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Initiating Sexual Life: Uncovering the HIV Risks for People with Disabilities in Bujumbura

Loic Nsabimana*, Gervais Beninguisse

This article compares the characteristics of sexual initiation among people with and without disabilities in Bujumbura, focusing on age at first sexual encounter, relationships with the first partner, age difference between partners, who initiated the sexual encounter, and male contraceptive use. The data are drawn from the HandiSSR survey conducted between 2017 and 2018 in Bujumbura. This survey uses stratified random sampling, including 600 people with disabilities and 600 people without disabilities (control group). We used matching to ensure comparability between groups and statistical tests to analyze the observed differences. The results show that people with disabilities initiate sexual activity at the same age as their peers without disabilities. These findings reveal that people with and without disabilities begin their sexual lives at similar ages, challenging outdated notions that people with disabilities are asexual or less sexually active. However, people with disabilities are more likely to have older and casual first partners, which increases their risk of adverse outcomes. Although male contraceptive use at the first sexual encounter is similar between the two groups, the reasons for non-use among people with disabilities include forced intercourse, highlighting an increased vulnerability to sexual coercion. These findings underscore the need for tailored public health policies to improve access to sexual education and protective practices among people with disabilities, in order to reduce their risk of HIV infection and enhance their sexual health outcomes.