Improving HIV/AIDS Awareness and HTC among People with Visual Impairments (PWVI) and the Deaf & the Hearing Impaired".

1. The 2nd HIV Capacity Building Partners’ Summit
Increasing Access to HIV/AIDS
To: 'abstracts@hivcapacityforum.org
Prevention, Treatment and Support
for PWDs in Kenya
RATN FUNDED INSTANT PROJECTS
19th -21st March 2013
Johannesburg, South Africa
Presenter – Cecilia Rachier - KAPC

2. Abbreviations
• KAPC – Kenya Association of Professional Counsellors
• PWHI – Persons with Hearing Impairment (including
Deaf)
• PWVI – Persons with Visual Impairment (including Blind)
• HCWs – Health Care Workers
• BSL – Basic Sign Language, SL – Sign Language
• SLI – Sign Language Interpreting
• PE – Peer Educators , PEL – Peer Educator Leaders
• DEK – Deaf Empowerment Kenya
• KSB – Kenya Society for the Blind

3. KAPC
A registered NGO since 1991. Programs include:
• Professional counselling and supervision
training, services and consultancies
• Membership Association and conferences
• Employee Assistance Programs (EAP)
• HIV/AIDS prevention work – through
counselling services, training, consultancies,
research, projects and contribution to policies
in Kenya and ESA region. RATN MI since 1995
• PWDs counselling services, training, projects

4. PWDs in Kenya:
Statistics for the 3 highest disabilities
Total Male Female
1 Physical 337,212 169,217 167,995
2 PWVI 331,593 153,781 177,812
3 PWHI 187,816 89,842 97,974
KAPC has worked with all the above 3 disabilities

5. PWDs Increased Vulnerability to
HIV/AIDS because of:
• Barriers to health information and services
due to restrictive cultural norms, stigma and
prejudice. Also mobility problems and
difficulty following audio/visual messages
• High poverty levels, low education,
unemployment, low self esteem, negative
attitudes by employers and the society,
discrimination, risk of sexual and other abuse
• Invisibility of PWDs in many programs
• Most interventions not disability friendly

6. UN Convention on Rights of PWDs
• Discourages viewing PWDs as ‘objects’ of
charity, medical treatment and social
protection and encourages viewing them as
‘subjects’ with rights, who are capable of
claiming those rights and making decisions for
their lives based on their free and informed
consent as well as being active members of
society. It reaffirms that all PWDs must enjoy
all human rights and fundamental freedoms.

7. KAPC PWDs Projects for PWHI&VI:
Objectives
• Improve/ increase HIV/AIDS awareness, HTC
and other health care services access and
uptake for PWD’s - specifically PWHI and VI
• Empower PWDs to protect themselves
• Greater involvement of PWDs
• Advocate for PWD enjoyment of health rights
• Obtain statistics regarding the number of
PWHI and VI seeking HIV/AIDS services.
• Create awareness of PWDs’ needs and plight
• Network with partners – All signed MOUs

8. Project 1: Increasing access and uptake of HTC and
other health care services for PWHI by integrating HTC
for PWHI in Government Health Centres
• 1 year project done in 2 phases in 2011/12 in
4 H/centres in 3 Nairobi districts
• 10 HCWs from 4 H/Centres trained in BSL&SLI
• 10 HIV/AIDS counsellors with HI from around
the 4 H/Centres trained in HTC & health topics
• Then deployed in the 4 H/centres to provide
HTC services to PWHI
• HTC counsellors supervised monthly by KAPC
• DEK assisted in mobilising PWHI community

9. Project 2: Increasing HIV/AIDS awareness
among PWVI through Peer Education by PWVI.
• The 6 months project began in Nov 2012
targeting PWVI around Nbi, Eld, Ksm and Msa
• 24 participants (20 PWVI PEs and 4 sighted
PELs) from the 4 towns trained in Nairobi on
HIV/AIDS Peer Education for PWVI using
Braille
• The 24 trained PEs and PELs returned to the 4
towns to provide HIV/AIDS peer education to
PWVI with support from KAPC branch offices
• KSB assisted in mobilising PWVI community

10. Successes: General
Project 1 and 2
• Improved HIV/AIDS awareness and increased
access and uptake of HTC and other health
services by PWDs
• Improved communication and acceptance
between persons with and without disabilities
• PWDs confidence, self esteem and CV boosted
• HIV AIDS statistics for PWDs obtained
• Disability-friendly services acknowledged
• Networks established and partners benefited

11. Successes: Specific
Project 1
• Increased access and uptake of HTC and other
Health services by the PWHI.
• Client confidentiality enhanced
• 737 persons accessed HTC services (432 in
phase 1 and 305 in phase 2)
• 25 tested HIV positive (12 in ph 1, 13 in ph 2)
• Counsellors/clients follow up at their homes
• Intervened and referred clients for better care

12. Successes: Specific
Project 1 cont.
• PWHI empowered to seek additional services
e.g. Assessments, NCPWD registration
• Capacity of PWHI in HTC/health provision built
• HCWs capacity to work with PWHI built
• Review of KAPC curriculum for PWHI HIV/AIDS
certificate and HTC courses
• KAPC trainers and staff trained in SL
• Adoption of the PWHI services by others
• DEK got Global funds to train HCW in SL
• Phase 2 funded after end of phase 1

13. Successes: Specific
Project 2
• Increased access to HIV/AIDS information
among PWVI in Nbi, Ksm, Msa and Eld
• Many embraced condoms and HTC services
• 577 PWVI seen in the four sites by Feb 2013
• 7 HIV turned positive and referred for care
• PWVI PE more knowledgeable in HIV/AIDS
• PWVI PEs self esteem, CV, confidence to leave
their houses and to speak in public boosted
• HIV/AIDS information gap in PWVI bridged
• KAPC got braille HIV/AIDS manuals from KSB

14. Successes: specific
Project 2 cont.
• Many PWVI empowered to seek more services
e.g. Braille, white cane orientation and
mobility classes, scholarships and business
• Some requested Brailed bibles -KUB to
provide
• Some needy PWVI children referred to EARC
(Educational Assessment and Resource
Centre) and school placement.
• One joined form 1 at St. Francis school,
another joined Mitoto integrated primary.

15. Challenges: General
Project 1 and 2
• Inadequate referral points for HIV positive
PWHI and VI
• Access to support difficult – cost implications
• Communication and language barrier with
PWHI and PWVI due to illiteracy, no
knowledge of Braille, SL, SLI, English, Kiswahili,
• Inadequate HIV/AIDS brailed resources for
PWVI and inability to afford SLI for PWHI
• Mobility issues due to difficulty to access/ use
white canes, paying guides, distance, weather

16. Challenges: General
Project 1 and 2 cont.
• Delay in getting phase 2 funds and closure of
one centre disrupted & reduced PWHI intake
• Closure of one H/Centre in Ph 2 affected PWHI
clients from 4 surrounding estates
• PWVI PEs felt they need more HIV/AIDS
knowledge for competence in the field
• PWVI dealing with others’ negative attitude
• Dependency –having others write their report
• High cost of doing PWDs training and projects
• Difficulty in accessing more funds for projects

17. Lessons learnt: General
• Involving the PWDs in providing services for
other PWDs, reduces stigma, increases
acceptance and understanding – PWDs also
worked with non PWDs clients.
• Integrating HTC services for PWHI in Health
centres using PWHI HTC counsellors increases
uptake by PWHI client and withdrawing them
reduced their uptake of the health services
• PWVI able to reach other PWVI with HIV/AIDS
information through Peer education
• Mobility problems hinder PWVI access/uptake

18. Lessons Learnt: General
• Sign language and Braille are essential for
communicating with PWHI and PWVI
• Training HCWs in BSL and SLI and PWHI
counsellors in HTC reduces communication
barriers and improves confidentiality and
privacy for PWHI patients and clients.
• Poor follow up of HIV+ PWHI–language barrier
• Statistics show more females PWDs than
male
• PWDs have special needs not addressed by
projects and which need budgets and funding

19. Recommendations
• Scale up and continuity of the projects
• Accessible support groups for HIV+ PWDs
• Train HCWs, other professionals, affected
parents, community members and school
children in BSL and SLI and Braille
• Train and involve PWDs in HIV/AIDS work
• Academic and professional training for PWDs
• Disability-friendly services and opportunities
• Fund disability friendly HIV/AIDS programs
• Address gender issues in PWDs

20. Conclusion and Way Forward
• The PWHI and VI projects includes, involves
and empowers PWDs to protect themselves
and others from getting and suffering from
HIV/AIDS and should be replicated in other
countries and organisations.
• Hopefully this project will help people gain
insights into and start to address the area of
disabilities and HIV/AIDS in their respective
countries.
• KAPC continues disseminating project findings
• KAPC continues search for partners/funds

21. A Deaf HTC Counsellor testing a client
at one of the Health Centres.

22. Blind Peer Educators and Leaders
during their training in KAPC