The Continuing Challenge of Reducing HIV Risk among Haitian Youth

Abstract

There is a dire need for interventions that will address the multiple factors-poverty, substance use, early sexual debut, and violence-that influence Haitian youth's engagement in risky behaviors. The deteriorating socioeconomic and political state of the country has had a deleterious effect on the sociocultural milieu and on the boundaries that have heretofore kept risky behaviors in check. Historically, the lakou system, a community-based approach that supports the family unit, has disintegrated, leading to the disruption of traditional parenting patterns. The unstable economic system has also led to the increasing use of children from poor families, who through the restavek system, are sent to work as servants in other households. The breakdown of traditional systems, coupled with the increasing economic and political instability, has had a significant effect on Haitian adolescents. Among boys, increased levels of substance use have been associated with multiple sex partnerships and very early sexual debut. Among girls, extremely high rates of sexual abuse and forced sex have led to relatively high levels of HIV. While the majority of them have been exposed to behavior change messages, behavior change itself has lagged because many adolescents do not accurately perceive their risk exposure. This review explores the risks of HIV transmission among Haitian youth, with a focus on vulnerability factors, including substance use, culture, and the socioeconomic context, and provides recommendations for intervention. An ecosystemic approach, designed specifically for Haitian youth and that takes environmental context and culture into account, is needed.

‘It’s Not a Gift When It Comes with Price’: A Qualitative Study of Transactional Sex between UN Peacekeepers and Haitian Citizens

“…Most relied on friends or traditional medicine practitioners for advice, some of which was inaccurate. This reflects that which is known about the HIV and pregnancy prevention in the general population (Dévieux et al 2015;Joshi et al 2014;Severe et al 2014).…”

“…The IHG itself was involved in widespread sexual abuse and exploitation by state agents (primarily security forces) and insurgent groups aligned with the IHG were blamed for both politically motivated mass rape and the sexual harassment and abuse of children during the conflict period and the first 22-months of the IHG's rule. Complicating matters further, the MIF was accused of sexual abuse and exploitation as well as some limited use of sexual harassment and threats to coerce the population (Davis 2010;Henry and Higate 2013;Higate and Henry 2009;Kolbe and Hutson 2006). When MINUSTAH took the reins from the MIF in May 2004, there was the opportunity to take a strong stance against the SEA of civilians by security providers.…”

“…This was increased in response to the January 2010 earthquake and then adjusted at several points afterwards as the UN Security Council adapted to changing circumstances on the ground and to the evolving political situation in Haiti. Though many of the peacekeepers have been concentrated in the capital of Port-au-Prince, MINUSTAH personnel are found in all geographic departments of the country and peacekeeper bases are located in all urban areas and many rural communes (Davis 2010;Henry and Higate 2013;Higate and Henry 2009;Kolbe and Muggah 2011;Schuller 2012).…”

‘Life under the tent is not safe, especially for young women’: understanding intersectional violence among internally displaced youth in Leogane, Haiti

“…The lack of housing after the earthquake resulted in young women exchanging sex for shelter [6,7]. Lack of security and protection in internally displaced persons camps, combined with inadequate lighting, bathing facilities, tents, and a lack of police patrols elevate exposure to violence – in particular GBSV – and precarious living for internally displaced persons in Haiti [1,2,8–10].…”

“…As of 2015, young Haitian women’s unemployment rate remained 5% higher than males [17]. Prior research in Haiti suggests that poverty may contribute to youths’ early sexual debut and engagement in transactional sex for survival [6,9]. …”