Disability and HIV: Vulnerability of People With Disabilities to HIV Infection in Sub-Saharan Africa — HandiVIH  

HIV Clinical Trial

Official title: Disability and HIV: an Appraisal of the Vulnerability of People With Disabilities to HIV Infection in Two Main Cities of Sub-Saharan Africa

Status Completed

Clinical Trial Summary

According to the recent World Report on Disability, around 15% of the world population lives with a disability and 80% of people with disabilities (PWD) live in developing countries. More and more evidence show that PWD are more likely to be poor, vulnerable to physical and sexual violence, and to have less access to education. Therefore, PWD are likely to have an increased risk for HIV infection, potentially being a key population in regard to this epidemic.

The vulnerability of PWD was recognized in 2007 by the United Nations Convention on the Rights of Persons with Disabilities. However, data on the extent how PWD are affected by HIV is still very limited. As a result, PWD are usually overlooked by National AIDS Control Programmes and few projects specifically targeting them have been developed.

Recognizing the need for appropriate and reliable data to help protect the rights of PWD and achieve a better inclusion of disability in National AIDS Control Programmes, the Institute of Research for Development (IRD), the Institut de Formation et Recherche Demographique (IFORD) and Handicap International (HI) propose this study that aims to provide quantitative and qualitative data on the vulnerability of PWD to HIV infection in Cameroon and Burkina Faso, in order to define if this vulnerable population is also a Key Population in relation to the HIV epidemic. This study adopts a multidisciplinary approach (quantitative and qualitative methods). Quantitative data are collected only in Cameroon.

Only the quantitative study is described here.

Clinical Trial Description

OBJECTIVES:

The general objective of this study is to provide information on the vulnerability of PWD to HIV infection.

The objectives of the quantitative component of this study are:

Estimation of the HIV burden among PWD:

• To estimate the prevalence of HIV in PWD comprehensively and for each of the following disabilities 1) hearing 2) visual 3) mobility 4) cognitive (intellectual)

• To compare the HIV prevalence between PWD and non-disabled matched controls

• To assess the association between PWD's social network characteristics and the risk for HIV

Assessment of the knowledge, behaviour and practice toward HIV infection and sexual and reproductive health (including contraception) overall and for each of the impairment groups mentioned above:

• To describe and analyze the knowledge, attitude and behaviours related to HIV infection

• To compare the knowledge, attitude and behaviours between PWD and non-disabled matched controls

• To describe sexual and reproductive activities of PWD

• To describe and analyze the access and actual use of family planning methods in PWD

Access to HIV prevention and health careglobally and for each of the impairment groups mentioned above:

• To describe and analyze the determinants of and barriers to access to prevention and testing services

• To describe and analyze the determinants of and barriers to access to care

• To compare the access to services between PWD and non-disabled matched controls

Specific objectives related to disability:

• To describe the population of PWD in Yaoundé

• To describe and analyze the characteristics of the social networks of PWD

METHODOLOGY

Study design:

This is a cross sectionnal study assessing HIV prevalence, HIV risk factors and sexual & reproductive health of PWD compared to a control group of Non-Disabled People. PWD are sampled from the general population using a two-step sampling method. Eligible subjects are proposed an HIV test and to respond to a questionnaire on their Knowledge, Attitudes and Practices (KAP) in relation to HIV and SRH, on their social network and on their access to prevention and care services. The life-grid interview method is used to collect data on subject's history of social participation, employment, resources, sexual partnership and reproductive life. Controls are selected from the PWD's neighborhood.

Sample size:

850 disabled subjects and 850 non-disabled controls

Study location: Yaounde, Cameroon

Estimated planning or Study timetable :

Study start date: April 2014 (exploratory work) Total trial/study duration: 24 months ;

Study Design

Time Perspective: Cross-Sectional

Related Conditions & MeSH terms

• Acquired Immunodeficiency Syndrome
• Disability
• HIV
• HIV Infections
• Reproductive Health

• NCT number: NCT02192658
• Study type: Observational
• Source: French National Institute for Health and Medical Research-French National Agency for Research on AIDS and Viral Hepatitis (Inserm-ANRS)
• Status: Completed
• Phase: N/A
• Start date: November 2014
• Completion date: July 2016