HIV Burden and Service Gaps among People with Disabilities in Low- and MiddleIncome Countries: A Systematic Review
1
Systematic Reviews Network (SRN), Calabar, Nigeria
Popul. Med. 2026;8(Supplement Supplement 1):A3088
ABSTRACT
BACKGROUND:
People with disabilities (PWD) are increasingly recognized as a population facing heightened vulnerability to HIV, yet they remain underrepresented in HIV surveillance, research, and programming. This systematic review synthesizes evidence on HIV prevalence, service uptake, risk factors, and structural barriers among people with disabilities in low and middle income countries (LMICs).
METHODS:
We conducted a comprehensive literature search of PubMed, Scopus, Web of Science, and Global Health in December 2025. Two reviewers independently screened studies, extracted data on HIV outcomes, risk factors, and barriers, and conducted quality appraisal. Due to heterogeneity in study designs and disability definitions, findings were synthesized narratively and organized by outcome domains.
RESULTS:
Thirty studies published between 2010 and 2023 were included, with most conducted in sub-Saharan Africa, including Cameroon, Burkina Faso, Uganda, Ethiopia, South Africa, Malawi, Nigeria, and Zambia. Most studies used cross sectional population based designs and commonly applied the Washington Group Short Set to define disability. Overall study quality was moderate to high. HIV prevalence among people with disabilities ranged from 4.6 percent to 6.5 percent in population based studies and was consistently higher than among people without disabilities. HIV testing uptake was suboptimal, with several studies reporting significantly lower testing among people with disabilities. For example, only 53.2 percent of youth with disabilities in Ethiopia had ever tested for HIV. Qualitative evidence identified persistent barriers including poverty, low educational attainment, inaccessible health facilities, transportation costs, food insecurity, and stigma within healthcare settings. Disability related stigma intersected with HIV related stigma, contributing to delayed testing, disengagement from care, and psychosocial distress.
CONCLUSIONS:
People with disabilities in LMICs experience a substantial HIV burden alongside persistent structural and social barriers to prevention, testing, and care. Disability inclusive surveillance, accessible HIV services, and integrated social protection responses are urgently needed to achieve equitable HIV outcomes.
People with disabilities (PWD) are increasingly recognized as a population facing heightened vulnerability to HIV, yet they remain underrepresented in HIV surveillance, research, and programming. This systematic review synthesizes evidence on HIV prevalence, service uptake, risk factors, and structural barriers among people with disabilities in low and middle income countries (LMICs).
METHODS:
We conducted a comprehensive literature search of PubMed, Scopus, Web of Science, and Global Health in December 2025. Two reviewers independently screened studies, extracted data on HIV outcomes, risk factors, and barriers, and conducted quality appraisal. Due to heterogeneity in study designs and disability definitions, findings were synthesized narratively and organized by outcome domains.
RESULTS:
Thirty studies published between 2010 and 2023 were included, with most conducted in sub-Saharan Africa, including Cameroon, Burkina Faso, Uganda, Ethiopia, South Africa, Malawi, Nigeria, and Zambia. Most studies used cross sectional population based designs and commonly applied the Washington Group Short Set to define disability. Overall study quality was moderate to high. HIV prevalence among people with disabilities ranged from 4.6 percent to 6.5 percent in population based studies and was consistently higher than among people without disabilities. HIV testing uptake was suboptimal, with several studies reporting significantly lower testing among people with disabilities. For example, only 53.2 percent of youth with disabilities in Ethiopia had ever tested for HIV. Qualitative evidence identified persistent barriers including poverty, low educational attainment, inaccessible health facilities, transportation costs, food insecurity, and stigma within healthcare settings. Disability related stigma intersected with HIV related stigma, contributing to delayed testing, disengagement from care, and psychosocial distress.
CONCLUSIONS:
People with disabilities in LMICs experience a substantial HIV burden alongside persistent structural and social barriers to prevention, testing, and care. Disability inclusive surveillance, accessible HIV services, and integrated social protection responses are urgently needed to achieve equitable HIV outcomes.
| eISSN: | 2654-1459 |
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