The HIV epidemic in Haiti: is disability a factor?

People with disabilities (PWD) are thought to be low risk for HIV because of social norms regarding disability and sex. However, qualitative studies indicate they are at risk and are not being reached by HIV programs. The Demographic and Health Survey (DHS) conducted in Haiti in 2016 included HIV biomarker data and disability status. Crude and adjusted odds ratios were calculated using a disability severity indicator as the independent variable and HIV infection as the dependent variable. Covariates were selected based on theory and previous studies. Individuals reporting milder disabilities had a higher odds of HIV infection in the crude model (OR:1.65; CI: 1.16-2.34) and those adjusted for demographics (OR:1.73; CI:1.19-2.51) and sexual activity (OR:1.60; CI:1.06-2.42). Those with moderate and more severe disabilities have the same odds of HIV infection as the general population. PWD are HIV-positive and at risk of HIV infection. Based on this, it is essential that HIV education, testing, and treatment programs are inclusive of PWD. Accessible HIV education materials need to be created. HIV testing programs should involve PWD in planning and implementation. Providers of HIV care must be trained regarding the needs of PWD for reproductive healthcare.

Experiences of gender based violence and help seeking trends among women with disabilities: an analysis of the demographic and health surveys.

Women with disabilities are more likely to experience violence than women without disabilities and there is a critical gap in research regarding this topic. This study uses Demographic and Health Survey (DHS) data to analyse the association between disability and experiences of gender-based violence (GBV) and help-seeking behaviour among women in Haiti, Pakistan, Timor Leste, and Uganda. These countries were chosen because they are representative of the regions where the DHS is conducted and include questions about GBV and disability. The data was analysed based on recommendations from the Washington Group using a disability severity indicator. Logistic regression was the primary method of analysis. Generally, we found women with disabilities had the same or greater odds of experiencing GBV and had the same or lower odds of help-seeking. Given women with disabilities are at least at equal risk of experiencing GBV, it is imperative that programs be developed that are accessible to all women regardless of functional limitations. Also, additional research is needed to determine if there are differences by disability type, if intersectionality is relevant, and to include more unmarried women.

Use of Universal Design for Learning Principles in a Public Health Course.

Background: Universal Design in Learning (UDL) is a pedagogical framework that increases accessibility in the classroom for students by offering structured flexibility regarding coursework. The main tenets of UDL are to: 1. provide multiple means of engagement; 2. provide multiple means of representation; and 3. provide multiple means of action and expression. Objective: This study aims to determine if students will use the extra options inherent in UDL if offered and if they are satisfied with the course that uses UDL. Methods: This study evaluates a maternal health course for first-year students that was designed using UDL principles and taught at Boston College in the spring semester of the 2021-22 academic year. The course included 26 students. Surveys and a focus group were used to gather both qualitative and quantitative data. Findings: All technological tools and learning options offered were used by at least some of the students. The majority of students submitted assignments via alternative format options and used non-traditional learning materials like podcasts and videos. Students rated their satisfaction with the course highly. During the focus group, students expressed that they appreciated the increased flexibility of having multiple ways to learn and show the knowledge they had acquired. Conclusions: UDL can work in an undergraduate-level public health course. Students learn well and are satisfied with courses when UDL is used for course design. Additional research needs to be done to determine if learning outcomes are impacted by the use of UDL and if UDL could be used in graduate-level public health courses as well.