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pubmed:otherAbstract |
PIP: Both the seroprevalence and epidemiology of human immunodeficiency virus (HIV) infection have demonstrated substantial changes in Haiti since the beginning of the epidemic in the early 1980s. Although seroprevalence rates vary greatly according to the population group tested, surveys of healthy urban adults have indicated an increase in HIV infection from about 8% in 1986 to 11% in 1991. The rate in rural areas remains at about 3%. Tuberculosis, herpes zoster, malignant prurigo, and weight loss are the most common signs of HIV infection before the virus progresses to acquired immunodeficiency syndrome (AIDS). The most significant changes in the pattern of HIV transmission in Haiti have been a decline in the proportion of cases among bisexuals/homosexuals (from 50% in 1983 to 1% since 1987) or related to blood transfusion. Also striking has been a change in the geographic distribution of HIV. In 1982, 80% of those infected with HIV were from the capital Port-au-Prince, 10% were from other major cities, and 10% were from other countries. In 1990, only 65% of cases originated from the Port-au-Prince area. Finally, there has been a shift in the sex distribution of HIV, with women contributing 38% of cases in 1989-90 compared to only 15% in 1979-82. Disturbing are survey findings that HIV-infected women, or those with an infected partner, continue to have unprotected sexual intercourse and to take no steps to avoid pregnancy. As a result of the growing number of AIDS cases among women, children under 14 years of age now comprises 6.6% of all AIDS cases compared to 2.4% in 1988. Development of a form of contraception that is as effective against HIV transmission as the condom yet could be used without the consent of the male partner would be an important advance in AIDS prevention in Haiti.
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