title: Using intersectionality to explore experiences of disability and HIV among women and men in Zambia.
abstract: OBJECTIVE
  Little is known about the experiences of people with disabilities (PWD) who live with HIV. Existing research largely assumes a "double burden" approach, which views HIV as doubling the load for people already burdened by disability. Intersectionality (a dynamic process of converging systems of relationships) offers an alternative approach for understanding differences in experience. This study uses an intersectional approach to explore the experiences of PWD in Zambia who have become HIV-positive.
  
  
  METHODS
  We conducted semi-structured, in depth interviews with 21 PWD who live with HIV in Zambia (12 women, 9 men). Participants had various impairments (visual, hearing, mobility, intellectual). Interviews were conducted to meet participants' accessibility preferences.
  
  
  RESULTS
  Our intersectional analysis demonstrates the dynamic and situational emergent meanings and consequences for PWD who are living with HIV related to: (1) meanings of HIV and disability linked with time and trajectory; (2) oppression and negotiation related to accessing health services and (3) social roles and relationships. Three case studies illustrate these circumstances.
  
  
  CONCLUSIONS
  Intersectionality offers a complementary approach for examining the complex interrelationship among HIV, disability, gender and time among PWD living with HIV. Findings illustrate directions for improved services and policies for this important group.
  
  
  CONCLUSIONS
  Rehabilitation services need to take a cross-disability (multiple disabilities) approach working with people living with HIV and disability. Rehabilitation, as illustrated by a CBR approach, needs to include services that will facilitate not only health, but education, jobs and housing for people living with HIV and disability. Rehabilitation needs to make more direct connections with Zambia social service sector to help address the fluctuating experience of living with HIV and disability.
authors.affiliation: Department of Physical Therapy, University of Toronto , Toronto, ON , Canada .
authors.forename: Karen
authors.initials: K
authors.lastname: Yoshida
authors.forename: Jill
authors.initials: J
authors.lastname: Hanass-Hancock
authors.forename: Stephanie
authors.initials: S
authors.lastname: Nixon
authors.forename: Virginia
authors.initials: V
authors.lastname: Bond
mesh_terms: D000328:Adult; D006233:Persons with Disabilities / Q000523:psychology / Q000534:rehabilitation; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D012737:Sex Factors; D015024:Zambia
keywords: AIDS; Africa; difference; disability; intersectionality