Surviving the Aftershock

Abstract

In this research we examined how the conditions of Haiti's tent communities, inhabited by those displaced by the January 10, 2010, earthquake, shaped access and adherence to highly active antiretroviral treatment (HAART) for Haitians with HIV. Conditions in the encampments were marked by unhygienic and cramped living spaces, exposure to the elements, a lack of privacy, unavailability of food and clean water, and a dependence on poorly functioning aid agencies. These conditions shaped access and adherence to HAART by (a) exacerbating the stigma of being HIV positive and undermining mental health; (b) presenting logistical challenges to accessing medical care, storing pills, and ingesting them safely and privately; and (c) sustaining a political economy of aid characterized by unequal treatment in major HAART-dispensing centers, unequal circulation of international funds, and the emergence of alternative medical institutions within encampments that could improve future treatment. Policy and intervention implications are discussed.

Determinants of HIV Serostatus Disclosure to Sexual Partner Among HIV-Positive Alcohol Users in Haiti

“…Prior to the earthquake, Haiti had the highest rate of PLWH in the Caribbean with an estimated 120,000 PLWH (9). A number of researchers have begun to document the immediate structural and psychological effect of the earthquake on Haitians living with HIV/AIDS, including on substance use, access and adherence to treatment, however the long term effects of the earthquake on the country’s HIV/AIDS trajectory may not be fully understood for many years (10–14). …”

A scoping review of non-professional medication practices and medication safety outcomes during public health emergencies

“…Several studies investigated populations that may be at greater risk of health inequalities 19 including those with physical disability [20][21][22] , HIV [23][24][25][26][27][28][29][30][31][32][33] , mental illness 15,[34][35][36] socioeconomic deprivation 14,[37][38][39] , refuge or displacement 13,25,37,[40][41][42] , opioid or other substance misuse or dependence 30,[43][44][45][46] , people of black and minority ethnicity 38,43,47 and men who have sex with men 31,48 .…”

“…A quantitative outcome of "adherence" or "compliance", as termed by the study authors, was reported in 30 studies, using four distinct measurement types: (1) A discrete self-report at one time point using a variety of phrasing of questions (n=24) 24,25,32,33,36,53,56,61,[68][69][70][71][72][73][74][75][76][77][78][79] , (2) a discrete single time point measure comparing two study groups 54,57,80 , (3) discrete measures at two times points 16,23,[81][82][83] and (4) calculated based on days of tablets remaining 28 .…”

Self care interventions could advance sexual and reproductive health in humanitarian settings

“…This has been reported among internally displaced people in Haiti. 19 Self care interventions could offer confidential and accessible information for this important group. For example, tailored information could be shared on mobile phone apps.…”