With an estimated “2.2% of adults” noting an HIV-positive status in 2010, Haiti faces “the largest [HIV] epidemic in the Caribbean.” In 2020, 150,000 children and adults in Haiti lived with HIV. People older than the age of 15 made up 93% of this population. In addition, 20% of Haitians living with the disease are unaware that they are HIV-positive. To help reduce the prevalence of HIV in Haiti, several initiatives are currently underway, run by the Centers for Disease Control and Prevention (CDC), UNAIDS and the Elizabeth Glaser Pediatric AIDS Foundation.
Since the CDC’s Division of Global HIV & TB opened its office in Haiti in 2002, the CDC has launched several initiatives to address the country’s HIV epidemic. The first aim is to strengthen health systems by training medical personnel, supporting staffing needs and strengthening the Haitian Ministry of Health’s governance. The CDC has also aided in the development of the iSanté national electronic medical record (EMR) software to better monitor and track HIV patient data. These innovative tools help inform evidence-based treatment for this disease. In 2018, iSanté, “along with two other EMR systems,” could monitor the data of “96% of HIV care and treatment sites.”
Another goal of the CDC office in Haiti helps improve laboratory resources. Through a collaboration with the National Public Health Laboratory and GHESKIO, a medical treatment, research and training center in Port-Au-Prince, Haiti, the CDC has helped develop and expand several HIV testing methods. In addition, the CDC assisted in developing “an external quality assurance program and a training curriculum” to support lab accreditation.
With support from UNAIDS, the Ministry of Public Health and Population and the U.S. government via the United States President’s Emergency Plan for AIDS Relief (PEPFAR), Haiti’s Civil Society Forum Observatory has initiated “community-led monitoring,” a program through which people living with HIV hold each other accountable throughout treatment. Community members are familiar with HIV patients from their community, and when patients do not follow through on treatments or follow-ups, community members know how to best communicate with them and encourage them to return. Community-led monitoring can provide valuable feedback on service delivery from a patient perspective, helping to improve on existing issues “to retain people in care.”
Community-led monitoring reveals the weaknesses of treatment plans for HIV in Haiti and brings corresponding solutions to light. For example, due to insight from community-led monitoring, the Civil Society Forum Observatory brings to light a need to increase the window of service hours and decrease patient wait times. It also recommends that stable HIV patients receive a six-month supply of antiretroviral medication. Through community-led monitoring and other resources, Haiti was able to allocate multiple months’ supplies of antiretroviral medicines to 88% of HIV patients during the COVID-19 pandemic.
Elizabeth Glaser Pediatric AIDS Foundation
The Elizabeth Glaser Pediatric AIDS Foundation strives to combat pediatric HIV worldwide through advocacy, research and initiatives for prevention and treatment. Although most HIV patients in Haiti are adults, 8,000 children younger than 15 lived with HIV in Haiti in 2020. Thus, addressing pediatric HIV in Haiti is an important health initiative.
Toward the latter part of 2020, the Foundation began its work in Haiti with the Delivering Technical Assistance Project. The project offers “cost-effective technical assistance (TA), capacity building and program implementation services” to HIV reduction programs. The technical assistance includes program management training, mentorship, consultations and workshops for health care workers.
These strategies, and many others throughout the country, are successfully helping lower HIV rates in Haiti. As organizations continue to implement HIV reduction plans, the severity of the HIV epidemic in Haiti may see a decline in the years to come.
– Aimée Eicher