In-depth: Haiti and HIV: "Gen espwa" - new hope dawns

HAITI: HIV masked by the smokescreen of insecurity

PORT-AU-PRINCE, 2 November 2007 (PlusNews) - Police officers struggling to keep a lid on Haiti's violent crime can find it difficult to accept that HIV represents just as real a threat as the armed gangs they battle.

"We don't talk about AIDS because it's scary, and then we can't [have sex]," smirked one officer, who drew laughs from his colleagues in the courtyard of the police headquarters when he asked, tongue-in-cheek, where he could find condoms.

But his bravado and denial are no laughing matter in a country with the region's worst HIV prevalence rate. The Haitian police have been regularly condemned for their lawlessness, which has included serious allegations of extrajudicial killings, corruption, sexual abuse and exploitation.

National HIV prevalence was estimated at around four percent in 1995; in the police service it "fluctuated between 4 percent and 6 percent, and was even higher among the former military integrated into the police: around 12 percent to 15 percent", said Dr Harry Brossard, head of the Haitian National Police health service.

Haiti's political upheavals and endemic poverty have stymied effective AIDS programmes. In 2004, tensions degenerated into violence as a rebel group made up of anti-government gangs and demobilised soldiers began to seize towns. President Jean-Baptiste Aristide was forced into exile, but clashes between his supporters and the new interim government continued.

The authorities have slowly managed to get a grip on the insecurity with the help of the United Nations' Stabilisation Mission in Haiti (MINUSTAH), creating a window for prevention and treatment programmes to get underway among the country's 7,000 police officers.

The United States-based social marketing group Population Services International launched a peer educators' programme in 2005, training around 200 officers who have encouraged their colleagues to use the HIV voluntary counselling and testing (VCT) centre in the police headquarters in the capital, Port-au-Prince.

Sponsors, such as the Global Fund to Fight AIDS, Tuberculosis and Malaria, and the US President's Emergency Plan for AIDS Relief, have also enabled the authorities to provide life-prolonging antiretroviral drugs. "Members of the police force who test positive do not have to worry, we look after them free of charge," commented Brossard.

However, an HIV-positive result rules out entry into the police academy. "Recruits who test positive are referred [to HIV treatment centres], but they are not hired," Brossard said. "We do not have adequate structures to integrate them, and when we have dealings with gangs or during riots they could get injured."

However, he noted, "it is not enough to hire men in good health, we must also keep them in good health". And in Haiti, one of the world's poorest countries, "we still don't have the resources to tackle the fight against AIDS".

The budget for the police health service is just US $1,000 a month to cover the needs of all the country's police officers. Some HIV/AIDS programmes have reduced or suspended services due to the lack of funds.

"Following the awareness campaign, we had between 40 and 50 requests for screening each month, but now we no longer have the funding, and visits have decreased," said Dr Edwin Belledent, VCT coordinator at the police health centre.

The unit's pharmacy has almost run out of even basic medication, admitted Brossard, opening the doors of a cupboard full of empty medicine boxes and packaging. The state of the pharmacy mirrors that of the country, where years of instability and mismanagement have kept development at bay.

HIV is a long-term threat rather than a pressing concern to many police officers, who work under wretched conditions of service and deal with violence every day. "We are poorly paid; we can be killed dealing with gangs, or even on the street on the way home because people know we are police officers," said one cop in his thirties, gesturing towards a police car riddled with bullets parked in the courtyard.

"The majority of police officers want to leave the force as soon as they find a better job," he added. "Personally, I'm going to change profession as soon as I can; it's too hard and too dangerous."

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Haiti and HIV: "Gen espwa" - new hope dawns October 2007
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Links and References
	• Country Profile: Haiti • Human Rights Watch • The Synergy Project • Global Fund in Haiti • PEPFAR in Haiti • UNAIDS Country progress report • National survey on mortality, morbidity and HIV/AIDS • Panos Institute of the Caribbean
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