Delays in presentation for HIV care in rural Haiti are linked to demographic, socioeconomic and structural factors, many of which are rooted in poverty. These data suggest that a multifaceted approach is needed to overcome barriers to early presentation for care. This approach might include poverty alleviation strategies; provision of effective, reliable and free medical care; patient outreach through community health workers and collaboration with traditional healers.

Haiti’s HIV/AIDS program has been highly successful, with a declining HIV prevalence, and long-term treatment outcomes that are similar to those of industrialized nations. The country is now on the way to providing universal treatment for HIV/AIDS nationwide. This success is tied to a strong foundation for HIV care in Haiti, which includes national guidelines issued by the Ministry of Health, political commitment at the highest levels of government, nongovernmental organizations providing high quality care for decades, and the assistance of the Global Fund to Fight AIDS, TB and Malaria, the US President’s Emergency Plan for AIDS Relief (PEPFAR) and other private donors. Challenges include two different procurement systems, with different formulations of medications and different laboratory systems and the lack of a single monitoring and evaluation plan for HIV care. The earthquake in Haiti has killed over 150,000 people, injured and displaced hundreds of thousands more, and destroyed the infrastructure in Port-au-Prince, which was the power grid of the entire nation. Yet, in spite of the overwhelming difficulties that Haiti now faces, the majority of HIV-infected patients continue to receive their antiretroviral therapy, and the Haitian government and a network of organizations are working together to treat the immediate needs of the survivors and to rebuild the healthcare system. We report on the successes and challenges facing Partners In Health and the Haitian Study Group on Kaposi’s Sarcoma and Opportunistic Infections (GHESKIO), the two nongovernmental organizations that work together with the Ministry of Health to provide and/or supervise treatment for nearly three-quarters of patients on HIV treatment in the country of Haiti.