interviewees including some government personnel have also been withheld at their request. With permission from the Ministry of Community Development and Mother and Health, Human Rights Watch visited seven primary healthcare sites, two mobile clinics and five tertiary hospitals. We also visited two children’s homes for orphaned and vulnerable children affected by HIV, four government education facilities with special education units for children with disabilities, and two Victim Support Units (VSUs) at local police stations. We conducted interviews with 41 healthcare workers including eight voluntary counselling and testing (VCT) and ART counselors, eight nurses, seven doctors, five clinical officers, two psychologists and five home healthcare workers. These interviews concerned their experiences in providing HIV services to persons with disabilities. We also sought their opinion on measures that could be taken to improve access to HIV services by persons with disabilities. Human Rights Watch also interviewed 18 local and national government officials from the Ministry of Community Development, Mother and Child Health, Ministry of Education, Science, Vocational Training and Early Education, Ministry of Home Affairs, Ministry of Justice, the National HIV/AIDS/STI/TB Council and the Zambia Agency for
some time, we didn’t tell anybody except me and her…I was worried that I have made a mistake because I have been going with others – I kept that a secret to myself.” He said that he and his wife experienced heightened fear of HIV-related stigma because of negative community attitudes about their right to a full sexual and reproductive life as a deaf couple. Several persons with disabilities told Human Rights Watch that they preferred not to seek ART at their local or closest health facility providing ART because of their fear of stigma. Matthew C. who has a physical disability, explained: “There is no privacy in the clinic – you can meet others from our community there and don’t want them to know your status…some of us would prefer to go for ART to a clinic far away.” While this fear of HIV related stigma is not unique to persons with disabilities, many of them told us that they face a heightened concern for privacy because of the double stigma they face in the community - related to both their disability and HIV status. HIV-related stigma also creates barriers for individuals with disabilities in adhering to treatment. Persons with disabilities are reliant on relatives or others to take them to medical appointments or communicate information to them, and therefore have to tell them about their status, depriving them of confidentiality and risking a stigmatizing response.
To address the lack of accessible information on HIV and sexual and reproductive health (SRH) services for persons with hearing disabilities in Zimbabwe, the HIV and AIDS Management and Support Organization (THAMASO-ZIMBABWE) and Disability HIV & AIDS Trust (DHAT) produced a sign-language dictionary for HIV and sexual and reproductive health and rights terms in 2013. It is designed for use within both educational and health institutions. The sign-language dictionary provides deaf persons with access to comprehensive information and clear communication in HIV and SRH services through a standardized sign-language vocabulary. The dictionary includes an illustrated guide to signing for individual letters as well as illustrations and descriptions for common HIV and SRH signs, and was developed in consultation with people with hearing disabilities from all provinces in Zimbabwe. South Africa – Ethical Guidelines for Healthcare Workers on HIV Counseling and Testing for People with Intellectual Disabilities Recognizing that healthcare workers require specific skills to provide inclusive HIV services to persons with intellectual disabilities, the Western Cape Forum for Intellectual Disability developed ethical guidelines and training to support healthcare workers. These guidelines support the need to involve people with intellectual disabilities in their healthcare decision-making and include information about informed consent, tools to guide HIV risk assessment, HIV education and pre- and post-test counseling for persons with disabilities.