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AIDS Care. 2014;26(12):1467-76. doi: 10.1080/09540121.2014.936820. Epub 2014 Jul 17.

Disability and HIV: a systematic review and a meta-analysis of the risk of HIV infection among adults with disabilities in Sub-Saharan Africa.

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1
a Institut de Recherche pour le Développement , Université de Montpellier I , Montpellier , France.

Abstract

More than one billion people worldwide are estimated to be living with a disability. A significant proportion of them lives in Sub-Saharan Africa where they are reported to be at increased risk of HIV. However, quantitative evidence on this remains scarce. A systematic review and a meta-analysis of the risk of HIV infection among people with disabilities living in Sub-Saharan Africa were undertaken. We searched all published or unpublished studies and national surveys reporting HIV prevalence among adults with disabilities living in Sub-Saharan Africa between 2000 and 2013. The risk ratio (RR) of HIV infection in people with disabilities versus people without disabilities was estimated through a random-effects meta-analysis. Of the 12,252 references screened, 13 studies were selected. HIV prevalence varied widely across studies from 1.1% to 29%. Pooled RRs of HIV infection in people with disabilities compared to the general population were 1.31 (1.02-1.69) overall; 1.16 (0.71-1.87) among people with mental illness or intellectual disabilities and 1.07 (0.58-1.95) among people with hearing disabilities. This meta-analysis provides evidence that people with disabilities do not have a lower risk of HIV when compared to the general population, and that women with disabilities are especially affected. A clear increasing gradient in the risk of HIV according to gender and disability status was also observed. The important heterogeneity across studies and their varying quality warrant a closer look at the intersection between disability and HIV. Additional studies with more systematic approaches and with higher-quality methodologies are required to further address this knowledge gap.

KEYWORDS:

HIV; Sub-Saharan Africa; disability; epidemiology; meta-analysis

PMID:
25033274
DOI:
10.1080/09540121.2014.936820
[Indexed for MEDLINE]

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