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- [00:00]
A
Glubber, glubber, glubber, glubber, glubber. On the one hand they fund the lecture series, on the other hand, they have funded over the last five years a series of large research consortia. And Dr. Turore is one of the researchers on one of the research consortia called abba, which means that if you look it up on the web, you're likely to get all kinds of other things as well as this, and that is addressing the balance of burden of aids. And one of my colleagues, two of them are actually applauding me for getting it right. Now, the point of that particular acronym and that particular title, the Research Consortium, is that it is looking at the way in which the social, economic and other effects of an AIDS epidemic affects differentially different sections of the population. And tonight's speaker, Dr. Sam Turore, is going to speak about HIV, AIDS and disability in Kenya. And we're very lucky to have Sam here. I have to remind myself from a piece of paper of all the things that he hears and he has done. He is a Human Rights Commissioner in Kenya. He's also a lecturer at Moi University where he is in the School of Public Health and he teaches Health economics. He's principal investigator for the area of research under the DFID program on people with disabilities and hiv. But most importantly of all, he is also an LSE and a London School of Hygiene and Tropical Medicine graduate. So yes, we should have a special sort of scattering of applause for that. So it's my enormous pleasure to introduce Dr. Sam Turore.
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B
Good. Hamjambo. Oh, you know a lot of Kiswahili here. Yeah, that makes me quite comfortable. And especially since we've come here to share ideas and I see that in Kenya we are very good at sharing ideas. You see, you have learnt, you from the UK here have learnt from us how to organize grand coalitions. So now you have a grand coalition of your own. Now you need to learn a few more political, some more political vocabulary, so that the two people that have gotten their parties into a coalition from now on are called the two principles. That's what we call them back at home. So Mr. David Cameron and Mr. Nick Clegg are the two principles who will teach you a bit of political jargon of coalitions, of not so like minded. And that's why I'm excited this evening and what we are going to talk about, I think already our first slide will be indicating that we want to talk about hiv, AIDS and disability. And we want to share with you some of the new findings that we are getting from Kenya. And it is very interesting that I got some of these ideas about being a researcher 19 years ago. Perhaps I was sitting in this particular theater. I'm not quite so sure. 19 years is a generation. And we are very happy in Kenya to be able to share with you these findings and to discuss with you. And I will tell you a few more secrets as we go along. Now, in our next slide, we say something a little about aba. But since Tony has already introduced the ABA Consortium, I'll only say in passing that this is one of the great ways in which collaboration can be achieved in doing research. That a group of six different organizations stretching from Europe to America to Africa can sit and agree on addressing a phenomenon together. The ABA Consortium is an inspiration indeed. And I think if the research can attract this kind of talent, I think we shall go very far. The ABA project in Kenya is coordinated by the Regional AIDS Training Network, which is a 25 member institution, Eastern Southern African organization that specializes in training and capacity building in support of HIV AIDS response. And so we are glad to be able to share with you. And the way to start is by first of all reminding those of us, although you answered my greeting in Kiswahili in the next slide to show you where we come from so that you can appreciate how this is so important for us. I think if you look at the map of Kenya, those of you who haven't been there, you will notice that we are not very far from here, but we are not very near either. And the fact that we are able to come and commune together on these issues is indeed exciting. And what we want to really look at is what are the new insights that we are getting out of this work. Now, before we even look at the insights, we have to deal with a very interesting phenomenon. And that is the phenomenon of how we consider ourselves who is a person with a disability. In the next slide, we Two slides, actually, next two slides, we discuss first in the first slide, the traditional definition of disability and by construction also a person with a disability. This definition is based on a medical construction, that is you are disabled if a doctor says certain of your limbs are not functional and that we are no longer able to do anything to restore to restore that function. So you then become classified as a person with a disability. And this definition was brought about by the efforts of the WHO and the ILO and for a long time is actually the basis for most of the statistics that we have. And the disability lobbyists and activists call this the Medical model. They say that disability is medicalized and they are not very much in love with it. So they have constructed a definition which talks about disability being the result of the interaction between a person and the environment. So they say that if you don't have a limb, you are not disabled until your environment prevents you from interacting to the same degree and as a person with that limb. So they say theirs is the social model, the social model of constructing disability so that then in this room we can be very disabled if we were on a wheelchair because of those many steps I came down on. But if there were a ramp and I am on a wheelchair, then I would be able to move and then I wouldn't be disabled. So the stress here is with the interaction between a person and the environment. And it is very important for us to try and understand this debate because it then informed the definition that the un, through the UN Convention on the Rights of Persons with Disabilities, which was the first treaty this century in the UN family, which was passed in 2006, that informed this attempt to bridge between the two divergent definitions. So in slide number five, we provide the text of the UN definition. And the key thing about the UN definition is to recognize the contribution of both these arguments, to recognize that there is something to be gained by understanding the medical offer and the social construction offer. So the UN definition is what we now call the standard definition. And it is hoped that it will bridge all other definitions. And before we leave the area of definitions, let us link this debate with a debate on HIV and aids. Now, you will all note that HIV and AIDS may also cause disability, but it could also affect people with pre existing disabilities. Now, there is growing literature now which started with a debate by o' Brien et al. And which has been carried on by my good friend Jill Hancocks and others, that many people consider that the disability likely to be caused by HIV and AIDS is seen as episodic. That is that it may be permanent, but it may also be temporary. And this concept of disability and linking up with the consequences and effects of HIV and AIDS has brought into light added interest in this field, because then we are seeing a convergence of interests. In fact, I remember that when we were negotiating the UN Convention, at some point there was an attempt to include persons living with HIV and AIDS in the family of persons with disabilities. And there was an interesting debate there because the people living with HIV and AIDS said they were not disabled and the people with disability said they were not sick. So, you know, it was not possible to agree. But indeed, we recognize that AIDS might cause disability, but AIDS might also infect, or people with disabilities might also be infected or be affected by HIV and aids. And we are hoping that this idea of the twin concepts of disability and HIV will attract greater interest, especially from some of you sitting in this hall tonight, this theatre tonight, that we can deepen our understanding about the interaction between HIV and disability. So I hope we have a good case why we should be concerned about HIV and disability. Now, for our sharing tonight, we go to the next slide. Tony. For our sharing tonight, we want to look at various aspects about our experience. We want to discuss some of the issues that we have come across and see if we can broaden some of this understanding. We want to look at what we now know, what is the new evidence, we want to look at what that new evidence, what policy implication it will have, and we want to reflect on where we might want to go from here. Now, when we look at the new evidence, let us first make a note that the research we are talking about in the whole area of HIV and disability, I think the research in this area is just around seven years, eight years old. So it's a very new field of interest. And I was very happy to meet one of the people that put this on the global map, and that is Professor Nora GROSS, WHO In 2004, for the World bank and Yale University, was the first to conceptually put forward the concept of disability and HIV AIDS as a serious field of study. And I think it's most gratifying that she's among the audience tonight. I'm sure you can give her an applause. And in Kenya, the first research effort was done in a small study that was done in 2003, basically on reproductive health. So AIDS wasn't the principal consideration. The initial interest was people with disability and their reproductive health needs. And then it was followed by other studies in 2006 by myself, and then in 2006 also by this ABBA Research Partnership consortium. And so far, the number of studies that we have come across are maybe the research consortium is doing about seven of them and the other people have done one or two. So they are very small number of studies. I think that's the point we are making now. There is something unique about the way the ABA RPC Consortium thinking was designed. The way we decided to run this research was to do it as a policy dialogue right from day one. So that the way we started the research was by calling people with disabilities, through their organizations and other interest groups, to come and set the research agenda for the rpc. So they are the ones that indicated to us what their interests would be. And because of this continuous dialogue between the researcher and the end user of the policy, and then later on with even the policy developer, we were able, for example, to influence the inclusion of a question on HIV and AIDS in the first national survey that was carried out for Kenya in 2007. And through that survey we were able to get the first large response to an HIV AIDS question. The survey interviewed about 3,000, a little over 3,000 people with disabilities, about 2,400 from the rural areas and just a little over 600 from the urban center. And that's the largest sample of people with disabilities ever interviewed on this issue in Kenya. This was a fully full scale national housing survey which was done for disability, and it is the first. Now, after that survey, the disability question was again introduced in the national census, which was done a year later and whose results we are still awaiting. So you can see there is a build up of interest and a build up of information, slow but sure, about this phenomenon. And we are excited that we can share with you that even as we conduct serious research, policy dialogue can continue. So we don't have to wait for research findings before we start influencing policy. The interesting thing was that we had thought that, like the WHO says that 10% of our population would have a disability, when the survey came out, they said it's only 4.6%. So therefore the magnitude of the problem or the magnitude of the people that would be affected would be anything between 2 and 4 million, depending on whether you accept the WHO estimate of 10% or the survey prevalence of 4.6%. And don't be surprised, in Ethiopia, every time they've done a census in the last few times, the prevalence goes lower. So maybe there is something to think about. This week our colleagues have been talking about challenging orthodoxies. Maybe it is time we start challenging whether the WHO estimate is still valid or whether it is time for it to be revised. So that is the first of the issues you have to deal with as a researcher. How many people will be affected by what it is you are trying to do. So for us, it's between 2 million and 4 million. But we have a friend who says that it's not so much a question of counting. What is important is that if there is one human being that can be helped by our effort, we must go for it. And that is why we go for serious HIV research. Now, what are some of the things that all these researchers and we will not confine our findings only to the ABBA study. We will share everything that has come up. What are some of the things that we are seeing when we do our research? Our next slide would show us that there are perceptions that we have been holding. One of the perceptions which came up or which comes up all the time is this myth that people with disabilities cannot possibly be at risk of being infected because, well, they don't know how to be infected. They don't engage in sex somehow because they are disabled. So therefore, even the other systems must be possibly disabled. Maybe that's our myth, and that kind of a myth makes the policymaker think that there is no need for any intervention activity. These guys are asexual. They don't do those things. They are childlike, you know. Now, the first thing we notice once we started the research is that not only is this fallacy, it is a mighty fallacy. People with disability are no less human beings than anybody else. And of all the researchers, including even the survey, the national survey and other research, we believe that people with disabilities are very sexually active. Their sexuality is not in doubt, and they engage in sex for all the reasons that the rest of everybody else engages in. And therefore they are at as much risk of infection as anybody else. And perhaps they are even a little more vulnerable. And they are a little more vulnerable because one of the findings we have is that especially people with intellectual disability get really abused. And the grand abusers are people that ought to be taking care of them. So imagine you're running, you think you're running to safety, and you run into the mouth of a lion. So we've found that a lot of abuse for people with intellectual disability is actually carried out by their families, members of their families, members known to them. And perhaps it is because they know that these people will not be able to tell on them because they will not remember. They will not know. Violations also occur even in other disability groups, in situations where they are unable to run away or something like that. But also, people with disabilities engage in sex sometimes as a way of gaining favor, just like everybody else. Sometimes they engage in sex as a way of retaining or maintaining this good friend who has turned up in their lives because they had been told that they are incapable of getting married. So if a guy turns up and is promising that there is hope here so that the person with a disability feel. Feels constrained to give those favors so that the fellow doesn't disappear. Because if the fellow disappears, how do you find another? So all those pressures kind of make people with disabilities a Little vulnerable. There are also other pressures. For example, some of them might want to show that they are as good as everybody else. And so they might want more than one partner to show that, you know, they are available and they are there. And these multiple partnerships, you know, are also potential for vulnerability. So these are some of the findings that we would like to share with you. The interesting finding is that the vulnerability is not equal. Among all the disability groups. There is differential. And so, again, when we consider interventions, we need to target each disability. We are also showing that in terms of marital relationships, the majority of relationships, about 39% are marital, but almost 70% are non marital relationships, which means that, again, this is a point of vulnerability and we need to address these issues. One of the interesting findings is in terms of stigma, that one would have thought that, you know, people with a disability are already stigmatized. So what happens when disability sets in? And we find that in qualitative research that we are doing, that stigma is a real problem. It really is a problem because people sometimes associate the fact that you may be infected with HIV to your disability, even if the two have nothing to do with each other. And stigma is even more deadly with persons with disabilities, because the persons with disabilities tend to be found amongst the poorest of the poor. So most of even our studies now, most of the people we find are in slum areas, and there are all those vulnerabilities and stigma. And in fact, I remember that one of our researchers reported that there was an elderly lady that was staying with an overgrown son, about 20 something years, but with a severe mental disability, but also very aggressive. And they had to share one little shack, the two of them. And the research assistant was querying how safe that lady was even in the hands of her own son. But what was the alternative? The lady cannot let that son out of her sight because he might be hurt. So these are some of the human angles that we seem to come across. The next slide illustrates for us what we just said about multiple partnerships and the increase that we can get of vulnerability. And you notice that we are reporting that up to 15% of persons with disabilities are in multiple partnerships, or they themselves report multiple partnerships. And out of this deaf report at about 20%, blind at about 11%, persons with physical disability at about 14%. And you notice that people with intellectual disabilities are missing because most of the time, because of methodological issues, they are not able to participate in these studies. What we have done is that we have a special group that are trying to study persons with intellectual disabilities. On their own as part of our ABA research partnership. And that's where we were getting those stories about the. Those vulnerabilities. Now, One of the issues that we normally would look at is why do people, for example, use or not use the messages they receive, for example, prevention messages? We report that, for example, 89% of people with disabilities we have interviewed so far report awareness about HIV and aids. And that is against the national general population average of 98%. And for us, the difference, although it may not look too big, for us, it's big because that percentage difference most likely is made up almost entirely of a given disability group, most likely the persons with intellectual disability. And therefore the fact that they don't know or they are not aware about HIV has a slightly different meaning for us. But what about those who know, for example, and we can use the example of condoms. What are some of the reasons that are given for using or not using condoms? One of our research teams, one of our colleagues, is actually studying deaf youth as youth with hearing impairment. And he has reported findings that 27.6% of deaf youth that he is talking to say they use condoms for prevention of pregnancy. Protection against HIV. AIDS is listed as 29%, 29.1%. Protection against other STIs, 24.8%. Adventure, you know, 6%. But the biggest problem is that whenever we have these questions, these probing questions that ask what your behavior is, the response rate to those questions is really challenging. So that one of the findings we are getting is that there is almost an unwillingness by persons with disabilities to answer certain probing questions. I'm sure this is the case also in the general population, but I think it is a bigger challenge in the case of persons with disabilities, because then you are usually dealing with, with very few numbers or small numbers, and you have quite a bit of reasons.
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C
For.
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B
Why deaf youth, perhaps other people with groups with disabilities, would not like to use condoms. And some have to deal with embarrassment. They don't want to go and be seen buying them. Some say they are expensive, but the main. Others say it's cumbersome. So I don't know how you get to know it is cumbersome before you use it. But the main reasons are those prevention of pregnancy, prevention of other STIs, and prevention of HIV and AIDS, which means that we are getting somewhere in our interventions. If we move to the next slide we do show. Yeah, we try to show slide nine.
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A
What's it called?
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B
Slide nine is hiv, AIDS and disability. So here we are showing the Reported distribution of where the knowledge, the knowledge base is. So for example, the group that know about HIV and AIDS in the rural area, are we there? Yes. Yeah. In the rural area, 82.7. In the urban area, 90.7 out of those. Because this was the large study, I alluded to the question. In the survey, the males are 84% and the females about 84%. Almost 50, 50. Now the most interesting thing is this, that the level of education is very important. Those who report that they only got nursery school education, that is the only he went to nursery. And no further 51% report that they are aware of HIV and AIDS. And those who went to primary school, 85. 88. Sorry. 88.2. Those who are post primary. Those who went beyond primary, 97.4 and those who went beyond secondary, almost 100%. 99.5. And that is repeated for all the other variables. Access the same pattern, access. Prevention or knowing how to prevent and so on. That pattern is repeated. And so since many of the disabled people do not access quality education or do not access any education at all, that is a serious concern for us. It seems that education, and I think this is also true in the general population studies that education is so important in how people are going to use behavior change messages. And so because most disabled people, I think the estimates are that just around 15 to 20% of persons with disabilities get education. And it means we have a serious concern. Sir, the one other thing we have looked at is what is the level of people with disabilities ever getting tested, ever been tested? And this is self reporting. So we have no way of doing anything other than to say we believe them. So those who have ever been tested in the rural area, 13%. In the urban area, 28.5%. Now, again, the same pattern in terms of education. Those who had only nursery level education, 6.9. Those who had some primary education, 14.4. Post primary, 29%. You can see a big difference. And post secondary 46.2%. So you see, the more the education, the more likely a person is to go for testing. The point to note is that the overall percentage of those who are ever tested is some studies give it at 16%, others at 19%. So that range 16 to 19% against the national average of about 39%. So it means about twice as many people with disabilities are not likely to be tested as in the general population. And this is again of concern to us because it means that the people with disabilities may not be testing and we need to find out why. They are not testing. Some of the initial postulations we make is that maybe there are certain difficulties in the issues around confidentiality in initial findings. The service providers tell us that they have issues with confidentiality. Most people with disabilities will go to the clinic accompanied. And you know that the rules of voluntary counseling and testing in Kenya, especially testing, indicate that you can only test somebody who can give consent. So there are issues to do with consent. If you have an intellectual disability, issues of consent become a problem. There are issues of confidentiality because who says that the escort I have gone with ought to know what my status is? They may actually go to Bush House and broadcast to Holland Sundry that I am HIV positive. So I am afraid, so I will not go for testing. These are some of the initial findings that we have come across that we think need further treatment. And finally, we are able to report right now that there are barriers to treatment. And some of these barriers to treatment would include financial difficulties. We have the inaccessibility of services, not so much physical, necessarily. For instance, we are reporting that among people with disabilities who visit health facilities, they rate the doctor 100%, friendly and helpful. They rate the nurse about 56%, 57%. They rate the counselor about 46%. That is interesting for us because why is this councillor, who I thought, or we would have thought would be the most liked? Why are they so lowly rated in terms of being friendly and helpful? These are some of the findings we're coming across and they are cause for further reflection. And as we reflect in the next slide, that really what we require to deal with in disability and HIV AIDS is really to expand our understanding, expand our knowledge of the interface between HIV and disability. We would like to see a situation where a few studies will now take place not only in Kenya, but in the rest of Africa and elsewhere, where all the issues that are being raised by these initial studies in Kenya, Kenya, and as I said, they're only 7 years old, can be, you know, explored, can be explained, can be understood better. Our reflection is to see that in due course, in due course, we achieve a universally accessible environment where all people with disabilities affected or infected by HIV AIDS can receive quality services. And as we conclude, I want to thank all of us for having come and for assisting us, hopefully to achieve universal access of utilization of HIV prevention, treatment, care and support services for people with disabilities everywhere. I want to thank all of us for having come. I want to thank my friend Tony here for inspiring me to come and give this lecture and having faith in me I want to thank Professor Nora Gross for finding time to be with us in this and making my nostalgia quite wonderful. 19 years since I might have sat in this theater listening to somebody. Today I'm sitting, talking, and I want to thank all my ABA colleagues, the dfid, for enabling the ABA process to. To go on, and all of us for clapping for ourselves and saying asante san.
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A
Okay, thank you very much, Sam. We'll take some questions. If you have questions, please say who you are. If you have a significant affiliation to some institution other than your home, whoever.
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B
Please just tell us that as well. It sometimes helps.
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A
Please say there's a microphone coming. Actually, I realize I forgot it and I'm just giving Sam some water.
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B
Is this working? Yes.
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D
My name is Roger Durer. I'm just a member of the public and I found that presentation absolute fascinating. I'm most grateful to you, sir, for having produced it. My question is concern about the issue of reporting. If in Kenya someone goes for an HIV check, if they are in the majority heterosexual, then they risk condemnation of the risk of being caught with hiv, which is not very nice. But if they happen to be homosexual, they risk possibly being imprisoned or even losing their lives, as I understand it, which is not the case in Europe. So I'm wondering whether that would perhaps upset the balance in some way and whether there is any possibility of progress in equality in that sense. Perhaps in the not too distant future.
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B
Maybe. Let me attempt a response and to observe this. First of all, homosexuality in Kenya is outlawed. It's against the law to be gay or lesbian, by the way. It's a law we inherited. We haven't changed yet. But there is a growing interest in the country now, growing debate in the country along the lines of if you require medical attention, surely it is not the doctor's business to know what you are saying. Sexual orientation is. If you come with an infection, the business of the doctor is to treat you and not to ask questions about what your orientation is. And it is a lively debate because I think, as you know, and I'm sure maybe your question is inspired by what is happening next door, where there is now a low to introduce very stiff penalties for homosexuality. So in Kenya, it's not tolerated. In fact, a few, two or so months ago, some fellows who wanted to do a public engagement, same sex engagement, were almost linked by members of the public. But in this instance, law enforcement saved them and they were saved so they were not lynched. But yes, there are those issues where you have certain orientation being made illegal and that makes it very difficult for the medical people to deal or to assist them.
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A
Any other questions? Yes, gentlemen. Oh, lady there, as you're close to the microphone.
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B
Right.
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E
Hi, I'm sue from the London School of Hygiene and Tropical Medicine. From a disability background, you said that there was some antipathy between AIDS groups and the disability groups, which is common in lots of countries. Did you manage to bridge that now and are they working on a conflict common platform?
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B
Unfortunately not. I think the debate is still on and it is good that now it has come to the academic front. I think I've put it for you, o' Brien et al, and Jill Hancocks and others that are bringing these issues now on the academic platform. But at that point when we were negotiating the convention, unfortunately we were not able to bridge that feeling and people with disabilities insisted that they would remain. They didn't want people living with HIV AIDS to be considered as people with disabilities. So it's one of those debates, I think, that will go on a little while before the resolution.
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F
Hi, my name is Niranjan Shaker. I'm from LSE Health. My question is a simple one. In the data for understanding or hiv, it says that there's quite a strong relationship between education and that information, the understanding. So my question is, is it part of the curriculum to learn about HIV and AIDS at any point along.
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A
Education?
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B
No, we don't have HIV and AIDS training in any of our school curricula at whatever level. So it must be assumed, and I think it is the case, that the differential has to do with the intrinsic value of education in this instance. So it's not that they were trained in school about HIV or aids? No, I think it's just to do with that when you have some education, it enables you to better deal with and cope with the challenges of life than if you do not have that education.
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A
And lady at the back, another lady here. Well, this lady here. In this row here. No, this row here. That's it. And then the lady.
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G
Hello, my name is Kyoko, Kyoko Sina. I'm a student of Westminster King College. My question is about the UN Convention of Human Rights with People with Disability. And in terms of education, the UN Convention might be forceful change or in your country, is there any area which is disposition discussed as a first priority for people with disabilities?
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B
I hope I got your question. You are asking whether in my country education is given priority education for people with disabilities.
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A
Naren, would you like to clarify further?
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G
No, I wanted to know whether the UN Convention will change in terms of Education or for the people, among people with disability. Is there any more prioritized issues about using the ratification of the UN Convention?
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B
I think the UN Convention will have its uses in every country. For example, in Kenya, the fact that Kenya has ratified the convention now means that we are a dualist country. So ratification alone doesn't make it part of our law. But we have a Persons with Disabilities act which predated the convention. So there are moves now by people with disabilities in the country to have the act amended to make it or to align it with the UN Convention. And one of the results of that will be that hopefully issues to do with education, rights to education, rights to other services like health, housing and so on will be brought on board. Also in Kenya now we are debating a new constitution. We are going to go to a referendum for a new constitution at the beginning of August. And for the first time, an article exclusively intended for to protect the rights of persons with disabilities is in that constitution. So hopefully, if we manage to pass the new constitution, then for the first time people, the rights of persons with disabilities will be constitutionally enforceable. And I suspect that that must have been a contribution from the UN Convention and the processes that went on to negotiate for it.
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A
And lady there. Yes, that's right, lady with the microphone.
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C
Thank you very much. This presentation has really inspired me to go into more research as it relates to disability. But I'm curious to know how this research and your country is responding or creating linkages between your research findings in the adult population and the orphans and vulnerable children population. The children population, yes, children with disability in particular. What is the relationship in program intervention as it relates to HIV AIDS knowledge, prevention, treatment and care for children affected or infected by HIVs, especially the vulnerable population, I.e. children with disabilities.
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B
At the moment, one of our research teams is actually researching on the contribution of life skills to prevention of HIV AIDS among children with disabilities. That research is still at an early stage. We haven't yet got findings to report, but we believe that when we get the findings, we will be able to negotiate. As I told you, our arrangement is to negotiate with policy, to have a policy dialogue throughout the country with all interested parties. So we are waiting for these findings and we shall negotiate vigorously for policy interventions to the direction where this study will point to so that we can get interventions. But generally the AIDS response services in Kenya have not had a big good enough dose on persons with disabilities. But partly due to our initiating the consortium, the third AIDS National AIDS Plan, National AIDS Action Plan, for the first time again has mentioned and plans to deal with persons with disabilities. So I think the policy dialogue is beginning to bear fruit because once that interest group gets into the national action plan, then the AIDS Control Council, that's the overall body dealing with HIV AIDS response, will then start allocating resources because hitherto no specific resources have been allocated for HIV sensitive, I mean disability sensitive, HIV AIDS response. So that will happen hopefully soon and that will include children.
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A
Lady over there, please.
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H
Thank you. My name is Kim Adams, I'm one of the part time student here, but I've also worked in sexual health in a primary care trust within one of the London burghers.
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A
You've worked in sexual health in the.
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H
Primary care trust in one of the London boroughs. My question to Dr. Sam is, has any of your work or researchers looked at sexual health workers like prostitutes or women who work in capital cities like Nairobi, and if any of the attitudes of requesting sexual health treatment, condoms or any of the treatments provided by the healthcare services, are the attitudes the same as what you'd find in disabled patients or have you not looked at that yet?
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B
We haven't gotten to that yet, but as I reported, the deaf youth report that one of the reasons they may engage in sex is to look for sexual, sexual favors, which I suppose for favors, not sexual favors, but for favors, for example, money, etc. So maybe when we are through, because our researchers are in various points of completion, maybe that will be one of the things that we will be looking at at the end of our researchers, which will be in the next three or four months, then we might want to compare with findings with various other groups in the AIDS research field.
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A
I think we're coming to the end of questions by the look of the audience. If anybody has a last question, this is your moment. As I don't see a hand shooting up, I can say thank you very, very much indeed, Sam.
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B
Been very good.
- [65:00]
A
Ladies and gentlemen, thank you very much for coming.