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www.aids2014.org
Social and Structural Contexts of
HIV Vulnerability Among
Internally Displaced Youth in
Leogane, Haiti
Ca...
www.aids2014.org
Background
www.aids2014.org
• Haiti has the highest HIV infection rate in the
Western Hemisphere with 1 in 50 people
infected (UNAIDS...
www.aids2014.org
• Poverty and gender inequity shape women’s
vulnerability to HIV infection in Haiti (Walton et al., 2004)...
www.aids2014.org
• January 12, 2010 earthquake devastated social,
health and social infrastructure: 2 million
homeless
• O...
www.aids2014.org
Objectives
• Understand contexts of HIV vulnerability among
internally displaced (ID) young men and women...
www.aids2014.org
Methods
Focus groups:
young women
(n=30)
18-19 (n=10)
20-21 (n=10)
22-24 (n=10)
Focus groups:
young men (n=30)
18-19 (n=10)
20-21 ...
www.aids2014.org
• Focus groups were conducted in Kreyol, digitally
recorded and transcribed verbatim, then
translated int...
www.aids2014.org
Theoretical Approach
www.aids2014.org
Structural Violence
Social structures (economic, political, legal,
religious, cultural) that prevent indi...
www.aids2014.org
Types of Violence
- Physical and psychological violence: “violence that
works on the body and violence th...
www.aids2014.org
Findings
www.aids2014.org
Macro-level: Direct Violence
Tents/housing
Sexual violence
Poverty driven transactional sex
www.aids2014.org
Housing
Life under the tent is not safe, especially for young women.
There was a young woman living under...
www.aids2014.org
Sexual Violence
Lack of money is the cause of the violence. A group of men
can break into a house to stea...
www.aids2014.org
Poverty driven transactional sex
Because you are not in a good economic situation, if the
person does som...
www.aids2014.org
Poverty driven transactional sex
In Leogane the young men do not respect women. There is
economic hardshi...
www.aids2014.org
Macro-level: Indirect Violence
Tent distribution policies
Hunger
www.aids2014.org
Tent Distribution Policies
It’s the way the NGO’s are distributing the help, which is
causing this increa...
www.aids2014.org
Tent Distribution Policies
There is more violence. The family is living in camps and
are somewhat separat...
www.aids2014.org
Hunger
Well it’s something that I can tell you that all Haitians
already know. The major problem is hunge...
www.aids2014.org
Protective Factors
www.aids2014.org
Protective Factors
Micro
• Intrapersonal
(hope, goals)
• interpersonal
Meso
• community
support
• social ...
www.aids2014.org
Discussion
www.aids2014.org
Complexity of Violence
Sites
• Housing
• Community
• NGO
• Police
Levels
• Micro
• Meso
• Macro
Forms
• L...
www.aids2014.org
Implications for HIV Prevention
Structural: macro
Poverty reduction
Gender-based violence
Education
Housi...
www.aids2014.org
Research Implications
Efficacious strategies to promote equitable
gender norms
Structural interventions t...
www.aids2014.org
Acknowledgments
• NEGES Foundation, Leogane, Haiti
• Participants, peer research assistants
• Funders:
– ...
Social and Structural Contexts of HIV Vulnerability Among Internally Displaced Youth in Leogane, Haiti
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Social and Structural Contexts of HIV Vulnerability Among Internally Displaced Youth in Leogane, Haiti

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Presentation given by Carmen Logie at the Under the Baobab African Diaspora Networking Zone at the International AIDS Conference, AIDS 2014.

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Social and Structural Contexts of HIV Vulnerability Among Internally Displaced Youth in Leogane, Haiti

  1. 1. www.aids2014.org Social and Structural Contexts of HIV Vulnerability Among Internally Displaced Youth in Leogane, Haiti Carmen Logie, PhD1; CarolAnn Daniel, PhD2 1: Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada; 2: Faculty of Social Work, Adelphi University, New York, USA
  2. 2. www.aids2014.org Background
  3. 3. www.aids2014.org • Haiti has the highest HIV infection rate in the Western Hemisphere with 1 in 50 people infected (UNAIDS, 2011) – highest rates of poverty in the region • HIV vulnerability in Haiti: – structural (e.g. poverty) and social factors (e.g. stigma) (Farmer, 2004) – high rates of TB co-infection, malaria and poor nutrition (Malow et al. 2010)
  4. 4. www.aids2014.org • Poverty and gender inequity shape women’s vulnerability to HIV infection in Haiti (Walton et al., 2004) – young women had lower rates of HIV knowledge than young men (UNAIDS, 2010) – young women twice as likely as young men to have an STI (Dorjgochoo et al., 2009)
  5. 5. www.aids2014.org • January 12, 2010 earthquake devastated social, health and social infrastructure: 2 million homeless • Over four years later approximately 280,000 persons remain displaced in Haiti and lack protection and basic services (Human Rights Watch, 2014; IOM, 2013) – In Leogane 5,000 people remain displaced and live in 15 IDP camps
  6. 6. www.aids2014.org Objectives • Understand contexts of HIV vulnerability among internally displaced (ID) young men and women in Leogane, Haiti
  7. 7. www.aids2014.org Methods
  8. 8. Focus groups: young women (n=30) 18-19 (n=10) 20-21 (n=10) 22-24 (n=10) Focus groups: young men (n=30) 18-19 (n=10) 20-21 (n=10) 22-24 (n=10) Individual interviews: key informants (n=11) peer leaders (n=6; 3 young ID women, 3 young ID men) youth ID community health workers (n=3) project coordinator (n=1); youth worker (n=1)
  9. 9. www.aids2014.org • Focus groups were conducted in Kreyol, digitally recorded and transcribed verbatim, then translated into English • Thematic analysis, a method used to identify, analyze and report themes in the data (Braun & Clarke, 2006)
  10. 10. www.aids2014.org Theoretical Approach
  11. 11. www.aids2014.org Structural Violence Social structures (economic, political, legal, religious, cultural) that prevent individuals, groups and societies from reaching their full potential Unequal access to resources, power, education, health care and legal standing Emerges as unequal life chances (Farmer 1999; 2004; Galtung, 1969)
  12. 12. www.aids2014.org Types of Violence - Physical and psychological violence: “violence that works on the body and violence that works on the soul” - Intended vs. unintended - Direct/personal: an actor commits the violence - indirect/structural: there is no individual actor - Manifest vs. latent: manifest violence is observable; latent violence is not yet there, yet may easily appear (Galtung, 1969)
  13. 13. www.aids2014.org Findings
  14. 14. www.aids2014.org Macro-level: Direct Violence Tents/housing Sexual violence Poverty driven transactional sex
  15. 15. www.aids2014.org Housing Life under the tent is not safe, especially for young women. There was a young woman living under a tent alone, when three young men came in and violated her. After this happened, she wanted to take it to the police, however she was scared that they may come back and kill her. She was also discouraged because no one felt that the police would take charge. (FG girls 18-19)
  16. 16. www.aids2014.org Sexual Violence Lack of money is the cause of the violence. A group of men can break into a house to steal, but when they get there they find women, they automatically add rape to their list of crimes, just because. Now the problem is with housing, women are forced to sleep somewhere that is unsafe. (FG girls 20-21)
  17. 17. www.aids2014.org Poverty driven transactional sex Because you are not in a good economic situation, if the person does something for you, you are forced to sleep with him even if you did not want to. This is another type of violence because you did it, but did not do it voluntarily. (FG girls 24)
  18. 18. www.aids2014.org Poverty driven transactional sex In Leogane the young men do not respect women. There is economic hardship. There is no work and young girls do not go to school. She decides to sell her body so that she can eat or to make money to go to school. The men who have money want young girls. Because she is in need, whether she was interested in him or not, she sleeps with him. (FG girls 20-21)
  19. 19. www.aids2014.org Macro-level: Indirect Violence Tent distribution policies Hunger
  20. 20. www.aids2014.org Tent Distribution Policies It’s the way the NGO’s are distributing the help, which is causing this increase [violence]. They should be seeking out the head of the households; they shouldn’t be offering it to children. The mother has a tent, the brother has a tent, and everyone gets a tent. And once everyone has their own tent, they offer them each some food. But in fact it the distribution should go to the head of the home to avoid all of this chaos. (FG boys 18-19)
  21. 21. www.aids2014.org Tent Distribution Policies There is more violence. The family is living in camps and are somewhat separated. The kids make their own little house and then the parents have no control, this now opens the door for rape and violence. (FG girls 20-21)
  22. 22. www.aids2014.org Hunger Well it’s something that I can tell you that all Haitians already know. The major problem is hunger. Hunger. Once there is hunger in a country, the country will not function properly. The more a child doesn’t eat properly…. Sometimes, someone doesn’t need to know the person to offer him or her food. And just that can cause them to do things they don’t want to do, like have sex without condoms. And they could then catch HIV. (FG boys 20-21)
  23. 23. www.aids2014.org Protective Factors
  24. 24. www.aids2014.org Protective Factors Micro • Intrapersonal (hope, goals) • interpersonal Meso • community support • social capital Macro • education • employment
  25. 25. www.aids2014.org Discussion
  26. 26. www.aids2014.org Complexity of Violence Sites • Housing • Community • NGO • Police Levels • Micro • Meso • Macro Forms • Latent • Direct and indirect • Physical, sexual
  27. 27. www.aids2014.org Implications for HIV Prevention Structural: macro Poverty reduction Gender-based violence Education Housing Effective law enforcement Community: meso Gender equity Community mobilization for social protection Social capital and social support Intra/interpersonal: micro Intra: resilience, self- worth, hope Inter: safer sex negotiation skills
  28. 28. www.aids2014.org Research Implications Efficacious strategies to promote equitable gender norms Structural interventions to address poverty, violence and HIV prevention Disconnect: surviving vs. realizing potential
  29. 29. www.aids2014.org Acknowledgments • NEGES Foundation, Leogane, Haiti • Participants, peer research assistants • Funders: – Grand Challenges Canada Rising Star in Global Health Award – Canadian Institutes of Health Research (CIHR) Contact me: carmen.logie@utoronto.ca

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