HIV/AIDS in Haiti - progress made, challenges remain

There is "some good news" in the fight against HIV in the Americas, Cesar Chelala -- an international public health consultant -- writes in a Miami Herald opinion piece, adding that "most surprisingly, it's coming from Haiti, one of the countries hardest hit by the epidemic." Chelala writes that United Nations data show that about 2.2% of Haiti's population -- or 120,000 people -- are living with HIV/AIDS and that AIDS-related deaths in the country have decreased in recent years.

This compares with an HIV/AIDS prevalence of 6.1% in 2001, according to Chelala. Haiti's progress has been "particularly significant for a country where 60% of the population lives below the poverty line of $2 per day," he writes, adding, "Only four of every 10 Haitians have access to potable water, and there is one doctor for every 10,000 inhabitants." However, the "scenario is optimistic," Chelala writes, noting that the percentage of HIV-positive test results among pregnant women has decreased by 50% over the past 10 years.

The progress in fighting HIV/AIDS in Haiti is "due in large part to the work of people like" Jean Pape -- a Haitian doctor who focuses on HIV/AIDS and founded GHESKIO -- and Paul Farmer of Partners in Health, Chelala writes. PIH, along with its HIV Equity Initiative, are "dedicated to preventing and treating AIDS in the context of primary care; improving care for tuberculosis; optimizing treatment for sexually transmitted infections; and emphasizing women's health," Chelala writes. More than 400 workers have been trained to administer no-cost antiretroviral drugs within the community, and more than 1,500 HIV-positive people are receiving treatment, he writes.

According to Chelala, "many challenges remain," and a majority of Haitians "still lack sufficient sex education, for example." He adds that only 15% of women and 28% of men between ages 15 and 24 know HIV prevention methods, and both boys and girls are becoming sexually active at earlier ages. In addition, Chelala notes that prevalence and incidence rates have been declining more slowly in rural areas than in urban areas.

Chelala concludes that the "advances in fighting the epidemic in Haiti show that although much remains to be done to achieve better results, a committed leadership, good planning, parallel attention to prevention and care, and community involvement can successfully control this terrible epidemic, even under the worst of circumstances" (Chelala, Miami Herald, 3/12).

An abstract of Chelala's report -- "AIDS: A Modern Epidemic" -- is available online.