Here we go again: American Academics, HIV/AIDS, and HaitiBy Bryan Schaaf on Tuesday, October 30, 2007.
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The estate of Katherine Dunham includes a forty-five acre botanical park and hotel (private villas with private pools), that have long been overtaken by squatters. The Club Med on the west coast has been/is being converted to private apartments. Gingebread houses which used to be beds/breakfasts are now school buildings.
The US embargo on Haiti killed industry. Deforestation is killing agriculture. But what brought tourism to its knees in Haiti? Thank the American academic community for that. Shoddy research, scholarly sensationalism, blamed Haiti for bringing HIV to the United States. Some authors blamed Vodoun. The end result is Haiti lost an important source of revenue.
True enough, Haiti was also an active sex tourism destination for men and for women as the film Ver La Sud reminds us. But Haiti was not alone in being the only Carribean sex tourist destination in Haiti.
More rigorous research suggests that it was sex tourists from the United States who brought the disease to Haiti. For this reason, I was suprised to read the article which suggests that a Central African migrant brought it to Haiti. Even during its economically strongest years, I doubt Haiti was much of a draw for central Africa or vice versa. Tourists could have visited several countries in one trip. One of the researchers remembers treating Haitians with a mystery disease in the seventies - is this to say they were the only Carribean population affected? One hopes not.
This is not to say HIV/AIDS does not continue to be a problem in Haiti. Though there is some debate on the prevalence rate, national seroprevalance surveys (with pregnant women as a proxy for the whole population) suggest that it has dropped from a high of approxmately 6 percent iin 1993 to around 2.2 percent in 2006. While a decline of four percentage posts is extremely significant, there is no room for complacency. HIV remains very high in certain sub groups such as commercial sex workers.
There is much more to be done, but progress is being made. After all the damage down by researchers in Haiti seeking the quick fix to understanding HIV, I just hate to see the issue dredged up again with work that is tinged with racism. I encourage the Haitian Diaspora and Friends of Haiti to speak out against this piece of research, which is at best, unhelpful.
We intend to do out part as well. Below is the article, welcome your thoughts.
Bryan
AIDS virus invaded U.S. from Haiti: study By Will Dunham Mon Oct 29, 5:43 PM ET
WASHINGTON (Reuters) - The AIDS virus invaded the United States in about 1969 from Haiti, carried most likely by a single infected immigrant who set the stage for it to sweep the world in a tragic epidemic, scientists said on Monday.
Michael Worobey, a University of Arizona evolutionary biologist, said the 1969 U.S. entry date is earlier than some experts had believed.
The timeline laid out in the study led by Worobey indicates that HIV infections were occurring in the United States for roughly 12 years before AIDS was first recognized by scientists as a disease in 1981. Many people had died by that point. "It is somehow chilling to know it was probably circulating for so long under our noses," Worobey said in a telephone interview.
The researchers conducted a genetic analysis of stored blood samples from early AIDS patients to determine when the human immunodeficiency virus first entered the United States.
They found that HIV was brought to Haiti by an infected person from central Africa in about 1966, which matches earlier estimates, and then came to the United States in about 1969.
The researchers think an unknown single infected Haitian immigrant arrived in a large city like Miami or New York, and the virus circulated for years -- first in the U.S. population and then to other nations. It can take several years after infection for a person to develop AIDS, a disease that ravages the immune system.
DISEASE MULTIPLIES
"That one infection would have become two, and then it doubles again and the two becomes four," Worobey said. "So you have a period -- probably a fair number of years -- where you're dealing with probably fewer than a hundred people who are infected.
"And then, as with epidemic expansion, at some point the hundred becomes 200, you start getting into thousands, tens of thousands. And then quite rapidly you can be up into the hundreds of thousands of infections that were probably already there before AIDS was recognized in the early 1980s."
The study was published in the journal Proceedings of the National Academy of Sciences. The path the virus traveled as it jumped from nation to nation has long been debated by scientists.
The University of Miami's Dr. Arthur Pitchenik, a co-author of the study, had seen Haitian immigrants in Miami as early as 1979 with a mystery illness that turned out to be AIDS. He knew the government long had stored some of their blood samples.
The researchers analyzed samples from five of these Haitian immigrants dating from 1982 and 1983. They also looked at genetic data from 117 more early AIDS patients from around the world.
This genetic analysis allowed the scientists to calibrate the molecular clock of the strain of HIV that has spread most widely, and calculated when it arrived first in Haiti from Africa and then in the United States.
The researchers virtually ruled out the possibility that HIV had come directly to the United States from Africa, setting a 99.8 percent probability that Haiti was the steppingstone.
"I think that it gives us more clear insight into the history of it (the AIDS epidemic) and what path the virus took -- and hard objective evidence, not justarmchair thinking," Pitchenik said in a telephone interview.
Studies suggest the virus first entered the human population in about 1930 in central Africa, probably when people slaughtered infected chimpanzees for meat. AIDS has killed more than 25 million people and about 40 million others are infected with HIV. |
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Immigrant? More like a sailor
That blood samples from a statistically insignificant number of immigrants is the foundation for research smacks of academic myopia.
It is well known that in developing countries certain tourists come to exploit economic conditions for their own sexual deviancy. This is a sub-culture in many industrial nations where statistics are non-existent.
It is very easy to point a finger at a marginalized migrant population while turning a blind eye to a glaring problem within our own culture.
A Rebuttal Against Bad Research (c/o Lynn Selby)
Empire State Medical Association Denounces Incomplete Research Claims made by Dr. Gilbert and Dr. Worobey on "HIV Coming from Haiti"
(www.nyesma.org)
The Empire State Medical Association is highly concerned about the claims by Michael Worobey that "AIDS virus invaded the United States in about 1969 from Haiti, carried most likely by a single infected immigrant who set the stage for it to sweep the world in a tragic epidemic".
We reject the comments that "researchers think an unknown single infected Haitian immigrant arrived in a large city like Miami or New York, and the
virus circulated for years -- first in the U.S. population and then to other nations."
Gilbert and Worobey, analyzed samples from only five of these Haitian immigrants dating from 1982 and 1983. They also looked at genetic data from 117 more early AIDS patients from around the world. This genetic analysis allowed them to calibrate the molecular clock of the strain of HIV that has
spread most widely, and calculated when it arrived first in Haiti from Africa and then in the United States. The researchers virtually ruled out
the possibility that HIV had come directly to the United States from Africa, setting a 99.8 percent probability that Haiti was the steppingstone.
For Haiti, the history of HIV/AIDS represents stigma, discrimination, and racism. In 1982, scientists at the Centers for Disease Control (CDC)
incorrectly inferred that Haitians were at increased for acquiring HIV as a racial group (1). HIV/AIDS therefore became known as the "4H Disease",
affecting homosexuals, heroin addicts, hemophiliacs, and Haitians.
This resulted in unprecedented national stigmatization and devastating economic,
social, and psychological consequences, decimating the tourist industry in this island nation. As reported at the time: "Haiti has been made an
international pariah by AIDS. Boycotted by tourists and investors, it has lost millions of dollars and thousands of jobs at a time when half the work
force is jobless. Even exports are being shunned by some (2)."
In 1985,when it became clear that Haitians share the same risk factors as other groups, the CDC dropped the Haitian association, but it was too late. HIV
and Haiti were inextricably linked in the minds of the general public. Haiti's economy has never recovered.
Gilbert et al once again link HIV and Haiti, stating: "Subtype B likely moved from Africa to Haiti in or around 1966" and then on to the U.S. Their entire hypothesis is based on virus isolated from five Haitian-Americans who were living in Miami in 1982-83. No other information is provided except
that they "entered the U.S. after 1975 and progressed to AIDS by 1981 and hence were presumably infected with HIV-1 before entering the U.S."
A host of questions remain. What were their risk activities? Where had they traveled? Did they have sex with Americans in Haiti? We do know that the
average time of progression of HIV infection to AIDS and to death in the pre-ART era was 4.5 and 7.4 years, respectively - these intervals are consistent with the five subjects acquiring the infection in the U.S, which limits the validity of their findings (3).
The authors go on to state: "The HIV-1 epidemic in Haiti exhibits a greater range of viral genetic diversity that the rest of the world's subtype B combined". The authors have not studied the virus in Haiti. Where are the data to support this claim?
They also state that their aim is to combine phylogenetic, molecular evolutionary, historical, and epidemiological perspectives in an attempt to
reconstruct the history of the subtype B pandemic. However, epidemiology studies conducted in Haiti do not support the author's hypothesis.
If the virus was in circulation in Haiti since 1966, there would not have been a much higher male: female ratio in the early years of the epidemic (80% of
the first Haitian patients were male in the early 1980's) which rapidly generalized as they spread the virus to their female partners (4,5). In addition, reviews of large samples of banked blood from the 1970's failed to yield a single case of HIV and thousands of autopsies did not diagnose an AIDS defining illness until 1978 (6).
Furthermore, only one case of Kaposi's sarcoma (KS) was noted by Haitian dermatologists prior to 1979 (7). KS is easily recognizable and it would not have been missed by Haitian dermatologists for over a decade. Haiti has overcome enormous obstacles and mounted one of the world's most successful responses to the HIV/AIDS epidemic.
Yet, the authors restate prejudices advanced two decades ago in the publication of Pitchenik et al
(8): "Haitians in Haiti and elsewhere are at risk of AIDS". People of all ethnicities in every country are at risk. Scientists need to be very responsible in their assertions, lest they do great harm.
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