title: Surviving the aftershock: postearthquake access and adherence to HIV treatment among Haiti's tent residents.
abstract: In this research we examined how the conditions of Haiti's tent communities, inhabited by those displaced by the January 10, 2010, earthquake, shaped access and adherence to highly active antiretroviral treatment (HAART) for Haitians with HIV. Conditions in the encampments were marked by unhygienic and cramped living spaces, exposure to the elements, a lack of privacy, unavailability of food and clean water, and a dependence on poorly functioning aid agencies. These conditions shaped access and adherence to HAART by (a) exacerbating the stigma of being HIV positive and undermining mental health; (b) presenting logistical challenges to accessing medical care, storing pills, and ingesting them safely and privately; and (c) sustaining a political economy of aid characterized by unequal treatment in major HAART-dispensing centers, unequal circulation of international funds, and the emergence of alternative medical institutions within encampments that could improve future treatment. Policy and intervention implications are discussed.
authors.affiliation: University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA. toorjo@sp2.upenn.edu
authors.forename: Toorjo
authors.initials: T
authors.lastname: Ghose
authors.forename: Edner
authors.initials: E
authors.lastname: Boucicaut
authors.forename: Charles
authors.initials: C
authors.lastname: King
authors.forename: Andrea
authors.initials: A
authors.lastname: Doyle
authors.forename: Virginia
authors.initials: V
authors.lastname: Shubert
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D055866:Earthquakes; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D006205:Haiti / Q000453:epidemiology; D006297:Health Services Accessibility; D006703:Ill-Housed Persons; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D010349:Patient Compliance; D015995:Prevalence; D012959:Socioeconomic Factors