"When there is no money, that is when I vomit blood": the domino effect and the unfettered lethal exploitation of Black labor on Dominican sugar plantations.

BACKGROUND: In this article, I utilize the concept of the Plantationocene as an analytical framework to generate a holistic and historical understanding of the present-day struggles of a mostly Haitian migrant workforce on sugar plantations in the Dominican Republic. METHODS: Inspired by Paul Farmer's methodology, I combine political economy, history, and ethnography approaches to interpret the experiences of sugarcane cutters across historical and contemporary iterations of colonial, post-colonial, and neo-colonial practices over the course of five centuries. RESULTS: My findings elucidate the enduring power of capitalism, implicating corporate and state elites, as the structural scaffolding for acts of racialized violence that condition the life-and-death circumstances of Black laborers on Caribbean plantations to this day. Although today's sugarcane cutters may suffer differently than their enslaved or wage labor ancestors on the plantation, I argue that an unfettered racialized pattern of lethal exploitation is sustained through the structural violence of neoliberalism that links present conditions with the colonial past. CONCLUSIONS: Ultimately, this paper contributes understandings of the plantationocene's enduring effects in the global south by demonstrating how imperialist arrangements of capitalism are not a distant memory from the colonial past but instead are present yet hidden and obscured while relocated and reanimated overseas to countries like the Dominican Republic, where American capitalists still exploit Black bodies for profit and power.

Haitian and Haitian American experiences of racism and socioethnic discrimination in Miami-Dade county: At-risk and court-involved youth.

We examine how juvenile justice-involved youth of Haitian descent in Miami-Dade County cope with structural racism and its impact on their mental health. Drawing on longitudinal ethnography, psychosocial assessment data, and a family-based clinical intervention funded by the National Institute on Drug Abuse, this article explores youth narratives of discrimination prior to and during the COVID-19 pandemic. We use critical race theory and theory of practice to understand youths' perceptions as racialized bodies and stigmatized selves, highlighting the experiences and perspectives of a particular black immigrant group, ethnic beings caught up in the everyday practices of racialization, sociocultural marginalization, and racism. We frame these experiences as a variation of the complex continuum of structural racism and racial domination in the US. These experiences have caused anger, fear, anxiety, chronic anticipatory distress, and hopelessness among youth of Haitian descent. We conclude with some recommendations for therapeutic support that encourages youth to process their experiences, promotes their development of a positive self-concept, and provides them with mind-body techniques to attenuate the physical impacts of discriminatory events. The clinical trial registration number for this study intervention is NCT03876171.

Psychometric Properties of the Haitian Creole Brief Religious Coping Scale (RCOPE) with a Sample of Adult Haitians Impacted by the 2010 Earthquake.

The current study investigated the psychometric properties of the Haitian Creole version of the Brief Religious Coping Scale (Brief RCOPE). A total of 256 adult survivors of the 2010 earthquake in Haiti completed the Brief RCOPE and measures of posttraumatic stress disorder symptoms, resilience, general coping, and posttraumatic growth. The results showed the Brief RCOPE to have excellent internal consistency reliability α = .94 and α = .85 for the positive religious coping and negative religious coping, respectively. Confirmatory factor analysis showed construct validity for the Brief RCOPE subscales. The results also showed evidence of convergent validity of the Brief RCOPE in relation to measures of positive spiritual change and religion. Independent t-tests revealed statistically significant gender differences in scores on the positive religious coping subscales as women scored higher than men. These findings suggest that the psychometric properties of the Haitian Creole version of the Brief RCOPE are adequate for the assessment of religious coping with Haitian adults exposed to a natural disaster.

Joint Associations of Maternal-Fetal APOL1 Genotypes and Maternal Country of Origin With Preeclampsia Risk.

RATIONALE & OBJECTIVES: Preeclampsia, which disproportionately affects Black women, is a leading cause of preterm delivery and risk for future hypertension and chronic kidney disease (CKD). Apolipoprotein L1 (APOL1) kidney risk alleles, common among Black individuals, contribute substantially to CKD disparities. Given the strong link between preeclampsia and CKD, we investigated whether maternal and fetal APOL1 risk alleles can jointly influence preeclampsia risk, and explored potential modifiers of the association between APOL1 and preeclampsia. STUDY DESIGN: Nested case-control study. SETTING & PARTICIPANTS: 426 Black mother-infant pairs (275 African Americans and 151 Haitians) from the Boston Birth Cohort. EXPOSURE: Maternal and fetal APOL1 risk alleles. OUTCOMES: Preeclampsia. ANALYTICAL APPROACH: Logistic regression models with adjustment for demographic characteristics were applied to analyze associations between fetal and maternal APOL1 risk alleles and risk of preeclampsia and to investigate the effects of modification by maternal country of origin. RESULTS: Fetal APOL1 risk alleles tended to be associated with an increased risk of preeclampsia, which was not statistically significant in the total genotyped population. However, this association was modified by maternal country of origin (P<0.05 for interaction tests): fetal APOL1 risk alleles were significantly associated with an increased risk of preeclampsia among African Americans under recessive (odds ratio [OR], 3.6 [95% CI, 1.3-9.7]; P=0.01) and additive (OR, 1.7 [95% CI, 1.1-2.6]; P=0.01) genetic models but not in Haitian Americans. Also, maternal-fetal genotype discordance at the APOL1 locus was associated with a 2.6-fold higher risk of preeclampsia (P<0.001) in African Americans. LIMITATIONS: Limited sample size in stratified analyses; self-reported maternal country of origin; pre-pregnancy estimated glomerular filtration rate (eGFR) and proteinuria data in mothers were not collected; unmeasured confounding social and/or environmental factors; no replication study. CONCLUSIONS: This study supports the hypothesis that fetal APOL1 kidney risk alleles are associated with increased risk for preeclampsia in a recessive mode of inheritance in African Americans and suggests that maternal-fetal genotype discordance is also associated with this risk. These conclusions underscore the need to better understand maternal-fetal interaction and their genetic and environmental factors as contributors to ethnic disparities in preeclampsia.

Remote delivery of a therapeutic intervention to court-mandated youths of Haitian descent during COVID-19.

The threat generated by the COVID-19 pandemic has triggered sudden institutional changes in an effort to reduce viral spread. Restrictions on group gatherings and in-person engagement have increased the demand for remote service delivery. These restrictions have also affected the delivery of court-mandated interventions. However, much of the literature has focused on populations that voluntarily seek out face-to-face medical care or mental health services, whereas insufficient attention has been paid to telehealth engagement of court-mandated populations. This article draws on data gathered on an NIH/NIDA-funded study intervention implemented with juvenile justice-involved youths of Haitian heritage in Miami-Dade County, Florida, during the COVID-19 public health crisis. We explore the process of obtaining consent, technological access issues, managing privacy, and other challenges associated with remote delivery of family-based therapy to juvenile justice-involved youth. Our aim is to provide some insights for consideration by therapists, healthcare workers, advocates, researchers, and policymakers tasked with finding alternative and safer ways to engage nontraditional populations in health services. The clinical trial registration number is NCT03876171.

Diabetes Mellitus Prevalence Among Haitian American Afro-Caribbeans in the United States.

To measure the prevalence of diabetes mellitus among Haitian American Afro-Caribbeans, a quantitative descriptive cross-sectional study was conducted using a convenience sample of 151 Haitian Americans in New York, New Jersey, and Florida. The results of the study revealed an age-adjusted prevalence of diabetes mellitus of 39.9% (95% CI 29.8% - 50.1%). This is greater than the prevalence in the U.S. population (12%) (Z = 5.54, p < 0.05) and the prevalence in the Black, non-Hispanic population (16.8%) (Z = 3.35, p < 0.05). There were 79 (52.3%) individuals with diabetes mellitus, of which 21 (13.9%) were individuals who were previously undiagnosed; and 56 (37%) were individuals who were taking medication(s) for controlling glucose. At a 39.9% prevalence rate of diabetes, Haitian Americans have an age-adjusted prevalence rate of diabetes that is more than twice the prevalence rate of diabetes in Black, non-Hispanic Americans and more than 3 times the rate in White, non-Hispanics. This rate is comparable to the prevalence rate in Native Americans of the Pima tribe. An urgent need exists to confirm these findings in a larger cohort.

Epidemiological and pathogenic characteristics of Haitian variant V. cholerae circulating in India over a decade (2000-2018).

Vibrio cholerae, causative agent of the water-borne disease cholera still threatens a large proportion of world's population. The major biotypes of the pathogen are classical and El Tor. There have been recent reports of variant V. cholerae strains circulating around the world. In the present study, the epidemiological status of V. cholerae strains circulating in the country over a decade was assessed. Also, a comprehensive analysis of the difference in pathogenicity between the different biotypes of V. cholerae strains was evaluated both in-vitro and in-vivo. The amount of CT produced by different biotypes of V. cholerae strains were analyzed by GM1 ELISA and the probable reasons for the difference in toxin production was discussed. MLST analysis grouped the isolates into a single Sequence Type (ST 69) whereas PFGE analysis clustered the isolates into ten different pulsotypes revealing molecular diversity. The circulating strains were identified to produce cholera toxin and CT mRNA intermediate to the classical and prototype El Tor strains. Also, the circulating strains were identified to possess four ToxR binding sequences. In-vivo pathogenicity analysis by rabbit ileal loop fluid accumulation assay revealed the Haitian variant strains to be more hyperemic than the prototype strains.

Comparison of Early Life Obesity-Related Risk and Protective Factors in Non-Hispanic Black Subgroups.

OBJECTIVES: Previous obesity prevention studies in preschool-age children have included non-Hispanic Black (NHB) children, but few have investigated between-subgroup differences even though there may be cultural risk and protective practice differences, challenging the generalizability of findings. The purpose of this study was to examine differences in early childhood obesity-related factors in NHB subgroups (Haitian, other Caribbean Islander and African-American [AA]) children. METHODS: Baseline data from two randomized controlled trials in 52 childcare centers of which 35 had data to test a preschool-based obesity prevention intervention was analyzed. The sub-sample included 370 caregiver-child dyads; 209 self-identified as AA, 120 as Haitian and 41 as Caribbean Islander/West Indian or mixed race. Multilevel regression models generated outcome estimates for group differences in body mass index (BMI) percentile, birthweight, breastfeeding initiation and duration, bottle feeding duration and age when solid foods were introduced. RESULTS: Mean BMI percentile was similar for AA, Haitian and Caribbean Islander/West Indian/Multiracial (60.1th percentile, 60.8th percentile, 62.8th percentile, respectively) as was birthweight (6.3, 6.8, and 6.6 lb, respectively). Children of US-born caregivers had significantly lower BMI percentiles (9.13 percentile points) versus foreign-born caregivers. Haitian women were significantly more likely to initiate breastfeeding (64.9%) versus AA (47.6%) and Caribbean Islander/West Indian/Multiracial (62.2%) (p < .01). No significant group differences were found in breastfeeding or bottle feeding duration or age solid foods were introduced. CONCLUSIONS: Findings here suggest that NHB race classification can identify important subgroup behavioral similarities which in turn may inform culturally sensitive strategies to promote early childhood healthy weight. Foreign-born caregivers may benefit from healthy weight promotion information, and as early as possible in their child's development.

Professional language use by alumni of the Harvard Medical School Medical Language Program.

BACKGROUND: Despite the growing number of patients with limited English proficiency in the United States, not all medical schools offer medical language courses to train future physicians in practicing language-concordant care. Little is known about the long-term use of non-English languages among physicians who took language courses in medical school. We conducted a cross-sectional study to characterize the professional language use of Harvard Medical School (HMS) alumni who took a medical language course at HMS and identify opportunities to improve the HMS Medical Language Program. METHODS: Between October and November 2019, we sent an electronic survey to 803 HMS alumni who took a medical language course at HMS between 1991 and 2019 and collected responses. The survey had questions about the language courses and language use in the professional setting. We analyzed the data using descriptive statistics and McNemar's test for comparing proportions with paired data. The study was determined not to constitute human subjects research. RESULTS: The response rate was 26% (206/803). More than half of respondents (n = 118, 57%) cited their desire to use the language in their future careers as the motivation for taking the language courses. Twenty-eight (14%) respondents indicated a change from not proficient before taking the course to proficient at the time of survey whereas only one (0.5%) respondent changed from proficient to not proficient (McNemar's p-value < 0.0001). Respondents (n = 113, 56%) reported that clinical electives abroad influenced their cultural understanding of the local in-country population and their language proficiency. Only 13% (n = 27) of respondents have worked in a setting that required formal assessments of non-English language proficiency. CONCLUSIONS: HMS alumni of the Medical Language Program reported improved language proficiency after the medical language courses' conclusion, suggesting that the courses may catalyze long-term language learning. We found that a majority of respondents reported that the medical language courses influenced their desire to work with individuals who spoke the language of the courses they took. Medical language courses may equip physicians to practice language-concordant care in their careers.

The long-term impact of providing nursing education in a low-income country.

OBJECTIVE: To measure long-term knowledge gain after provision of nursing education in a low-income country. DESIGN AND SAMPLE: Global health education research has often focused on the short- term effects of providing education and direct patient care. Assessment of long-term knowledge gain is key for determining whether education knowledge transfer is sustainable. MEASUREMENTS: This prospective cohort study of educational training for nurses in Haiti tested knowledge gain before, immediately after, and 6 months after education. INTERVENTION: Quantitative assessments were obtained through multiple choice tests at 3 time points. Qualitative data were obtained through focus groups and self-assessments. RESULTS: Knowledge gain was significant from pretest to immediate posttest, and knowledge retention was assessed at 6 months after the education. Qualitative data showed improvement in reported confidence levels and patient care activities. Short-term knowledge gain was statistically significant for improvement; however, long-term knowledge gain was statistically significant in only 4 of 19 lectures. CONCLUSIONS: Reported qualitative improvements in patient care indicated added value of providing education to the nursing staff. Hands-on learning techniques were important to long-term retention, and building trust was vital to the completion of our study.

Understanding Type 2 Diabetes Mellitus Among Haitian American Women: A Cultural Perspective.

The prevalence of type 2 diabetes mellitus (T2DM) is 19.7% in Haiti (DeGennaro et al., 2018). Haitian American women (HAW) experience difficulties with adherence to T2DM treatment and management (Bivins, 2016; Magny-Normilus et al., 2019; Vimalananda et al., 2011; Huffman et al., 2013); however, no previous study was found that focused exclusively on Haitian American women with T2DM. Van Manen's six research activities guided this phenomenological qualitative inquiry. Recruitment included 25 Haitian American women (N = 25) with T2DM from three South Florida counties. Data were collected using a vignette and audio-recorded semi-structured interviews with open-ended questions. Recordings were then transcribed and analyzed to identify thematic concepts and patterns. Themes of spiritualizing and shifting cultural norms with the subtheme of dietary restrictions were found. In conclusion, to promote health outcomes nurses must incorporate these salient factors in the care of Haitian American women with T2DM.

RANDOMIZED CONTROLLED TRIAL COMPARING THE EFFECTS OF ALFAXALONE AND KETAMINE HYDROCHLORIDE IN THE HAITIAN GIANT GALLIWASP ( CELESTUS WARRENI).

The immobilization properties and cardiopulmonary effects following intramuscular administration of one of two chemical immobilization agents were compared in the Haitian giant galliwasp ( Celestus warreni) in a prospective, blinded, randomized controlled trial. Adult, clinically healthy galliwasps ( n = 30) were given a randomly assigned single intramuscular injection of either 15 mg/kg alfaxalone ( n = 15) or 40 mg/kg ketamine hydrochloride ( n = 15). Heart rate, respiratory rate, and depth classification stage were recorded every 5 min; cloacal temperature was recorded every 15 min to ensure maintenance within this species' preferred optimal temperature range (75-85°F, 24-29°C). Physical examination, radiographs, and phlebotomy were performed in all animals. Alfaxalone given intramuscularly resulted in reliable anesthetic induction, maintenance, and recovery (total duration of anesthesia 57.7 ± 23.6 min, recovery 7.9 ± 7.8 min). Ketamine hydrochloride resulted in variable levels of sedation or anesthesia and a longer recovery (total duration of anesthesia 14 ±17.5 min, recovery 47.9 ± 19.3 min). Heart and respiratory rates remained within clinically acceptable ranges in all lizards using both protocols; however, alfaxalone animals had lower heart rates and respiratory rates associated with increased anesthetic depth as compared to ketamine hydrochloride animals (heart rates: alfaxalone 59.6 ± 13.3 beats/min, ketamine hydrochloride 71.9 ± 7.9 beats/min; respiratory rates: alfaxalone 33.4 ± 16.8 breaths/min, ketamine hydrochloride 50.0 ± 16.2 breaths/min). Duration of anesthesia for alfaxalone-treated galliwasps was longer than previously reported in other studies. This study determined that a single injection of alfaxalone at 15 mg/kg administered intramuscularly can be used for consistent induction and maintenance of anesthesia and prompt recovery in the Haitian giant galliwasp, while ketamine hydrochloride even at 40 mg/kg was unreliable and is not recommended as a sole immobilization agent in the Haitian giant galliwasp.

Intravaginal practices are associated with greater odds of high-risk HPV infection in Haitian women.

OBJECTIVE: Haitian women have the highest incidence of cervical cancer within the Western hemisphere. Intravaginal hygiene practices have been linked with human papilloma virus (HPV) infection and cervical dysplasia. These practices, known as 'twalet deba' in Haitian Creole, are common among Haitian women and are performed with various natural and synthetic agents. As part of a community-based participatory research initiative aimed at reducing cervical cancer disparities in rural Haiti, we explored the use of intravaginal agents and their associations with high-risk HPV infection. DESIGN: Community Health Workers recruited 416 women for cervical self-sampling from two neighborhoods within Thomonde, Haiti. Participants were interviewed regarding intravaginal hygiene practices and completed a cervical self-sampling procedure. Cervical samples were analyzed for the presence of high-risk HPV infection. Associations between each intravaginal agent and high-risk HPV infection were examined via univariate logistic regression analyses, as well as via multivariate analyses controlling for sociodemographic factors and concurrent agent use. RESULTS: Nearly all women (97.1%) performed twalet deba, using a variety of herbal and commercially produced intravaginal agents. Approximately 11% of the participants tested positive for high-risk HPV. Pigeon pea and lime juice were the only agents found to be associated with high-risk HPV in the univariate analyses, with women who used these agents being approximately twice as likely to have high-risk HPV as those who did not. Only pigeon pea remained significantly associated with high-risk HPV after controlling for sociodemographic factors and concurrent agent use. CONCLUSION: Two agents, pigeon pea and lime juice, may contribute to risk for HPV infection in this population. Results suggest that in addition to cervical cancer screening interventions, future preventive initiatives should focus on minimizing risk by advocating for the use of less-toxic twalet deba alternatives.

Vibrio cholerae O1 El Tor variant and emergence of Haitian ctxB variant in the strains isolated from South India.

Cholera still continues to be an important cause of human infection, especially in developing countries that lack access to safe drinking water and proper sanitation. In the present study, we report the emergence of new variant form of V. cholerae O1 El Tor biotype with a novel mutation in ctxB in strains isolated from various outbreaks during 2010-2014 in Belgaum situated in north-west Karnataka, India. A total of 14 occurrences of cholera were documented from Belgaum Division of North Karnataka during the 4-year period from 2010 to 2014. All the V. cholerae O1 isolates were subjected to DAMA PCR to detect the three different allelic subtypes of ctxB and PCR-based detection of virulent genes, and subsequently, 14 strains (one strain from each outbreak or sporadic case) were subjected to ctxB gene sequence and pulsed-field gel electrophoresis (PFGE) analysis. A total of 54 V. cholerae O1 strains were obtained of which 21 strains isolated during 2010-2011 had classical ctxB and remaining 33 strains isolated during 2012-2014 belonged to Haitian variant. In the cluster analysis, the PFGE profiles were divided into clades A with and B. Clade A contained eight strains with 94 % similarity and Haitian type of ctxB. Clade B contained six strains and had Haitian type of ctxB except one with classical ctxB. To the best of our knowledge, this is the first report of the Haitian variant of V. cholerae O1 Ogawa causing outbreaks and sporadic cases of cholera in South India.

Adapting an evidence-based intervention for HIV to avail access to testing and risk-reduction counseling for female victims of sexual violence in post-earthquake Haiti.

Haiti has the highest prevalence of HIV/AIDS in the Caribbean. Before the 2010 earthquake, Haitian women bore a disproportionate burden of HIV/AIDS, had lower HIV knowledge, less capacity to negotiate for safer sex, and limited access to HIV testing and risk-reduction (RR) counseling. Since 2010, there has been an increase in sexual violence against women, characterized by deliberate vaginal injuries by non-intimate partners, increasing victims' risk of sexually transmitted infections including HIV/AIDS. Needed is an adaptation of evidence-based interventions for HIV that include HIV testing and counseling for this stigmatized population. We reviewed several features of Centers for Disease Control and Prevention's 103 evidence-based interventions for HIV (e.g., measures used, participant risk characteristics, theoretical framework, outcome variables, and evidence tier) in an attempt to seek a feasibly adaptable evidence-based intervention for HIV that could be used for victims of sexual violence (VOSV). RESPECT, one of the reviewed evidence-based HIV interventions, comprises of one-on-one, client-focused HIV prevention/RR counseling, and RAPID HIV testing. Adapting RESPECT can enhance access to testing for Haitian VOSV and can influence their perceptions of HIV risk, and establishment of RR goals for future consensual intimate relations. Adapting and implementing RESPECT can increase uptake of evidence-based HIV interventions among Haitians and positively affect a region with high HIV prevalence and increased rates of sexual violence.

The concept of stigma in mental illness as applied to Haitian Americans.

AIM: To report on the analysis of the concept of the stigma of mental illness within the Haitian American community. BACKGROUND: Mental illness is a highly stigmatized condition within certain communities making it challenging for individuals to seek effective treatment. The consequences of such stigma can have lifelong corollaries for the individuals, the families and the communities. INTRODUCTION: The concept of stigma is not fully developed in nursing; clarity of the concept of stigma of mental illness is still needed in the nursing literature. In order to assist patients in accessing mental health services, the concept of stigma must first be clarified. METHODS: The method used for this concept analysis was that of Walker and Avant. FINDINGS: Five attributes were identified, creating the following definition: labelling, stereotype, negative attitude, emotional response, and discrimination. The antecedents for stigma of mental illness are lack of knowledge about mental illness, emotional state and cultural beliefs and values. IMPLICATIONS FOR NURSING AND HEALTH POLICY: The origins of stigmatization of mental illness among Haitian Americans need to be understood. Mental health illnesses are stigmatized within the Haitian culture, which presents as a barrier to accessing help for many Haitian American women suffering from mental illness. The defining attributes can be used to develop tools to help clinicians identify patients being stigmatized. Once stigma is recognized, nurses can develop strategies and policies that can mitigate the effects of stigmatization of mental illness among this patient population. CONCLUSION: Further research is essential to examine the ways in which this concept impacts the Haitian American community, as well as effective strategies to help minimize its effects.

"This Method, I Think, Can Shed New Light": Haitian-American Women's Reflections on Risk, Culture, and Family Planning Decisions From a Short-Term Trial of a Cervical Barrier (Femcap™).

Improving the reproductive health of immigrant populations requires understanding the specific context of risk and need. As part of a field trial of the FemCap™, a woman-initiated cervical barrier contraceptive, we conducted postintervention focus group discussions (FGDs) with 20 women (five FGDs) of Haitian background, the majority of whom were born in Haiti and spoke Haitian Créole at home, at a community health center in south Florida. Participants discussed the role of religion and inequitable gender norms in Haitian traditions about family planning decisions and provided important insights into the gender-power nuances of their partnership dynamics vis à vis the use of female barrier methods. Encouraged by more equitable gender norms in the United States, participants were eager to serve as health education agents, with strong altruistic sentiments toward other Haitian girls and women who they felt could be encouraged to negotiate for greater reproductive decision-making power.

Long-term outcomes among child and adolescent survivors of the 2010 Haitian earthquake.

BACKGROUND: We examined the prevalence and predictive factors of PTSD and depression in relation with peritraumatic distress, trauma exposure, and sociodemographic characteristics among children and adolescent who survived the 2010 Haiti's earthquake. METHODS: We analyzed data collected between June and July 2012 from a sample of 872 participants aged 7 to 17 in 12 schools, door-to-door canvassing and two centers for street children at Port-au-Prince. Participants completed the Impact of Event Scale Revised (IES-R), Peritraumatic Distress Inventory, Child Depression Inventory 2 (CDI), and sociodemographic and traumatic exposure questionnaires. RESULTS: Of 872 participants, respectively 322 (36.93%); and 403 (46.21%) reported a clinically significant symptoms of PTSD and depression, which were significantly higher among girls. The best predictive variables are peritraumatic distress for PTSD (ß=0.53,P<.0001) a traumatic exposure for depression (ß=0.23,P<.0001). The comorbidity between PTSD and depression symptoms is 22.25%. CONCLUSIONS: This first study in children on the prevalence of PTSD and depression resulting from the 2010 Haiti earthquake demonstrates a need for improvement in treatment aimed at reducing PTSD and depression. Such treatment should be geared primarily toward girls, adolescents between the ages of 14 and 17 and those children and adolescents who have lost a family member in the earthquake.

'Men don't need to know everything': a field trial of a discreet, female-initiated, contraceptive barrier method (FemCap™) among Haitian-American women.

Worldwide, women report the need for safe, non-hormonal, woman-initiated methods of family planning. Cervical barriers provide such technology but are under-researched and under-promoted. In the USA, there are few studies of cervical barriers among women at high unmet need for contraception. A feasibility study of the FemCap™ was conducted among US women of Haitian origin. Participants were heterosexual and seeking to avoid pregnancy. At first visit, participants completed baseline assessments, underwent group counselling and were fitted with FemCap™. Women were asked to insert or use the cap at home. The second visit (2-3 weeks) included an interviewer-administered questionnaire and a focus-group discussion. Participants (n  =  20) were Haitian-born (70%), married (55%) and parous (85%). Their mean age was 32.6 years. Seventy percent reported recent unprotected sex. All women inserted the device at home and 9 women used it during intercourse, including 5 without prior partner negotiation. Of 20 women, 11 liked FemCap™ very much or somewhat; 7 considered it 'OK'; 2 disliked it. Best-liked attributes were comfort, discreet wear and reusability. Difficulties with removal abated over time. Qualitative data revealed a high value placed on lack of systemic side effects. Use of FemCap™ was feasible and acceptable, supporting expansion of research, particularly among relevant populations with unmet need.

An examination of the HIV serostatus disclosure process among Haitian immigrants in New York City.

Little is known about the HIV serostatus disclosure experience of Haitian immigrants in the USA. We employed the disclosure processes model to examine the disclosure experience of 21 HIV-positive Haitian immigrants in New York City. Data were collected through in-depth interviews conducted between May 2012 and January 2013 with participants from four community-based organizations providing HIV/AIDS services. Analysis of the interviews yielded several enablers relevant to reasons for disclosure including participants being in a close relationship with someone they trusted or felt comfortable with, and the need for support and understanding about the illness. Some of the barriers to HIV serostatus disclosure were fear of being stigmatized, rejected. For participants who had disclosed to significant others in the USA and in Haiti, they reported that they experienced both positive and negative outcomes including social support, emotional relief, encouragement to take their medication, and on some occasions mistreatments, isolation, and stigma. The strategies participants employed during the disclosure event also revealed the additional challenges immigrants face when deciding to disclose their HIV serostatus to family members living in their country of origin. These findings suggest the need to develop culturally appropriate interventions to address the disclosure needs of ethnic minorities residing in the USA.