Women with disabilities in hearing: the last mile in the elimination of mother-to-child transmission of HIV – a cross-sectional study from Zambia

ABSTRACT

This article explored the differences in HIV testing in the elimination of mother-to-child transmission of HIV (EMTCT) between women with and without disabilities aged 16–55 years, reported being pregnant and receiving the social cash transfers (SCT) social safety nets in Luapula province, Zambia. We tested for associations between HIV testing in EMTCT and disability using logistic regression analyses. We calculated a functional score for each woman to determine if they had mild, moderate or severe difficulties and controlled for age, intimate partner sexual violence, and the SCT receipt. Of 1692 women, 29.8% (504) reported a disability, 724 (42.8%) mild, 203 (12.0%) moderate, and 83 (4.9%) severe functional difficulties (adjusted odds ratio [aOR] 1.33; 95% confidence interval [CI] 1.04–1.70). Women with moderate (aOR 2.04; 95% CI 1.44–2.88) or mild difficulties (aOR 1.66; 95% CI 1.32–2.08) or with a disability in cognition (aOR 1.67 95% CI 1.22–2.29) reported testing more for HIV than women without disabilities; Women with a disability in hearing (aOR 0.36 CI 0.16–0.80) reported testing less for HIV. Disability is common among women receiving the SCT in the study area accessing HIV testing in the EMTCT setting. HIV testing in EMTCT is challenging for women with disabilities in hearing.

KEYWORDS:

• Antenatal clinic
• EMTCT
• women with disability
• social cash transfers
• HIV testing
• disability score

Disclosure statement

No potential conflict of interest was reported by the author(s).

Acknowledgements

We acknowledge financial support from the United Kingdom Research in Innovation (UKRI) Global Challenges Research Fund (GCRF) Accelerating Achievement for Africa’s Adolescents Hub (Principal Investigator Prof. Lucie Cluver). Olivia Keiser was supported by the Swiss National Science Foundation (grant no 163878).

We acknowledge the support of the Ministry of Community Development and Social Welfare, Ministry of Health, National AIDS Council, the Global Fund to Fight AIDS TB and Malaria Zambia Country Co-ordinating Mechanism secretariat. The Joint United Nations Programme on HIV/AIDS (UNAIDS), and the International Labour Organisation, are appreciated for their support.

Author contributions

Conceived the study: DC, OK JE HS. Led data collection: DC, AT, MC, GT. Data analyses was performed by DC. HS, OK, ET, JE, SA, contributed towards data analysis. DC drafted the manuscript. HS, ET, OK JE, PC, JM, SA, KK, MC, GT, and PGF commented on the drafts. DC revised the draft. HS, OK, JE, ET made additional comments on the revised draft, which DC incorporated.

Disclaimer

Information in this article are the views of authors and not of UNAIDS, ILO nor other institutions listed.

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

This work was supported by United Kingdom Research in Innovation (UKRI) Global Challenges Research Fund (GCRF) Accelerating Achievement for Africa’s Adolescents Hub (Principle Investigator Prof. Lucie Cluver ); Swiss National Science Foundation.