Activity and participation experiences of people with disabilities in Ethiopia

Ethiopia, as a State Party to the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD), has committed to upholding the rights of people with disabilities in Ethiopia. There is little evidence, however, reflecting the impact of this commitment on the lived experiences of people with disabilities in Ethiopia. Objectives: This study sought to uncover how the experiences of participation and activity shape the enactment of rights for Ethiopians with disabilities as enshrined in the UNCRPD. Method: Analysis of 25 qualitative interviews with people with disabilities and family members living in Ethiopia used a reflexive thematic analysis approach to arrive at central themes. Results: People with disabilities in Ethiopia experience marginalization, distress and practical challenges in both routine daily activities and participation in broader social roles and opportunities. These experiences affect their ability to claim many of the rights afforded by the UNCRPD. Conclusion: Despite legislative efforts to bring about change in Ethiopia, people with disabilities continue to live on the social margins. A meaningful change will require substantial allocation of needed resources by the Ethiopian government to support national-level programs and policy change. It is critical that people with disabilities and their families are engaged in receiving relevant support and serve as change leaders. Contribution: This study illustrates how marginalization, distress and practical challenges in daily activities and social participation arise and are sustained for people with disabilities in Ethiopia. The findings can help to inform the country's efforts to enact the rights of Ethiopians with disabilities as enshrined in the United Nations Convention on the Rights of Persons with Disabilities

Exploring the role and lived experiences of people with disabilities working in the agricultural sector in northern Nigeria

It is estimated that over 75.0% of households in sub-Saharan Africa are involved in agriculture, and the majority of the poor in rural areas rely on agriculture for their livelihoods. One billion people living with disabilities in low- and middle-income countries are argued to make up the poorest of the poor, yet to our knowledge, no literature has captured the livelihood of people living with disabilities in the context of farming in Nigeria, specifically northern Nigeria where most of the households are involved in agriculture and related activities. Objectives: This article reports on findings from a study that sought to understand disability in the context of northern Nigerian farming, with a particular focus on the role and lived experiences of people living with disabilities working in the agricultural sector. Method: A survey questionnaire was developed and captured the experiences of 1067 people living with disabilities working in the agricultural sector across five states (Adamawa, Bauchi, Jigawa, Kaduna and Yobe) in northern Nigeria. Results: Findings indicate that people with disabilities are actively participating in agricultural activities for several reasons, which specifically included 'forced to and for survival'. When participants reported needing care, this was predominantly provided by family members. Findings also showed that participants with disabilities experienced several economic and sociocultural challenges because of their impairments. Conclusion: This study adds to the very limited literature on farmers living with disabilities in sub-Saharan Africa and so highlights the need for more research to be conducted with farmers living with disabilities in Nigeria, particularly female farmers living with disabilities. These will provide more evidence pertaining to the experiences of farmers living with disabilities in order to provide effective disability- and gender-inclusive agricultural and entrepreneurship programs in Nigeria. Contribution: The results of this research reveal important insights relating to the experiences of farmers living with disabilities in northern Nigeria, which can contribute to informing future developmental projects to achieve effective inclusion and actively benefit people living with disabilities.

Exploring the role and lived experiences of people with disabilities working in the agricultural sector in northern Nigeria

It is estimated that over 75.0% of households in sub-Saharan Africa are involved in agriculture, and the majority of the poor in rural areas rely on agriculture for their livelihoods. One billion people living with disabilities in low- and middle-income countries are argued to make up the poorest of the poor, yet to our knowledge, no literature has captured the livelihood of people living with disabilities in the context of farming in Nigeria, specifically northern Nigeria where most of the households are involved in agriculture and related activities. Objectives: This article reports on findings from a study that sought to understand disability in the context of northern Nigerian farming, with a particular focus on the role and lived experiences of people living with disabilities working in the agricultural sector. Method: A survey questionnaire was developed and captured the experiences of 1067 people living with disabilities working in the agricultural sector across five states (Adamawa, Bauchi, Jigawa, Kaduna and Yobe) in northern Nigeria. Results: Findings indicate that people with disabilities are actively participating in agricultural activities for several reasons, which specifically included 'forced to and for survival'. When participants reported needing care, this was predominantly provided by family members. Findings also showed that participants with disabilities experienced several economic and sociocultural challenges because of their impairments. Conclusion: This study adds to the very limited literature on farmers living with disabilities in sub-Saharan Africa and so highlights the need for more research to be conducted with farmers living with disabilities in Nigeria, particularly female farmers living with disabilities. These will provide more evidence pertaining to the experiences of farmers living with disabilities in order to provide effective disability- and gender-inclusive agricultural and entrepreneurship programmes in Nigeria. Contribution: The results of this research reveal important insights relating to the experiences of farmers living with disabilities in northern Nigeria, which can contribute to informing future developmental projects to achieve effective inclusion and actively benefit people living with disabilities

Pandemics, professionalism and the duty of care: Concerns from the coalface

It is likely that the SARS-CoV-2 pandemic will affect a large part of the world's population and will last for several years. Many critical ethical issues have arisen in the healthcare context. While response from healthcare professionals to participating in the care of patients in the era of COVID-19 has generally been positive, there have also been disturbing experiences on the ground. The practice of medicine is a social contract with humanity. Challenges have arisen because the patient is both a victim and a vector of the coronavirus. All humans should have a natural instinct to care for those in need. Ethically and legally, healthcare professionals cannot be expected to assume a significant and unreasonable risk of harm. While fear is understandable, altruism and interest in serving the sick exemplify the value of solidarity. Social harms like stigmatisation and discrimination can occur. Concerns have been raised regarding protection of privacy and respect for rights of infected individuals. In the era of COVID-19, fear, misinformation and a detachment from one's calling put professionalism strongly to the test

An exploratory study of stigma and discrimination among people living with HIV/ AIDS in Abuja Municipal Area Council, Nigeria

This study examined the magnitude of HIV/AIDS stigma and discrimination among people living with HIV/AIDS (PLWHA) in Abuja Municipal Area Council (AMAC). A descriptive cross-sectional study was conducted using both qualitative and quantitative methods to survey 100 PLWHA resident in AMAC-FCT. Participants were selected through a combination of two-stage and systematic random sampling technique using a table of random numbers. A 40-item structured questionnaire adapted from the HIV Stigma Scale and a semi-structured focus group discussion (FGD) guide were used to collect data. Quantitative data were coded and entered SPSS statistical software. Frequency tables were generated, and data subjected to descriptive and inferential statistics. Cross tabulations examined pattern of associations between respondent's characteristics while qualitative findings utilized content analysis along five specific themes to demonstrate the way HIV/AIDS stigma manifested among respondents. Participation was 100% and HIV/AIDS stigma prevalence was high at 67%, with mean age 33.01years (SD±5.94years) for respondents. Findings confirmed rejection of PLWHA by sexual partners, family members and friends, dismissal from work, decrease in the quality of health care services and sometimes outright denial of services. A high correlation was found between the scales and subscales of the HIV Stigma Scale with all correlation values reaching statistical significance (p =0.01). Regret for disclosure of status and ending social interaction by PLWHA was reported as consequences of disclosure and potential hindrance for disclosure which will encourage ongoing transmission of the virus. Our study provides evidence on stigma and discrimination of PLWHA in AMAC, FCT-Abuja in the face of limited evidence to drive HIV prevention interventions. Further studies should investigate other predictors and reasons for stigma and discrimination among this population

Implementation of the 2006 convention on the rights of persons with disabilities in Zimbabwe: a review

Background: The Convention on the Rights of Persons with Disabilities came into place in 2006, as the main instrument for advancing the human rights of persons with disabilities. For many African states, the Convention came amidst ubiquitous marginalisation and discrimination of persons with disabilities. As expected, the Convention has been hailed as a landmark in the struggle to reframe the needs and concerns of persons with disabilities. Objectives: This article reviews the implementation of the Convention by the Zimbabwean government.Method: The study relies on reviews of extant literature on disability rights. Reviewed documents include the Convention, constitution and other related national laws, policies and measures pertaining to disability rights. Results: This article lauds the state for promulgating a disability-friendly constitution that resembles the Convention to effectuate a human rights approach to disability issues. Relatedly, the state came up with institutions that collaborate with research institutes and disability organisations to conduct research, provide services to persons with disabilities, raise awareness and advocacy and litigate for disability rights.Conclusion: In spite of these efforts, this article shows that Zimbabwe has yet to close the gap on the ideals of the Convention, mainly because of limited resources amongst state-funded institutions for advancing disability issues. The government of Zimbabwe is challenged to domesticate all provisions of the Convention and to provide resources to institutions for progressive realisation of the rights of persons with disabilities

HIV and AIDS-related stigma and discrimination in two referral hospitals in Ethiopia

The aim of the study was to determine the magnitude of HIV and AIDS-related stigma and discrimination (SAD) and its associated factors in healthcare settings. Primary data were collected from June to September 2014 from two referral hospitals located in north-west Ethiopia. The study used pre-test/post-test design with a non-equivalent control group using a quantitative approach. Healthcare professionals were divided into strata and then, using the stratified random sampling technique, the study participants were selected from each stratum. The median age of study respondents in the treatment group was 32.2 years with standard deviation (SD) of 7.74. The regressions of stigma for the pre-tests of the first hospital and second hospital participants' knowledge about SAD-related issues and perceived risk of HIV infection were found to be significantly associated with stigma in the first hospital. In the first hospital, healthcare professionals who felt HIV risk of infection at different contact points with HIV-positive patients were more than 13 times more likely to present stigmatising attitudes towards the patients (OR = 13.46, p = 0.005). In the second hospital, only perceived risk of infection was significantly associated with stigma (p = 0.036). Interventions to lessen HIV and AIDS-related SAD in healthcare settings must focus on improving the knowledge, attitudes and practices of healthcare professionals as well as overcoming the institutional barriers existing in the healthcare settings through staff training and hospital strategy development

We Keep her Status to ourselves': Experiences of Stigma and Discrimination among HIV-Discordant Couples in South Africa; Tanzania and Ukraine

In HIV-discordant relationships; the HIV-negative partner also carries the burden of a stigmatised disease. For this reason; couples often hide their HIV-discordant status from family; friends and community members. This perpetuates the silence around HIV-discordant relationships and impacts on targeted HIV prevention; treatment and counselling efforts. This article reports on experiences of stigma and discrimination among HIV-discordant couples in South Africa; Tanzania and Ukraine. During 2008; HIV-discordant couples who had been in a relationship for at least one year were recruited purposively through health-care providers and civil society organisations in the three countries. Participants completed a brief self-administered questionnaire; while semi-structured interviews were conducted with each partner separately and with both partners together. Interviews were analysed using thematic content analysis. Fifty-one couples were recruited: 26 from South Africa; 10 from Tanzania; and 15 from Ukraine. Although most participants had disclosed their HIV status to someone other than their partner; few were living openly with HIV discordance. Experiences of stigma were common and included being subjected to gossip; rumours and name-calling; and HIV-negative partners being labelled as HIV-positive. Perpetrators of discrimination included family members and health workers. Stigma and discrimination present unique and complex challenges to couples in HIV sero-discordant relationships in these three diverse countries. Addressing stigmatisation of HIV-discordant couples requires a holistic human rights approach and specific programme efforts to address discrimination in the health system

Journey through the trials and triumphs of disability

One Woman's journey through the Trials and Triumphs of Disability, Disabled Peoples International 8th World Assembly 2011 Durban, South Africa, October 10­13, 2011. When embarking on my career as a teacher at a special school in South Africa, I never thought that a motor vehicle accident would place me in the position where my learners with disabilities suddenly saw me as an ally. Little did I realise the chasm that exists between able-bodied people and people with disabilities, or the remarkable role I would find myself in whilst actively addressing disability and Inclusive Education issues. My experiences with disability in South Africa drew encouraging attention from delegates at the Disabled People's International 8th World Assembly when I shared my story. The resounding positive response affirmed that my experiences are not unique to nationality, gender, race or age, and are typical of the time and country in which I live, where people with disabilities are considered to have little potential, and woman with disabilities are further marginalised. In the infancy of our democracy, we are still in the early days of attending to equity amongst all South Africans. This story comprises both a narrative and a graphic presentation which run parallel, although not always telling an identical story; they complement one another and should be experienced simultaneously. Ultimately, it relates the success that can be achieved by pro-active people with disabilities as members of the South African society within their own spheres of knowledge and skill to change attitudes and practices of people without disabilities in education and local communities

The Perspectives of Users of Antiretroviral Therapy on Structural Barriers to Adherence in South Africa

Background: The effectiveness of antiretroviral therapy (ART) and the importance of adherence to treatment regimens are widely known. Yet; suboptimal adherence to ART and retention in care of patients still persists and; by many accounts; is fairly widespread. The aim of this study was to identify the structural barriers that influenced adherence among patients who were enrolled in the national ART programme in South Africa.Method: In this qualitative study; semi-structured interviews were conducted with a sample of 10 patients receiving ART at a public hospital in South Africa.Results: The results of the interviews were categorised according to poverty-related; institution-related and social barriers to clinic attendance and pill-taking; which collectively formed the structural barriers to adherence. The chief structural barriers to clinic attendance were time away from work; transport expenses; long waiting times and negative experiences with clinic staff. The chief barriers to pill-taking were food insecurity; stigma and discrimination.Conclusion: The barriers to adherence are discussed. Attention is called to the extraindividual factors that influenced ART adherence. We conclude that contextual factors; such as a healthcare-enabling environment; might play an important role in influencing healthcare-promoting behaviour among patients

Social Impact of HIV/AIDS on Clients Attending a Teaching Hospital in Southern Nigeria

People living with human immunodeficiency virus and acquired immune deficiency syndrome (PLWHA) face numerous social challenges. The objectives of this study were to assess the level of self-disclosure of status by PLWHA; to describe the level and patterns of stigma and discrimination; if any; experienced by the PLWHA and to assess the effect of sero-positivity on the attitude of friends; family members; health workers; colleagues and community. This was a cross-sectional descriptive study carried out among PLWHA attending the University of Uyo Teaching Hospital; Uyo; Southern Nigeria. Information was obtained using an interviewer-administered semi-structured questionnaire; which was analysed using the Epi 6 software. A total of 331 respondents were interviewed. A majority; 256 (77.3); of the respondents were within the age range of 25-44 years. A total of 121 (36.6) PLWHA were single and 151 (46.6) were married; while the rest were widowed; divorced or separated. A majority; 129 (85.4); of the married respondents disclosed their status to their spouses and 65 (50.4) were supportive. Apart from spouses; disclosure to mothers (39.9) was highest. Most clients (57.7) did not disclose their status to people outside their immediate families for fear of stigmatization. Up to 111 (80.4) of the respondents working for others did not disclose their status to their employers. Among those whose status was known; discrimination was reported to be highest among friends (23.2) and at the workplace (20.2). Attitudes such as hostility (14.5); withdrawal (11.7) and neglect (6.8) were reported from the private hospitals. Apart from disclosure to spouses; the level of disclosure to others was very low. Those whose status was known mainly received acceptance from their families but faced discriminatory attitudes such as hostility; neglect and withdrawal from friends; colleagues and hospital workers. There is a need for more enlightenment campaigns on HIV/AIDS by stakeholders to reduce stigma and discrimination and ensure adequate integration of PLWHA into the society

Sanctuary or Double-Edged Sword? Challenges Confronting Adolescents Living at Nkosi's Haven in Johannesburg; South Africa

Living in an institution associated with HIV and AIDS is likely to exacerbate difficulties experienced by teenagers who have to cope with the normal stresses of adolescence. The aim of the study was to explore the challenges that adolescents living at Nkosi's Haven encounter and whether they experience any problems when interacting with their peers and other members of the community. The study was located within a qualitative research paradigm and utilised a purposive; non-probability sample of 15 participants recruited from two Nkosi's Havens. A semi-structured interview schedule was employed as the research tool; with in-depth one-on-one interviews adopted as the method of data collection. Thematic content analysis was used to analyse the data collected during the interviews. The main finding that emanated from the study was that Nkosi's Haven is indeed a place of care and nurturing as adolescents are afforded the opportunity to continue with their educational needs while basic and psychosocial needs are also addressed. However; it also emerged that rejection; discrimination; social exclusion and stigmatisation associated with the setting make it difficult for resident adolescents to integrate freely with their peers at school and in the community. The conclusion drawn is that Nkosi's Haven can be regarded as a double-edged sword as it presents both positive and negative factors that impact on its resident adolescents. Results are discussed in terms of their implications for community awareness programmes; policies and practice changes regarding employment and training of staff; and visiting of parents as well as future research

Nigerian Health Workers' Views Concerning Factors Influencing Paediatric Adherence to Anti-Retroviral Therapy

New studies have focused on paediatric anti-retroviral therapy (ART) adherence in Nigeria; probably because of the ethical challenges involved in studying children. The study aimed to identify factors that influence paediatric ART adherence as perceived by health care workers providing ART services in two cities in Nigeria. Knowledge about such factors would be used to formulate recommendations for enhancing paediatric ART adherence in Nigeria; for facilitating the tasks of the health care workers and for enhancing the ART programme's effectiveness. An exploratory descriptive qualitative research design was used to identify and to describe health care workers' views in Kano and Lagos; Nigeria. Three focus group discussions were conducted at two clinics that provide free paediatric ARVs (antiretroviral drugs). The transcribed data were analysed by using the framework approach of data analysis. Health care providers perceived poverty; illiteracy; stigma; discrimination; inappropriate care approaches; and parental dynamics as factors that influence paediatric ART adherence. Paediatric ART adherence levels in Nigeria could be enhanced by emphasising paediatric ART adherence counselling and by adopting a comprehensive family centred care approach; by improving free paediatric ART services and by empowering parents and reducing stigma and discrimination

Addressing HIV/AIDS Challenges in Uganda: does Social Capital Generation by NGOs Matter?

HIV/AIDS has had devastating impacts in many countries; Uganda in particular. However; Uganda is depicted as one of the most successful countries in fighting HIV/AIDS. Among others; Uganda's success story is attributed to the open general environment which allows open discussions surrounding HIV/AIDS when other countries such as South Africa and Kenya denied the existence of the disease in their countries. In addition; the success is attributed to the policy which allowed many actors to participate in the fight against the disease. The primary focus of this article is to map the process of social capital generation by NGOs and how social capital benefits enhance mitigation of HIV/AIDS challenges in Uganda. The key to social capital is nurturing relationships. In this regard; HIV/AIDS NGOs play a central role in the way individuals; groups and communities interact; and how various kinds of social relations are forged with people living with HIV/AIDS and especially for those who are HIV infected. NGOs' success in reducing the number of HIV/AIDS cases in Uganda is based on their abilities to generate social capital. This involves inclusion and building social networks and empowerment at the individual and community levels; and disseminating information to reduce social stigma as well as discrimination. We used a mixed-method strategy to collect data for this study. We used a structured questionnaire having quantitative and qualitative question sets which focused on different social capital measurement indicators. We used observations and in-depth face-to-face interviews. A major finding of the study is that the ways individuals and groups are connected and interact with each other are important mechanisms for alleviating HIV/AIDS challenges in Uganda

ASystematic Review of HIV/AIDS-Related Stigma and Discrimination in India: Current Understanding and Future Needs

HIV/AIDS-related stigma is recognised as a major barrier to HIV prevention efforts and an impediment to mitigating its impact on individuals and communities. This paper reviews the existing research literature on AIDS stigma in India with the objective of documenting the current status of research; highlighting major findings and identifying key gaps remaining. Thirty publications were identified through a careful search of which a majority focused on stigma assessment and very few on stigma measurement; conceptual aspects of stigma or stigma reduction interventions. A few standardised stigma measures are available but more are required to assess causes of stigma among general population and compounded and internalised stigma among positive people. Research exploring linkages between stigma and HIV services uptake or the effect of HIV care and treatment programs on stigma levels are largely missing and need to be prioritised. In addition; more research is needed to advance conceptual understanding of stigma within the cultural context of the country including research on the neglected groups such as; transgender people. Context-specific (health care; community) interventions are needed to address various forms of stigma - enacted; perceived; internalised and layered - including structural approaches besides inter-personal and information-based approaches. A major gap relates to meager research on developing and evaluating stigma reduction interventions and needs priority focus. Overall; the review recommends developing a national agenda on AIDS stigma research and interventions to help realise the government's goal of stigma reduction

To Tell or not to Tell: Negotiating Disclosure for People Living with HIV on Antiretroviral Treatment in a South African Setting

Disclosure of HIV status occurs for a variety of reasons and in various contexts; such as to sexual partners to enable safer sexual choices; to health-care workers to access treatment and care services and to family and community members to gain various forms of support. The reasons for disclosure or non-disclosure are shaped by the relationships; needs and circumstances of people living with HIV (PLHIV) at the time of disclosure. The purpose of this study was to investigate and describe the act and experience of disclosure in order to understand how these experiences of disclosure impact on the lives of PLHIV on antiretroviral (ARV) treatment and influence adherence to treatment. Using a qualitative research design; I conducted an ethnographic study at and through the referral clinic at the Tygerberg Hospital in Cape Town; South Africa. Ninety-three adult patients (75 women) participated in the study; 32 of whom were visited at home to conduct semi-structured in-depth interviews; and 61 of them participated in a cross-sectional study at the referral clinic using researcher-administered questionnaires. A general inductive approach was used to analyse the data. Participants in both arms of the study disclosed mainly to family members; then partners and then to friends and other persons; only five had not disclosed to anyone at all. In deciding to disclose or not; the author began to see how patients negotiated their disclosure. From weighing up other people's reactions; to being concerned about the effect of their disclosure on their disclosure targets; to concealing one's status to evade untoward negative reactions towards themselves. Further; negotiating one's disclosure is not only about to whom or how to disclose; it also means finding good opportunities to disclose or conceiving ways of hiding one's status and/or medication from others in order to enhance access and adherence to their ARV treatment. Perceived rather than actual stigma played an important role in decisions not to disclose. Nonetheless; HIV remains a highly stigmatising disease. The author suggests that both the gains in support and the evasion of negative reactions from the disclosure will continue to drive negotiation of disclosure of one's status in order for patients to access and remain adherent to their treatment. Thus; areas of disclosure and concealment as they influence one's adherence to treatment need to be investigated further to facilitate adherence to treatment

Experience of stigma and discrimination and the implications for healthcare seeking behavior among people living with HIV/AIDS in resource-limited setting

Background: Stigma and discrimination can limit access to care and treatment services. Stigma hides HIV from the public; resulting in reduced pressure for behavioral change. For effective behavior change; empirically grounded and theory-based behavioral change approaches are fundamental as a prevention interventions directed on decreasing stigma and discrimination. The objective of the study was to assess the experience of stigma and discrimination on the psychosocial and health care seeking behavior of people living with HIV/AIDS (PLHIV) in Arba Minch; Ethiopia. Methods: This study uses qualitative methods involving focus-group discussions and in-depth interviews conducted in Arba Minch town and nearby Kebeles. Our sample consisted of PLHIV and other key informants who were purposively selected. Data were analyzed manually using thematic content analysis framework. Results: It appears that the magnitude of stigma and discrimination in the area has decreased to a considerably lower level; however; the problem's severity is still being influenced by various factors including: current residence; disclosure status and level of community's awareness about HIV/AIDS. Care and support services provided to PLHIV were well accepted by the respondents and the majority of them were willing to make use of any service available. Health information messages that have been disseminated to the public through mass media since the start of the epidemic in 1984 and AIDS cases in 1986 have played a significant role regarding the current prevailing problem of stigma and discrimination of PLHIV. Conclusion: Stigma and discrimination have come to a level that can be tolerated by most PLHIV that live in this region; especially those who have disclosed their HIV status and were living in urban areas. This calls for a strategy that improves the rates of serostatus disclosure after HIV counseling and testing and strengthens and integrates activities in the task of expanding care and support activities

Perception of HIV/AIDS Among the Igbo of Anambra State; Nigeria

Perception is fundamental in the fight against stigmatization of people living with HIV/AIDS (PLHIV). Perception generally influences discriminatory attitudes towards PLHIV which exacerbates their problems and quickens the degeneration of the disease from HIV to AIDS. This study examined the Anambra people's perception and knowledge of HIV/AIDS with the goal of creating knowledge on these issues in order to design effective intervention programmes towards the reduction of social stigmatization associated with the pandemic. The study was carried out in Idemmili North and Oyi local government areas of Anambra State. Qualitative and quantitative methodologies were used to elicit information from respondents who were adult males and females of 18 years and above. The research instruments were questionnaires and in-depth interview schedule. Questionnaires were administered on 1000 respondents while 13 people were interviewed in-depth. Analysis of quantitative data were conducted by using the Statistical package for Social Sciences. Univariate analysis in the form of frequencies were conducted which generated the distribution of respondents across the research variables. Furthermore; multivariate analysis were conducted to test the hypotheses and sought for relationships among variables. The qualitative data were reported in themes based on the research objectives and were analysed jointly with the quantitative data. The findings were that majority of the respondents viewed HIV/AIDS as a disease that afflict immoral people and as a punishment from God. Only a handful of them saw the disease as a disease that could afflict anybody. Also; many of the respondents said that AIDS is real but showed a low level of knowledge. It was further indicated that there were significant relationships between educational level; sex; occupation; income influence perception and peoples' reactions to HIV positive status of a relative while there were no significant relationships between these variables and knowledge of HIV/AIDS. It was concluded that these negative perceptions were as a result of the people's low level of knowledge and cultural belief systems; which see a strange illness as punishment from God for disobedience. Furthermore; the fact that most of the socio-economic characteristics of the respondents had significant relationship with perception and reaction to HIV was an indication that most people in the study area had a uniform perception. It was also an indication that government HIV/AIDS awareness programmes were not effective. It was recommended that strategies for effective HIV educational programme should be sought and carried out in the study area. Effective intervention programme have the power to change behaviours and would likely change the people's negative perception and low level of knowledge of HIV/AIDS; thereby reducing stigmatization of people living with HIV/AIDS

Perceptions of the Availability and Effectiveness of HIV/AIDS Awareness and Intervention Programmes by People with Disabilities in Uganda

The World Health Organization has recommended collaborative activities between TB and HIV programmes with routine counselling and testing for HIV among TB patients in order to improve the uptake of HIV services. We carried out qualitative research interviews with 21 TB patients in four selected TB and HIV/AIDS treatment centres in the Northwest Region of Cameroon to explore the facilitators and barriers to HIV testing. The desire to be healthy and live longer from knowing one's status inspired by the anticipated support from loved ones; faith in a supreme being; influence and trust in the medical authority; encouraged HIV testing. Men also demonstrated their masculinity by testing; thus portraying themselves as positive role models for other men. Meanwhile; the overwhelming burden of facing both TB and HIV simultaneously; influenced by the fear of disclosure of results; harmful gender norms and practices; fear of stigma and discrimination; and misconceptions surrounding HIV/AIDS deterred HIV testing. However; as a result of conflicting emotional experiences regarding to test or not to test; the decision-making process was not straightforward and this complex process needs to be acknowledged by health care providers when advocating for routine HIV testing among TB patients