AIDS in America - a Haitian disease?

In 1982 the Centers for Disease Control (CDC) officially described AIDS as the disease of the "4 H's" - homosexuals, hemophiliacs, heroin addicts and Haitians. Not yet knowing that HIV is transmitted through body fluids, the CDC labeled an entire country's population as being at risk of HIV for no other reason than their country of origin.

In 1982, some of the first cases of HIV outside of the US and Europe were reported in Haiti. It was an extremely professional and progressive team of Haitian researchers from the clinic where I work who recognized and documented karposi's sarcoma, an infection associated with AIDS, in a group of young Haitian men. No reports of similar cases had come in yet from Africa or Asia - so it was assumed by the CDC that AIDS was a Haitian disease (not that Haiti was quicker to identify and report an emerging global epidemic).

Significant consequences accompanied the labeling of AIDS as a "Haitian" condition by the US government. In the 1980's and 1990's people of Haitian descent in the United States were prohibited from donating blood. The tourist trade in Haiti collapsed partly under the stigma of AIDS and has not yet recovered.

25 years later, being Haitian is no longer considered an HIV risk factor, but some researchers are still trying to point to Haiti as the source of the AIDS epidemic in the USA. There has been quite a bit of press recently about a study that examined the genetic material from five HIV-infected Haitian who immigrated to the United States in the early 1980s. They were looking at the mutation patterns of the virus in these five people. Based on their limited analysis, the authors jump to a conclusion that it was a single Haitian immigrant the late 1960's who was responsible for bringing the disease to the US. The authors were some of the same people who worked at the CDC in the early 1980's....is this a coincidence or might they have professional reasons for wanting to justify their previous policy decisions to blacklist Haitians?

Check out this NPR interview with Dr. W. Johnson the Director of the Division of International Medicine at Cornell's Medical School who is a close friend and mentor to the director of the clinic where I work. He has some fantastic sound bytes that question the validity of the study including its methods, its conclustions and implications for racism and bias in medicine.

People like to talk about science as being unbiased but the reality is that scientists usually have an easier time finding what they set out looking for than what they are not expecting to see. Unfortuanately in the case of Haiti, the consequences of such widely publicized biases continue to be devastating as it perpetuates the completely unfounded racism, fear, and mistrust directed at many Haitians and Haitian immigrants ,,,, so much so that several members of the Haitian community have even threatened a law suit against the researchers who published their conclusions.

UPDATE - Here is a link to a commentary on the study above by Edwidge Dandticat, a wonderful (Oprah endorsed) Haitian-American writer. Read her editorial and then check out some of her fabulous books. Here is a link to a Dec 8 editorial in the Miami Herald about the study by the former USAID Haiti director.