Haiti has a generalized HIV/AIDS epidemic, with an estimated 2.2 percent of adults living with the virus. This represents the largest epidemic in the Caribbean, where approximately three-quarters of HIV-positive people reside in Haiti or the Dominican Republic. The first reported HIV infections in Haiti occurred in 1979, and prevalence increased until the early 1990s. However, prevalence then began to decline, particularly in urban areas, with a notable decrease in HIV prevalence among pregnant women attending antenatal clinics from 5.9 percent in 1996 to 3.1 percent in 2004. The decline appears to have stabilized at 2.2 percent prevalence in recent years.
Women are disproportionately affected by the epidemic, with young women ages 15 to 24 more than twice as likely to be HIV infected as young men. Regional variation is also apparent, with Nippes having the highest prevalence rates and the Southeast having the lowest prevalence rates. The majority of HIV cases reported in Haiti are due to heterosexual transmission, which is sometimes tied to formal and informal sex work. According to surveys, 2 percent of women in Haiti were involved in sex work in 2001, and high rates of HIV have been identified among sex workers in the Caribbean.
Behavioral studies have shown a similarity between the situation in Haiti and other countries in the Caribbean. While research indicates increasing knowledge about HIV/AIDS, the percentage of young women and men ages 15 to 24 who can both correctly identify ways of preventing HIV transmission and reject major misconceptions regarding HIV transmission remains low, at just 35 percent. Knowledge of HIV is not necessarily correlated with the adoption of safer behavior or preventive practices. For example, between 1994 and 2006, the percentages of young women and young men ages 15 to 24 who became sexually active before their 15th birthday increased from 9 to 15 percent among young women and from 17 to 43 percent among young men.
The Government of Haiti (GOH) is strengthening its HIV/AIDS response and intensifying efforts in prevention, care, support, and treatment. The latest National Multisectoral Strategic Plan was developed for five years (2008-2012) and outlines the structure of the National Commission for the Fight against AIDS and the establishment of a single system of monitoring and evaluation (M&E). Sectors involved include the Ministry of Public Health and Population (MSPP), the Ministry of Social Affairs and Labor, the Department on the Condition of Women and the Rights of Women, and the Ministry of Education and Vocational Training. The MSPP coordinates the national plan to ensure proper planning, standardization, and M&E of activities.
The national response includes support and prevention activities. Support focuses on adults, children at risk or who have HIV, support for STIs in general, and support for TB-HIV co-infection. Prevention activities focus on behavior change communication, voluntary counseling and testing services, prevention of mother-to-child transmission of HIV (PMTCT), and blood and injection safety. Each year, the Department of Communication for Behavioral Change and Community Engagement launches a national information and awareness campaign that reflects national needs and the international theme of World Youth Day. The campaign lasts one year, with intensified efforts during key periods, including World AIDS Day, Carnival, Valentine’s Day, Memorial Day, the summer holidays, local festivals, and during disaster situations.