USAID support for sexually transmitted infections and HIV/AIDS programming in Haiti : assessment and recommendations for future action

In FY 2002, for example, USAID will reduce its overall funding from $50 million to $35 million, which will affect the Mission"s population, health, and nutrition activities, in particular Mission efforts to combat HIV/AIDS, which has struck Haiti harder than any other Caribbean nation. This report reviews USAID"s current HIV/AIDS portfolio in Haiti and makes related recommendations. While there have been significant accomplishments, such as a high level of awareness of HIV among the population (studies show that 98% of the population knows about AIDS, and more than 65% understand the modes of HIV transmission) and a national condom social marketing program has been established, protected sex is not widely practiced and multiple sexual partners are common. At the same time, there seems to be a growing commitment, in both public and private sectors, to confront the challenges posed by ignorance and discrimination, poor health systems, lack of access to care and support, and lack of political will. The launch on May 7, 2001, of a new national strategic planning process by the Ministry of Health gives rise to the hope that policy guidance and funding commitment will follow. The national plan acknowledges the direct linkages between sexually transmitted infections (STIs), HIV, and other infectious diseases, such as tuberculosis. It will become operational by the end of 2001. Responding to the generalized HIV/AIDS epidemic in Haiti requires a dual approach: providing decentralized prevention and care services throughout the country, while ensuring extra coverage of high-risk settings or "hot spots" where transmission is most rapid. Priority recommendations in these areas are provided.