Cahiers d'études et de recherches francophones / Santé


AIDS-related Knowledge Attitudes, Beliefs and Practices in Haiti Volume 1, issue 1, Avril 1991

Centre d’études sur le SIDA, département de santé communautaire, Hôpital général de Montréal et départements d’épidémiologie et biostatistiques et de médecine familiale, université McGill, Institut haïtien de l’enfance. Centre d’études sur le SIDA, département de santé communautaire, Hôpital général de Montréal, Montréal, Canada H3H 2K3.
  • Page(s) : 59-67
  • Published in: 1991

AIDS is now one of the major public health problems in Haiti. We report here a study undertaken to determine knowledge, attitudes, beliefs, and practices related to AIDS in Haiti. The ultimate goal of this research was to provide data for the development and evaluation of information, education and communication interventions in Haiti. We first identified patterns of behaviour and associated values related to AIDS through in-depth interviews and focus groups of sexually active young adults, female prostitutes and their clients, female itinerant vendors, truck drivers and soldiers. Based on the specific opinions, fears, preferences, values and behaviour of these groups, we developed a questionnaire to be administered to 1,300 men and 1,300 women aged 15 to 49 years. We used a three-stage cluster sampling design. Structured face-to-face interviews were used at the home of the interviewee. Study recruitment began in December 1989 and ended in February 1990. Although, 98.5% of our sample population had heard of AIDS, misconceptions still exists. The Main findings of the qualitative study were: men’s multiple sexual partners, economic dependance of women, ostracism of people with AIDS, external locus of control of large segments of the population. Men’s multiple sexual partners: In the survey, only 19 women compared to 280 men reported sexual contact with persons other than their regular sexual partner. Based on these findings, we developed a scale of male sexual behaviour at risk for HIV transmission. We decided not to take into account the use of condoms in setting these criteria because it is difficult to measure consistency and because the study identified several significant obstacles to the use of condoms. Respondents believed they prevent pleasure and can cause health problems, and associate them with a lack of trust between partners. In addition, many have doubts about the quality of the condoms available in Haiti, particularly those which are distributed free. According to our set of criteria, of the 1,115 sexually active male respondents, 63.0% were engaged in low-risk behaviour, 9.0% in medium-risk behaviour and 28.0% in high-risk behaviour. The study also shows that the highest percentage of risk behaviour corresponds to the highest educational level, with 44.8% of highly-educated men engaging in high-or medium-risk behaviour and only 27.4% of respondents with little education engaging in such behaviour. Economic dependence of women: The qualitative phase of the study showed that in certain groups sexual relations have important economic value. The inability to negotiate condom use was an illustration of this dependence. The study clearly shows that it is the men who decides to use or refuse to use condoms: 61.0% of the women and 77.0% of the men we asked said that it was up to the man to decide. Ostracism towards HIV-infected individuals: Almost 37.0% of the people interviewed said they believed illness was thrust upon its victims by fate. It is considered to be extremely difficult, if not impossible, to protect oneself against «mo SIDA», a disease attributed to the victim being stricken by fate. This may explain, in part, the fact that only 36.3% of people engaging in low-risk behaviour held this belief compared to 49.5% and 42.3% of those with medium - and high-risk behaviour. The threat of AIDS comes is the greatest health problem in Haiti. Preventing the spread of the disease must therefore be incorporated into the existing health care strategy. This is a long-term commitment which goes far beyond limited educational or training campaigns. The task is enormous and a concerted national effort is essential.