With an estimated 150,000 people living with HIV/AIDS in 2016 (or an approximately 2.1 percent prevalence rate among adults aged 15–49), Haiti has the most overall cases of HIV/AIDS in the Caribbean and its HIV prevalence rates among the highest percentage-wise in the region. There are many risk-factor groups for HIV infection in Haiti, with the most common ones including lower socioeconomic status, lower educational levels, risky behavior, and lower levels of awareness regarding HIV and its transmission.
HIV prevalence in Haiti is largely dropping as a result of a strong AIDS/HIV educational program, support from non-governmental organizations and private donors, as well as a strong healthcare system supported by UNAIDS. Part of the success of Haiti's HIV healthcare system lies in the governmental commitment to the issue, which alongside the support of donations from the Global Fund and President's Emergency Plan For AIDS Relief (PEPFAR), allows the nation to prioritize the issue.
Despite the extreme poverty afflicting a large Haitian population, the severe economic impact HIV has on the nation, and the controversy surrounding how the virus spread to Haiti and the United States, Haiti is on the path to provide universal treatment, with other developing nations emulating its AIDS treatment system.
History
AIDS in Haitians was first recognized in 34 Haitians living in the United States in 1982. In the same year eleven individuals in Haiti were suspected to be HIV infected. Since the majority of these individuals did not fall into the classic risk-factor groups, being Haitian was initially classified as a separate risk-factor group, causing damage to Haiti's image and economy and affecting tourism. In the same year, the Haitian Study Group on Kaposi's Sarcoma and Opportunistic Infections (GHESKIO) was formed to study the new epidemic.
GHESKIO used retrospective diagnosis to conclude that from 1979 to 1982, there were 61 cases of AIDS in Haiti. Through various studies and analyses, GHESKIO concluded that the risk factors identified in the 61 individuals were no different from those in other countries, with the primary risk factor being the fact that most of the patients lived in the suburb of Carrefour where prostitution was prevalent. The stigmatization of Haiti continued, and during the presidency of Jean-Claude Duvalier, it was illegal to mention AIDS/HIV in Haiti.
From 1983 to 1987, the virus spread quickly through the population mostly through heterosexual sex, as HIV infected cases attributed to homosexuals or bisexuals went down from 50% to less than 1%. In a 1985 to 2000 study, the virus spread twice as fast in developed nations prior to the use of antiretrovirals, as malnutrition, infectious communities, and active tuberculosis were all prevalent in Haiti. Jean-Bertrand Aristide, the first democratically elected President of Haiti, was the first Haitian president to include HIV/AIDS into his platform for his 2001–2004 presidency and initiated governmental policies to ensure the blood supply remains uncontaminated and to prevent and treat the virus amongst the population.
Prevalence
In Haiti, the three groups where HIV/AIDS is most prevalent are men who have sex with men, sex workers, and prisoners, with prevalence rates of 18.2, 8.4, and 4.3 respectively. As opposed to the United States, intravenous drug use in Haiti was more rare and the blood supply was not initially affected by HIV infected individuals. As such, intravenous drug users and hemophiliacs were never major risk factor groups in Haiti since the start of the epidemic.
According of unaids.org, as of October 2021 Haiti has turned the tide on its HIV epidemic. HIV prevalence among adults is now 1.9%, down from a high of 3.2% in the mid-1990s. According to government statistics, of the estimated 154 000 people living with HIV, 89% know their status. Ninety-three-percent of diagnosed people are on antiretroviral therapy and 87% of people who are on antiretroviral therapy are virally suppressed. Over the past decade, deaths due to AIDS-related illnesses fell by 63% in the Caribbean country. These achievements are the result of collaboration between the Government of Haiti, civil society and international development partners.