De Beaudrap, P., Beninguisse, G., Pasquier, E., et al. The Lancet HIV (April 2017), doi:10.1016/S2352-3018(16)30209-0.
Globally, people with disabilities experience greater health risks compared to those without disabilities; yet they have been left behind in the response to HIV. The HandiVIH study, a cross-sectional, population-based, observational study, compared HIV prevalence and associated risk factors between people with and without disabilities. From October 2014 through November 2015, the authors recruited 807 adults with disabilities and 807 matched control participants in Yaoundé. Participants were offered voluntary HIV testing and counseling and took part in structured interviews. Participants with disabilities had less education, lower income, and less access to transportation and health services relative to those without disabilities. HIV prevalence in participants with disabilities was higher than in those without (6.8% versus 3.9%). Women with disabilities were more often involved in paid sexual relationships (2.5% versus 1%), and they were also at increased risk of sexual violence relative to their non-disabled counterparts (34% versus 27%). Sexual violence and sex work were strongly associated with increased risk of HIV infection among participants with disabilities, but not among controls. The authors said that the higher prevalence of HIV in people with disabilities reflected greater exposure to HIV, which appeared to be shaped by social and environmental factors. They recommended research to inform actions for preventing HIV in this vulnerable population.