Do people with disabilities have the same level of HIV knowledge and access to testing? Evidence from 513,252 people across 37 Multiple Indicator Cluster Surveys

Abstract

AbstractBackgroundDisability and HIV are intricately linked, as people with disabilities are at higher risk of contracting HIV and HIV can lead to impairments and disability. Despite this well-established relationship, there remains limited internationally comparable evidence on HIV knowledge and access to testing for people with disabilities.Methods and FindingsWe used cross-sectional data from 37 Multiple Indicator Cluster Surveys. 513,252 people were eligible for inclusion, including 24,695 (4.8%) people with disabilities. We examined risk ratios and their 95% confidence intervals for key indicators on HIV knowledge and access to testing for people with disabilities by sex and country. We also conducted a meta-analysis to get a pooled estimate for each sex and indicator. Men and women with disabilities were less likely to have comprehensive knowledge about HIV prevention (aRR: 0.74 [0.67, 0.81] and 0.75 [0.69, 0.83], respectively) and to know of a place to be tested for HIV (aRR: 0.95 [0.92, 0.99] and 0.94 [0.92, 0.97], respectively) compared to men and women without disabilities. Women with disabilities were also less likely to know how to prevent mother-to-child transmission (aRR: 0.87 [0.81, 0.93]) and ever have been tested for HIV (aRR: 0.90 [0.85, 0.94]), while men with disabilities showed some evidence of relative inequities for these indictors. There was also some evidence women with disabilities were less likely to be tested for HIV in the past year.ConclusionMen and women with disabilities face inequities in HIV knowledge and access to testing, particularly for women with disabilities. Governments must include people with disabilities in HIV programs by improving accessibility and increasing disability-inclusion in each health system building block.