Study rethinks AIDS prevalence among Haitians

In the early days of the AIDS epidemic, before the syndrome had a scientific name, the illness was sometimes called “the 4H disease,” named for four groups thought to be at highest risk: homosexuals, hemophiliacs, heroin users, and Haitians.

Haitians who immigrated to the United States have been stigmatized, and even blamed for bringing the virus to North America, since that time, partly based on higher estimates of infections among Haitian-born people compared to other groups. A new study led by a Haitian-American researcher challenges those rates with data showing that the prevalence of AIDS among Haitian immigrants is similar to the levels reported among African-Americans.

Dr. Linda Marc of the Center for Multicultural Mental Health Research at Cambridge Health Alliance led a team that analyzed national AIDS data from 1985 through 2007. According to the US Centers for Disease Control and Prevention, Haitian-born immigrants made up 1.2 percent of AIDS cases in the country, but they accounted for only 0.18 percent of the US population. That amounts to a seven-fold over-representation of AIDS among Haitian immigrants compared to the US population as a whole.

But when higher population figures from Haitian consulates in US cities were used, that over-representation of AIDS cases fell to four-fold, which is about the same level as among African-Americans.

Haitian immigrants are likely to be undercounted by American census takers, Marc and her co-authors write, particularly if they are not in the country legally. Sources at Haitian consulates estimate that 1.2 million Haitian-born people live in the United States, double the US census figure.

Marc’s paper, which appears in the journal AIDS, also reports that Haitian immigrants tend to be diagnosed with HIV at a later stage than other people. That means public health messages need to be targeted and tailored to this group, Marc said in an interview.

“We didn’t know that Haitians are getting in much later for their diagnoses,” she said. “They’re not being tested for HIV as part of routine care and they don’t recognize the signs and symptoms of the illness. It has major implications for us.”