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APHA Scientific Session and Event Listing

Recorded presentation

Gilbert Saint-Jean, MD MPH PhD¹, Jessy G. Desvieux, PhD², Nisha Farrell, BA², and Robert Malow, PhD². (1) Miller School of Medicine, University of Miami, 1801 NW 9th Ave Room 212 C, Miami, FL 33136, 305-243-6571, gsaint@med.miami.edu, (2) AIDS Prevention Program, Florida International University, Biscayne Bay Campus, AC I 260, 3000 NE 151st Street, North Miami, FL 33181

BACKGROUND: In resource-poor countries, Voluntary Counseling and Testing (VCT) for HIV is an effective and affordable HIV prevention strategy. Lack of access to basic health education and services has been viewed as a human rights violation. We evaluate differences in knowledge, attitudes, and behaviors about HIV/AIDS and VCT between urban and rural residents.

METHOD: Data from the 2000 countrywide EMMUS survey were analyzed using Chi square and logistic regression analysis to a probability sample of 8,206 Haitian adults (3,205 urban and 5,001 rural).

RESULTS: Compared to urban, rural residents demonstrated lower knowledge about HIV transmission (9.7%/23.4%, p=0.00); mother-to-child transmission (68.2/83.3, p=0.00) and transmission by sorcery (51.4/57.4, p=00); lower positive attitude toward PLWHA (4.6%/9%, p=0.00); and lower usage of condom at last intercourse (4.6%/16.0%, p=0.00). Additionally, fewer knew a place to obtain an HIV test (23.3%/42.3%, p=0.00); had ever been tested (1.7%/8.2%, p=0.00); and expressed a willingness to be tested (54.9%/59.3%, p=0.00). Controlling for socio-demographic differences, overall knowledge of HIV prevention (OR = 1.44, p=0.00) and education level (OR = 1.45, p= 0.00) accounted for the largest variances in urban/rural differences in willingness to be tested.

DISCUSSION: Rural residents low performance on overall HIV/AIDS knowledge, attitude, and behavior indices as well as specific VCT knowledge, attitude, and behavior, clearly suggest the need to expand basic HIV prevention programs to rural areas. This is especially crucial in view of recent epidemiological trends that show decreasing HIV prevalence in urban areas and increasing rates in rural areas.

Learning Objectives: At the end of the presentation the participant should be able to

• Describe differences in HIV knowledge, attitudes, behaviors, and practices between rural and urban residents of Haiti.
• Describe and apply the statistical methods used in this study to conduct studies on similar populations.
• Apply the findings to design interventions to disparities in HIV/AIDS transmission and prevalence in Haiti and other countries with similar health inequities.

Keywords: HIV/AIDS, Health Care Access

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation