Compiled by Sonam Lhaden and E. Mohamed Rafique, Resource Persons, and Saraswati and Rituu B. Nanda, Research Associates,Issue Date: 26 August 2008:
Members from Solution Exchange Bhutan and the AIDS Community of Solution Exchange India responded to the query on sex and HIV education for the disabled. Respondents agreed that the disabled have equal rights to access information on sex and HIV and supported the introduction of sex education for disabled youth.
Discussants reiterated that HIV outreach efforts around the world generally exclude people with disabilities, and cited the Global Survey on Disability and HIV/AIDS, which highlighted the fact that persons with disabilities are vulnerable to HIV. Despite this vulnerability, the service providers have not often educated the disabled community. Another study, conducted in the Indian state of Maharashtra emphasized these findings. Further, members informed that the emphasis tends to be on enhancing educational and employment opportunities and promoting economic self-reliance and independent living for the disabled, overlooking their sexual needs and aspirations.Respondents pointed out that there are only a limited number of studies on the issue and limited sporadic efforts made to include the disabled in HIV programs. Members said that society ignores the disabled, largely because people see them as medical anomalies, helpless victims or a lifelong burden for family and community. Additionally, discussants highlighted challenges in reaching out to disabled groups, such as difficulty finding effective means of communicating, especially regarding health needs, due to various physical and mental disabilities as well as low literacy rates.
As such, members noted that the disabled are quite vulnerable to acquiring diseases, mainly due to lack of knowledge regarding the modes of transmission and protective measures. Additionally, this group has other unique risks associated with particular disabilities:
· tendency to have several sexual partners and unstable relationships, because they are less likely to marry
· increased chances of being victims of sexual abuse or rape, in cultures where people infected with HIV believe they can be “cleansed” of the virus by having sex with a virgin, because it is often assumed disabled people are not sexually active
· physical dependence, either within a family or institution
· prevalence of the misconception that disabled people cannot be a reliable witness on their own behalf
Discussing how to impart effectively education on sex and HIV, respondents emphasized the importance of having skilled teachers with special education skills. The findings of a study conducted in Kenya highlighted that teachers undergo training for special education skills to help educate disabled students on sex.
Members felt it is essential to provide information to girls and boys at different stages of adolescence. They recommended teaching male and female students separately in the beginning, until they are comfortable with each other’s presence while discussing sexual health matters.
Respondents also suggested setting up help-lines to provide information on sexuality, reproductive health, and HIV, as well as conducting sessions about sex and HIV in schools and colleges. Another suggestion was to set up camps or centres to reach out to both ‘in-school’ and ‘out-of-school’ populations. With either approach, members advised starting out with separate gender groups, depending on the setting and comfort levels.
Additionally, members noted that in May 2008 the United Nations Convention on the Rights of Persons with Disabilities came into force, strengthening the legal protection available to the disabled. The Convention includes various suggestions for program planners, policy makers, and monitoring and evaluation specialists and encourages the provision of more resources for the disabled. Respondents felt that organizations and agencies could leverage the recommendations laid out in the Convention to ensure disabled groups receive education on sex and HIV.
Discussants also shared the successful experiences of some NGOs and governments in providing sex and HIV education to disabled groups. For example, in Kenya, the government helped develop a peer education network in several schools for the deaf. The program involved training of master educators to train students to become peer educators. Under the program, the master educators and peer educators developed a training curriculum with many participatory activities and games. Similarly, in Bihar, India, a sign language expert conducted an HIV awareness program for speech and hearing challenged youth.
Another experience from India , highlighted the work of an NGO in Jharkahand, where based on research into the HIV awareness levels of disabled youth, a workshop is being planned to educate youth on sex and HIV. Discussants also mentioned one successful case from Bhutan, where a private company took the inative of training all of its employees on HIV.
Additionally, respondents listed numerous resources, including websites related to sexuality education and disabilities. These resources contained various curricula that could help the professionals in teaching individuals with disabilities, including “Disability, Sexuality and Reproductive Health in India, “Family Life and Sexual Health (FLASH),” “Sexually Education within Comprehensive School Health Education,” and “The Deaf Peers’ Education Manual.”
Respondents also expressed concern regarding the growing number of HIV cases in Bhutan , despite efforts put forward by the Ministry of Health to raise awareness on HIV. Therefore, they proposed assessing population groups engaged in risky behavior, and then conducting a study to determine the reach of awareness campaigns to figure out if the right messages reaching these groups to encourage behavior change. Other recommendations for curbing the spread of HIV in Bhutan were to monitor proper utilization of condoms, explore the possibility of introducing a sexologist for counselling, and restrict bar licenses to minimize alcohol consumption.
Finally, discussants stressed that the disabled population in Bhutan will remain highly vulnerable to HIV infection, as long as they continue to engage in high-risk behaviors. Hence, they supported the introduction of sex education for the disabled youth in Bhutan .