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Assessing the Impact of HIV and AIDS on Older People (50+) and Persons with Disability in Africa a Case of Data

Disaggregation by Age, Sex and Impairments
Mwachi, D1. et al, 2013 – HelpAge International- East, West, Central and Southern Africa Regional Development Centre Regional Monitoring Evidence and Learning Adviser Acknowledgment: Dr. D. Lackey, Mr. K. Mambo, Mr. S. Obara, Ms. Wamuyu Manyara, Muriel Mac-Seing – Handicap International Issues: Lack of disaggregated data by age, sex and impairment for older people (50+) despite studies indicating that they are at risk due to the fact that they are sexually active or at risk as care givers to the orphaned children by AIDS Description: Lack of data disaggregation by age and impairment by HIV and AIDS related population based surveys and routine data sources in Sub Saharan Africa. Lack of data has made it difficult to determine and understand the needs of these vulnerable groups and to monitor the adequacy of service provision. Older people are also care givers to the orphaned children by AIDS, but the available data is scanty. There is also no linkage between HIV and AIDS data and that of persons with disabilities. For instance, there currently exist no data on the number of persons living with HIV who also are disabled and on older people who are receiving antiretroviral (ARV) drugs. Without the data, regional and national HIV and AIDS strategic frameworks and plans of action will not prioritize and resource programmes to address the impact on older persons and persons with disabilities. Lessons: Countries where data is available on older people and person with disabilities in Sub-Saharan Africa, HIV prevalence has been shown to equal to or higher than national prevalence. For example the rate for the 50-54 age groups in Kenya, South Africa and Swaziland is higher than national average, and in Kenya 5% for the 50-64 age group compared to 7.1% for the 15-49 age groups2. Studies also estimate that, at least 40%-50%3 of caregivers are older people, mainly women. A survey from South Africa reports HIV prevalence among persons with disabilities at 14.1%4; a study from Kenya among deaf people reports HIV prevalence of 7% 5; and unpublished data from Senegal suggest that HIV prevalence among persons with disabilities in the Dakar region is almost double (1.2%) that of the non-disabled population6. Next steps: HIV and AIDS sero-behavior surveys, such as AIDS indicator survey, should extend to age 65, demographic and health surveys should determine HIV prevalence for both women and men up to age 60. The tools also need to be revised to assess access to HCT and ART services for the 50+ group. Need to integrate data on older people and persons with disabilities in national HIV and AIDS database (HMIS). Involvement of key stakeholders in national survey design and data collection tools, strengthening the collaboration between national bureau of statistics and CSOs representing older people and persons with disabilities and lastly national governments commitment and gaining the support of influential organizations and donors for data disaggregation by age, sex and impairment.

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Kenya AIDS Indicator Survey 2007, South Africa National HIV Prevalence IBC Survey 2008, Swaziland DHS 2006-2007 Unicef. State of World Children Report 2007 4 Shisana, O. et al. South African National HIV Prevalence, Incidence, Behaviour and Communication Survey 2008: A Turning Tide among Teenagers? 2009, HSRC Press: Cape Town. 5 Taegtmeyer, T. et al.A peer-led HIV counseling and testing programme for the deaf in Kenya Disability and Rehabilitation, 2008.31(6): p. 508-514. 6 RARS/APAPS. Rapport de l’étude sur la vulnérabilité des personnes vivant avec un e déficience face au VIH dans la région de Dakar au Sénégal, 2011. Unpublished report. Handicap International.