🔴 MYTH

Current evidence is sufficient to guide disability-inclusive HIV programmes.

What does this mean?

Evidence informs decision-making. When important areas remain under-researched, it becomes difficult to design, implement, and evaluate HIV services that are fully responsive to the needs of persons with disabilities.

What did the evidence show?

• Important evidence gaps were identified across HIV testing, treatment, long-term care, implementation, and monitoring.

• Several disability groups and geographic regions remain underrepresented in the literature.

• These gaps limit the evidence available to support disability-inclusive HIV programming.

🟢 REALITY

The burden of inclusion should never fall on women and girls with disabilities, it should be built into HIV services.

What does this mean?

Disability inclusion is a shared responsibility of health systems, policymakers, programme managers, and healthcare providers. Women and girls with disabilities should not have to advocate for basic access to HIV services, they should be able to expect it.

What did the evidence show?

• The review found that disability inclusion depends on health-system adaptations rather than individual effort.

• Achieving disability-inclusive HIV services requires coordinated action across communication, service delivery, policy, implementation, and monitoring.

• The evidence highlights the importance of embedding disability inclusion into the design and delivery of HIV programmes, not treating it as an optional add-on.

🔴 MYTH

The assumption that HIV services designed for the general public inherently cater to the needs of women and girls with disabilities is incorrect.

What does this imply?

Creating HIV services for all does not guarantee that they will be accessible or inclusive for everyone. Women and girls with disabilities may need tailored communication, reasonable adjustments, services that respond to their disabilities, and fair chances to access HIV programs.

What did the research reveal?

• It cannot be presumed that disability inclusion is achieved merely because HIV services are aimed at the general population.

• The review highlighted significant deficiencies in how disability inclusion has been examined among various demographics and stages of HIV care.

• These gaps in evidence underscore the necessity of deliberately crafting HIV programs that acknowledge varied needs instead of assuming a one-size-fits-all solution.

🔴 MYTH

Evidence on disability-inclusive HIV services is evenly distributed across the HIV care continuum.

What does this mean?

Research helps us understand where HIV services are working well and where improvements are needed. However, the available evidence is concentrated in some areas of the HIV care continuum, while other stages have received little or no research attention.

What did the evidence show?

• Most studies focused on HIV prevention, education, and information access.

• Very few studies examined HIV testing, treatment, or ART adherence.

• No eligible studies investigated retention in care, viral suppression, HIV self-testing, PrEP, differentiated service delivery, or prevention of mother-to-child transmission (PMTCT).

🟢 REALITY

Most barriers to disability-inclusive HIV services originate within health systems rather than from disability itself.

What does this mean?

Many barriers to HIV services arise from how health systems are designed and delivered not from disability itself. Inaccessible communication, stigma, inadequate provider training, and limited disability-responsive services can prevent equitable access to HIV care.

What did the evidence show?

• Most reported barriers were structural and health-system related.

• Common barriers included inaccessible communication, stigma and discrimination, inadequate provider preparedness, transportation challenges, weak disability-responsive programming, and limited policy implementation.

• The review also identified facilitators, including provider training, accessible communication, disability-responsive service models, and stronger implementation of inclusive policies.

🔴 MYTH

Communication accessibility is just one small part of disability inclusion.

What does this mean?

Communication accessibility is fundamental to disability-inclusive HIV services. When health information and services are not provided in accessible formats, persons with disabilities may face barriers to understanding HIV information, making informed decisions, and accessing appropriate care.

What did the evidence show?

• Communication accessibility was the most consistently reported dimension of disability inclusion.

• Studies found lower HIV knowledge, reduced access to HIV information, and exclusion from mainstream communication channels among persons with disabilities.

• Accessible communication including disability-adapted materials and sign language support was identified as a key facilitator of inclusive HIV services.

🟢 REALITY

Without disability-disaggregated data, inequalities in HIV services may go unnoticed.

What does this mean?

To improve equity, health systems need to know who is being reached and who is being left behind. Collecting and reporting disability-disaggregated data helps identify disparities in access, service use, and outcomes, enabling more inclusive HIV programmes.

What did the evidence show?

• Few studies reported disability-disaggregated outcomes.

• No Nigerian study has examined disability-disaggregated outcomes for key HIV indicators such as treatment initiation, ART adherence, retention in care, or viral suppression.

• Limited disability-disaggregated data make it difficult to monitor whether HIV services are reaching persons with disabilities equitably.

🟢 REALITY

Without disability-disaggregated data, inequalities in HIV services may go unnoticed.

What does this mean?

To improve equity, health systems need to know who is being reached and who is being left behind. Collecting and reporting disability-disaggregated data helps identify disparities in access, service use, and outcomes, enabling more inclusive HIV programmes.

What did the evidence show?

• Few studies reported disability-disaggregated outcomes.

• No Nigerian study has examined disability-disaggregated outcomes for key HIV indicators such as treatment initiation, ART adherence, retention in care, or viral suppression.

• Limited disability-disaggregated data make it difficult to monitor whether HIV services are reaching persons with disabilities equitably.

🔴 MYTH

Having an HIV policy automatically leads to disability-inclusive services.

What does this mean?

Having a policy is an important first step, but it does not guarantee that HIV services are inclusive in practice. Disability inclusion depends on how policies are implemented through accessible services, trained healthcare providers, adequate resources, and accountability.

What did the evidence show?

• Evidence on disability-inclusive policy implementation was limited.

• Existing studies identified weak implementation, inadequate funding, limited healthcare worker training, and insufficient disability-responsive programming.

• Few studies examined how HIV policies translated into inclusive service delivery for persons with disabilities.

🟢 REALITY

Disability inclusion must extend beyond HIV prevention to the entire HIV care continuum.

What does this mean?

Disability-inclusive HIV services should support people throughout the entire continuum of care from prevention and HIV testing to treatment, long-term care, and viral suppression. Inclusion is not complete if people can access information but face barriers to diagnosis, treatment, or ongoing support.

What did the evidence show?

• Most research focused on HIV prevention and education.

• HIV testing, treatment, ART adherence, and viral suppression received much less attention.

• Important evidence gaps remain across the HIV care continuum.

HEAR HER - MYTH VS REALITY

AN EVIDENCE-TO-ACTION GUIDE ON DISABILITY-INCLUSIVE HIV SERVICES

HEAR HER: Myth or Reality? is an interactive Evidence-to-Action Guide developed by the Stellaheart of Passion Foundation to challenge common misconceptions about disability inclusion in HIV services. Drawing on findings from our Evidence Gap Review, this activity invites participants to distinguish myths from realities, explore the evidence, and reflect on how HIV programmes can become more accessible, equitable, and inclusive for women and girls with disabilities. Together, we move beyond assumptions and towards evidence-informed action that leaves no one behind.

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