Beaudrap Pierre de auteur aut IRD Beninguisse G. auteur aut IRD Moute C. auteur aut IRD Temgoua C. D. auteur aut IRD Kayiro P. C. auteur aut IRD Nizigiyimana V. auteur aut IRD Pasquier E. auteur aut IRD Zerbo A. auteur aut IRD Barutwanayo E. auteur aut IRD Niyondiko D. auteur aut IRD Ndayishimiye N. auteur aut IRD text journalArticle eng text/pdf reformatted digital access Background: In resource-limited contexts, available data indicate that people with disability are disproportionally affected by the HIV epidemic. While disability resulting from chronic HIV infection has received some attention, few epidemiologic studies have examined the vulnerability of people with disability to HIV acquisition. The aims of the study were as follows: to estimate and compare HIV prevalence among people with and without disability living in Bujumbura, Burundi; to examine how the interaction among disability, gender and socioeconomic environment shapes vulnerability to HIV; and to identify potential pathways to higher HIV risk. Methods: In 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. Findings: 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). Higher HIV prevalence was observed among women with disability (12.1% [8.2-16]) than among those without (3.8% [1.7-6], ORa 3.8, p<0.0001), while it was similar among men with disability and those without (p = 0.8). Women with disability were also at higher risk of sexual violence than were those without (ORa 2.7, p<0.0001). The vulnerability of women with early disability to HIV was higher among those who were socially isolated (HIV prevalence in this group: 19% [12-27]). In addition, education level and sexual violence mediated 53% of the association between early disability and HIV (p = 0.001). Interpretation: This study highlights how the intersection of disability, gender and social environment shapes vulnerability to HIV. It also shows that the vulnerability to HIV of women who grew up with a disability is mediated by sexual violence. specialized Disability HIV Sexual violence Gender Intersection Sub-Saharan African BURUNDI AFRIQUE SUBSAHARIENNE BUJUMBURA 056 052 25 100477 [12 ] 2020 2589-5370 https://www.documentation.ird.fr/hor/fdi:010081394 10.1016/j.eclinm.2020.100477 2589-5370 [F B010081394] https://www.documentation.ird.fr/hor/fdi:010081394 https://horizon.documentation.ird.fr/exl-doc/pleins_textes/2021-06/010081394.pdf IRD - Base Horizon / Pleins textes 2021-06-15 2025-02-24 fdi:010081394 fre