and HIV/AIDS and their access to and use of services, i.e. education and health

Keyword(s): Disabilities, HIV/AIDS

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a public health professional working in international development for over twelve years providing technical assistance to HIV/AIDS, school health and nutrition, sexual and reproductive health, inclusive developement programs most recently in Liberia, Zambia and Haiti. I have a MA in International Development concentrating in Public Health and a Certificate in International Population and Reproductive Health.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.