I spoke at an AIDS conference not long ago, and after the talk, someone asked me how I had contracted H.I.V. “Well,” I replied, “sexually.” Staring at my crutches, which I have used since I got polio as a child, she exclaimed, “But how?”
The assumption that all disabilities — of hands, feet, hearing, sight — somehow also affect the ability and desire to have sex is common. It would be comic if it didn’t have such serious consequences: people with disabilities are rarely exposed to sex education and are almost never considered in need of information about H.I.V. and treatment for it.
As a result, although people with disabilities are just as likely to be sexually active as people without, our H.I.V. infection rate is up to three times higher.
In Africa, children with disabilities are less likely to receive sexual health education, both because they are less likely to be enrolled in school, and because those who attend are sometimes removed from sexual health classes. Due to the widespread belief that we are asexual, we are often left out of family planning programs, despite the fact that many of us want children or are parents already.
The blind can’t read H.I.V. prevention posters; the deaf can’t hear radio campaigns. Vague messages are not understood by those with intellectual disabilities. Places where condoms and education materials are available are often physically inaccessible.
People with disabilities are often among the poorest of the poor, and can’t afford health care services. But even those with access to health care often experience discrimination and loss of privacy in health centers. Consider my hearing-impaired friends, who have to bring a family member to interpret if they want to get tested for H.I.V. In many places, people face being evicted or ostracized if family members learn they have H.I.V. The lack of confidentiality is a big deterrent to testing and treatment.
Worst of all, when drugs and services must be rationed, our lives are sometimes valued less than others. I have heard of cases where people with disabilities are given a lower priority for life-saving antiretrovirals.
Last week world leaders met at the United Nations to discuss efforts to fight H.I.V. Despite pledges for universal access to prevention, treatment and care, some people — children and heterosexuals — always get more attention in these meetings than others — sex workers, drug users, gays and lesbians and people with disabilities.
We must no longer be overlooked because of false assumptions about our sexuality. People with disabilities can and do have sex. I know from my own experience. We need to be a part of the fight against H.I.V., too.
Winstone Zulu, an adviser for AIDS-Free World and the coordinator of Health Triangle Zambia.