Leaving no one behind: Disability and HIV prevention, knowledge among adults in a population cohort in Uganda

People with disability are a vulnerable population and are at a high risk of acquiring human immunodeficiency virus (HIV) infection.

We investigated the association between severity of disability and not having knowledge of any HIV prevention method among adults in Uganda.

Between January 2015 and December 2015, data were collected within a general population in Uganda, on six domains of disability based on the Washington Group Short Set on Functioning. In addition, routine data on socio-demographic factors and other HIV-related data were collected among adults aged 16 years and above. A continuum of functioning was developed: without disability, mild, moderate and severe. Bivariate and multivariate associations of disability and not knowing any HIV prevention method were fitted using logistic regression models.

A total of 3331 adults (60.4% female) were included. Of these, 14.5% (n = 482) were classified as having either moderate or severe disability, and this proportion exponentially increased with age (p < 0.001). Overall, 4.2% (n = 140) reported not knowing any HIV prevention method, with a slightly higher proportion among females than males (3.1% in males, 4.9% in females). Compared to people with no disability, those with moderate or severe disability were 5 times more unlikely to know any HIV prevention methods (adjusted odds ratio = 5.45, 95% confidence interval = 3.25-9.13, p < 0.001). Additionally, the combined effect of moderate and severe disability and none/incomplete primary education increased the likelihood of not knowing HIV prevention methods over and beyond their separate effects (p < 0.001).

Effective HIV prevention strategies must integrate best practices that target people with disabilities.

These findings contribute to the evidence of the lack of HIV prevention knowledge among people with disabilities in general populations.