Abimanyi-Ochom Julie, Mannan Hasheem, Groce Nora Ellen, McVeigh Joanne
School of Health and Social Development, Deakin University, Melbourne, Victoria, Australia.
School of Nursing, Midwifery and Health Systems, Health Sciences Centre, University College Dublin, Dublin, Ireland.
PLoS One. 2017 Apr 13;12(4):e0174877. doi: 10.1371/journal.pone.0174877. eCollection 2017.
Uganda is among the first to use the Washington Group Short Set of Questions on Disability to identify persons with disabilities in its Demographic and Health Survey. In this paper, we review the HIV Knowledge, Attitudes and Behaviour component of the 2011 Ugandan Demographic and Health Survey, analysing a series of questions comparing those with and without disabilities in relation to HIV/AIDS knowledge, attitudes and practices. We found comparable levels of knowledge on HIV/AIDS for those with and those without disabilities in relation to HIV transmission during delivery (93.89%, 93.26%) and through breastfeeding (89.91%, 90.63%), which may reflect increased attention to reaching the community of persons with disabilities. However, several gaps in the knowledge base of persons with disabilities stood out, including misconceptions of risk of HIV infection through mosquito bites and caring for a relative with HIV in own household (34.39%, 29.86%; p<0.001; 91.53%, 89.00%; p = 0.001, respectively). The issue is not just access to appropriate information but also equitable access to HIV/AIDS services and support. Here we found that persons with multiple disabilities were less likely than individuals without disabilities to return to receive results from their most recent HIV test (0.60[0.41-0.87], p<0.05). HIV testing means little if people do not return for follow-up to know their HIV status and, if necessary, to be connected to available services and supports. Additional findings of note were that persons with disabilities reported having a first sexual encounter at a slightly younger age than peers without disabilities; and persons with disabilities also reported having a sexually transmitted disease (STD) within the last 12 months at significantly higher rates than peers without disabilities (1.38[1.18-1.63], p<0.01), despite reporting comparable knowledge of the need for safer sex practices. This analysis is among the first to use HIV/AIDS-related questions from Demographic Health Surveys to provide information about persons with disabilities in Uganda in comparison to those without disabilities. These findings present a more complex and nuanced understanding of persons with disabilities and HIV/AIDS. If persons with disabilities are becoming sexually active earlier, are more likely to have an STD within the preceding 12 month period and are less likely to receive HIV test results, it is important to understand why. Recommendations are also made for the inclusion of disability measures in Uganda's AIDS Indicator Survey to provide cyclical and systematic data on disability and HIV/AIDS, including HIV prevalence amongst persons with disabilities.
乌干达是最早在其人口与健康调查中使用华盛顿小组残疾问题短卷来识别残疾人的国家之一。在本文中，我们回顾了2011年乌干达人口与健康调查中的艾滋病毒知识、态度和行为部分，分析了一系列关于艾滋病毒/艾滋病知识、态度和做法的问题，比较了残疾人和非残疾人的情况。我们发现，在分娩期间艾滋病毒传播（93.89%，93.26%）和通过母乳喂养传播（89.91%，90.63%）方面，残疾人和非残疾人对艾滋病毒/艾滋病的了解程度相当，这可能反映出对残疾人社区的关注有所增加。然而，残疾人知识基础中的几个差距较为突出，包括对通过蚊虫叮咬感染艾滋病毒风险的误解以及在自己家中照顾艾滋病毒感染者的误解（分别为34.39%，29.86%；p<0.001；91.53%，89.00%；p = 0.001）。问题不仅在于获取适当信息，还在于公平获得艾滋病毒/艾滋病服务和支持。我们发现，多重残疾者比非残疾者返回获取其最近一次艾滋病毒检测结果的可能性更小（0.60[0.41 - 0.87]，p<0.05）。如果人们不返回了解自己的艾滋病毒状况，必要时也不联系可用的服务和支持，那么艾滋病毒检测就毫无意义。其他值得注意的发现是残疾人报告首次性接触的年龄比非残疾同龄人略小；而且残疾人报告在过去12个月内感染性传播疾病（STD）的比率也明显高于非残疾同龄人（1.38[1.18 - 1.63]，p<0.01），尽管他们报告对安全性行为需求的了解程度相当。这项分析是首批利用人口健康调查中与艾滋病毒/艾滋病相关的问题来提供乌干达残疾人和非残疾人相关信息的研究之一。这些发现对残疾人和艾滋病毒/艾滋病有了更复杂和细致入微的理解。如果残疾人更早开始性活跃，在前12个月内感染性传播疾病的可能性更大且获取艾滋病毒检测结果的可能性更小，那么了解原因就很重要。还建议在乌干达的艾滋病指标调查中纳入残疾措施，以提供关于残疾和艾滋病毒/艾滋病的周期性和系统性数据，包括残疾人中的艾滋病毒流行率。
