@article{fdi:010081394,
  title = {{T}he multidimensional vulnerability of people with disability to {HIV} infection: {R}esults from the handi{SSR} study in {B}ujumbura, {B}urundi},
  author = {{B}eaudrap, {P}ierre de and {B}eninguisse, {G}. and {M}oute, {C}. and {T}emgoua, {C}. {D}. and {K}ayiro, {P}. {C}. and {N}izigiyimana, {V}. and {P}asquier, {E}. and {Z}erbo, {A}. and {B}arutwanayo, {E}. and {N}iyondiko, {D}. and {N}dayishimiye, {N}.},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground: {I}n resource-limited contexts, available data indicate that people with disability are disproportionally affected by the {HIV} epidemic. {W}hile disability resulting from chronic {HIV} infection has received some attention, few epidemiologic studies have examined the vulnerability of people with disability to {HIV} acquisition. {T}he aims of the study were as follows: to estimate and compare {HIV} prevalence among people with and without disability living in {B}ujumbura, {B}urundi; to examine how the interaction among disability, gender and socioeconomic environment shapes vulnerability to {HIV}; and to identify potential pathways to higher {HIV} risk. {M}ethods: {I}n this cross-sectional population-based study, 623 persons with disability (302 with disability onset <= 10 years ["early disability"]) and 609 persons without disability matched for age, sex and location were randomly selected to be tested for {HIV} and to participate in an interview about their life history, their social environment and their knowledge of sexual health. {F}indings: {A} total of 68% of men and 75% of women with disability were affected by multidimensional poverty compared to 54% and 46% of their peers without disability (p<0.0001). {H}igher {HIV} prevalence was observed among women with disability (12.1% [8.2-16]) than among those without (3.8% [1.7-6], {OR}a 3.8, p<0.0001), while it was similar among men with disability and those without (p = 0.8). {W}omen with disability were also at higher risk of sexual violence than were those without ({OR}a 2.7, p<0.0001). {T}he vulnerability of women with early disability to {HIV} was higher among those who were socially isolated ({HIV} prevalence in this group: 19% [12-27]). {I}n addition, education level and sexual violence mediated 53% of the association between early disability and {HIV} (p = 0.001). {I}nterpretation: {T}his study highlights how the intersection of disability, gender and social environment shapes vulnerability to {HIV}. {I}t also shows that the vulnerability to {HIV} of women who grew up with a disability is mediated by sexual violence.},
  keywords = {{D}isability ; {HIV} ; {S}exual violence ; {G}ender ; {I}ntersection ; {S}ub-{S}aharan {A}frican ; {BURUNDI} ; {AFRIQUE} {SUBSAHARIENNE} ; {BUJUMBURA}},
  booktitle = {},
  journal = {{EC}linical{M}edicine},
  volume = {25},
  numero = {},
  pages = {100477 [12 ]},
  ISSN = {2589-5370},
  year = {2020},
  DOI = {10.1016/j.eclinm.2020.100477},
  URL = {https://www.documentation.ird.fr/hor/fdi:010081394},
}