Fresh Approaches to HIV Prevention in Haiti

By Bonnie Eissner

Even before the devastating 2010 earthquake, Haiti had the highest HIV infection rate in the West, outside of Africa, according to Adelphi Associate Professor of Social Work CarolAnn Daniel, Ph.D. The quake and its dire aftermath have only exacerbated the situation. Dr. Daniel and a colleague, Carmen Logie, Ph.D., from the University of Calgary, have spent the past year and a half working on two grant-funded programs intended to support the most vulnerable Haitians and assist them in preventing HIV and other sexually transmitted infections (STI).

This past May, Dr. Daniel and Logie completed a yearlong project to develop and test a community health worker-delivered HIV/STI prevention program for 200 women living in internally displaced persons camps just outside of Port-au-Prince, in Léogane, Haiti. For the project, Dr. Daniel and her colleague developed a six-week psychoeducational and sexual health program to encourage dialogue on such issues as STI and what puts women at risk. They also created surveys to determine what the women knew about HIV and STI and the individual, social and environmental factors that contribute to infection before and after the education program. Dr. Daniel explains that, “Capacity building was another important goal of the project, so we hired and trained 10 internally displaced women to run the groups and conduct the surveys.” The project was funded by $100,000 from Grand Challenges in Global Health and was the only social research project—out of 20—to receive a Grand Challenges grant.

For their second project, which began this past summer, Drs. Daniel and Logie received $25,000 from the Canadian Institutes of Health Research to conduct a photo voice project to, in Dr. Daniel’s words, “understand HIV prevention priorities, barriers and facilitators among young women and men 18–24 in Léogane.” The roughly 60 young people who are participating in the project use instant cameras to document the people, places and situations that put them at risk for STI. They then select the pictures that are most meaningful to them and explain them in written or oral narrative. Dr. Daniel says that the photo voice approach “puts people in charge of how they represent themselves and their situation.” She continues: “It also allows the young people to become competent participants in the research process—both of which are very important to us, given the negative folk narrative in the U.S. about people in Haiti.”

Ultimately, Dr. Daniel intends to “demystify the biosocial aspects of HIV.” She says, “Haitians are very clear that it’s their poverty and desolation that leads people to do things that put them at risk…Once you work there, it’s not difficult to see it, you just have to know how to listen to really get it.”

Young people in Léogane, Haiti, who worked with Adelphi Associate Professor of Social Work CarolAnn Daniel, Ph.D., on an HIV and STI documentation project