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AIDS in the Haitian Community

From the beginning of 1982, Arthur Pitchenik and his colleagues at the University of Miami noticed that several Miami-Dade residents were presenting with undeniable symptoms of AIDS. They were not, homosexual, nor were they I.V drug abusers. They only shared one trait; all were Haitians. They suffered not only from the entire gamut of opportunistic infections but also Kaposi’s sarcoma, with a high incidence of Tuberculosis and Cerebral toxoplasmosis. In nine cases the onset of the illness was certainly before 1982. Only three AIDS patients hospitalized in Miami before June 1982 were not Haitians; one was a drug addict and the other two were gay. The physicians were confused by the fact that virtually none of the Haitians were addicts or homosexuals. Other similar cases of Haitians were observed in Canada and New York depicting a specific trend. By the summer of 1982, their ranks reached 6% of the total number of AIDS patients in the United States.

Why Haitians? Why were they alone affected outside those groups of individuals who practiced intravenous injection or anal intercourse? Certainly the early, classical observations on Kaposi’s sarcoma made one consider a sort of racial determinism in such diseases, but they accorded poorly with an exclusively infectious etiology. The Haitians were declared a risk group and official reports began to classify this geopolitical group alongside the definite categories by a particular way of life. The Haitians were stigmatized as potential carriers of the contamination, some among them even coming under the suspicion of being importers, veritably the original source of AIDS. A scapegoat had been found. In the three Haitians hospitalized in Miami, symptoms had begun to appear before they left their native land.

Other physicians drew attention to the frequency of enteric forms of AIDS among the inhabitants of Haiti. Earlier patient records as well as their own personal collections revealed that the Haitian AIDS was a recent epidemiological phenomenon and not some long standing but poorly known endemic. Farmer asserts that its appearance only dated back to the end of the 1970’s and hence was strictly contemporary with the onset of the American epidemic (59). The truth finally came out in 1983 when the Haitian Physician Association revealed that 30% of the Haitian AIDS patients admitted homosexual contacts, notably with foreigners. This was an economic necessity rather than personal preference. They did not consider themselves homosexuals, a shameful label in the Haitian culture.