The following is a piece from a theory paper I completed in my Health Communication graduate course. I address the factors that make Haiti a country with the highest HIV/AIDS prevalence rate outside of Africa. What I don’t address here are the spiritual implications for this issue. What are the spiritual implications for HIV/AIDS, specifically for Haiti?
“HIV/AIDS has impacted Haiti more severely than any other country in Latin America or the Caribbean, attaining prevalence rates of nearly 5 percent in the general population” (Ahanda, Diop-Sidibé, Heerey, Hempstone, & Lauredent, 2004, p. 8). Martel and Mueller (2006) reported that 65 percent of all Caribbean cases are from Haiti, and according to the CIA World Factbook, the population of Haiti totals 9,203,083 (Haiti, 2010). For a nation with a relatively small population, the numbers are truly astounding. In fact, outside of Africa, Haiti has the highest incidence of HIV. What is even more upsetting is that the youth of Haiti are the ones that are suffering the most.
High fertility rates have resulted in a very young population. Over 60 percent of the Haitian population is under 19 (Ahanda et. al., 2004). There are 1.6 million youth ages 15 – 24 in Haiti (Justesen & Verner, 2007). Almost 25 percent of the population is women of childbearing age (Ahanda et al., 2004) and 43 percent are under the age of 15 (Martel & Mueller, 2006). “Of the age group (that is) 15 – 19 years old, 5.2 percent has HIV/AIDS” (Justesen & Verner, 2007, p. 3). The median age a girl first has sex is at 16 years, and boys have their first sexual encounter between 12 and 14 years (Speizer, Beauvais, Gómez, Outlaw, & Roussel, 2004). As Goh, Primavera and Bartalini (1996) stated, it is clear that adolescents are at significant risk of HIV infection. The youth of Haiti have a high risk of contracting HIV/AIDS based on sheer numbers alone, not to mention other factors that put Haiti’s youth at risk.
Along with the numbers, there are socioeconomic factors, a lack of a strong educational system, conflicting religious belief systems and a long and complicated national history that contribute to an overwhelming problem with HIV/AIDS transmission among youths. As Justesen and Verner (2007) put it,
A series of factors predisposes a large proportion of youth to poverty, school dropout, unemployment, early sexual initiation, teenage pregnancy, HIV/AIDS, sexual and physical abuse, crime and violence, substance abuse and drug dealing, and social exclusion. Indicators for Haiti on most of these factors are among the poorest in the Latin American and Caribbean region (LAC) and some are worse than those of African countries with the same level of GDP per capita. Dictatorship, military intervention, and lack of stability have been determining factors in Haiti’s social and economic development history (p. 3).
Along with the lack of stability caused by governmental and socioeconomic factors, the majority of Haitians do not have consistent access to educational mass media including magazines, television, newspapers or libraries. The lack of new health communication in the Haitian community is one contributing factor to the lack of health education the youth receive. Haitian educators also have a lack of formal training which plays a big role in health education inconsistencies (Martel & Mueller, 2007).
An important aspect of youth belief and attitude toward HIV/AIDS has to do with the nation’s religious identity. There are two dominating belief systems in Haiti that conflict both with one another and with scientific knowledge about the causes of HIV as well as mainstream prevention techniques: Voudon and Catholicism. Voudon beliefs teach that HIV/AIDS could be a punishment from the gods or sent by a jealous person (Martel & Mueller, 2007). In a highly religious context, the youth may not understand the biological ways that HIV/AIDS is contracted which could lead to high-risk behaviors.
On the other hand, Catholic teaching tends to stray believers from condom use at all. In fact, the Catholic Church has a strong moral stance on human sexuality and birth control. The Church is known for its strong opinions on condom use in general. In 1987, “Many Faces of AIDS: A Gospel of Response” was published by the U.S. Catholic Conference Administrative Board. In the statement, the Catholic Church “promised to provide education to limit the spread of AIDS and to offer support for persons living with AIDS” all over the world, but it mentioned “nothing about condoms” (Chikwendu, 2004, p. 312).
In the early years of the epidemic, the Church continued to refuse discourse on the very important topic of condom use as a prevention technique. In 1996, French Bishops Conference gave a statement supporting condom usage (p. 313). In contrast, seven years later, the president of the Vatican’s Pontifical Council for the Family, Cardinal Alfonso Trujillo, made a statement that condoms are not effective in prevention techniques because they have tiny holes in them (p. 313). The conflict within the Catholic Church is reflected onto the Haitian believers. Haitian Catholics may not engage in preventative condom usage based on religious duty. However, these same believers may engage in high-risk behaviors without the protection they need.
Even though the youth of Haiti are at high risk to receive HIV/AIDS, they are also the ones who will educate and hopefully change the circumstances that lead to such a high prevalence rate. As Justesen and Verner (2007) stated, “Haiti’s history, combined with the country’s social and poverty indicators, show that youth should be seen not as a problem, but as a product of the family and community environment and therefore should be treated as a potential solution to Haiti’s development challenges” (p.3). Haiti’s youth are not the bad guys here, but instead products of a crisis that threatens to engulf. Haiti’s youth are the ones who have the potential to change the face of HIV/AIDS in their country if they are given the right tools, resources and education.
Ahanda, K., Diop-Sidibé, N., Heerey, M., Hempstone, H., & Lauredent, E. (2004). HIV/AIDS in Haiti: a literature review. United States Agency for International Development, 1-55.
Chikwendu, E. (2004). Faith-based organizations in anti-HIV/AIDS work among African youth and women. Dialectical Anthropology, 28, 307-327.
Goh, D., Primavera, C. & Bartalini, G., (1996). Risk behaviors, self-efficacy, and AIDS prevention among adolescents. Journal of Psychology, 130(5), 537.
Haiti. (2010). CIA World Factbook. Retrieved from https://www.cia.gov/library/publications/the-world-factbook/geos/ha.html.
Justesen, M., & Verner, D. (2007). Factors impacting youth development in Haiti. World Bank Policy Research Working Paper, 4110, 1-42.
Martel, L., & Mueller, C. (2006). HIV/AIDS teaching behaviors of educators in Haiti. Journal of HIV/AIDS Prevention in Children & Youth, 7(2), 105-118.
Speizer, I., Beauvais, H., Gómez, A., Outlaw, T., & Roussel, B. (2009). Using multiple sampling approaches to measure sexual risk-taking among young people in Haiti: programmatic implications. Studies in Family Planning, 40(4), 277-288.