Recently, however, a study conducted by a University of Arizona researcher (discussed in the Literature Review section below) has identified Haiti as the path through which AIDS entered the United States in the late 1970’s. The study indicated that the Haitian lineage, carrier of the HIV virus, may have been the sole propagator of the virus into the US.

The purpose of this paper, as a result, is two-fold. First, it seeks to identify and examine the scientific findings related to the genesis of this now world epidemic. Such a compilation of information will comprise both national and international data on the subject. Secondly, it will seek to delineate the principal parameters, both linguistic and sociological, within which research findings ought to be differentiated from assumptions and inferences emanating from those studies, and the consequences such a distinction may imply. Some of the investigative questions to be explored in this paper will include the following:

• What was the geographical scale, worldwide, of the earliest AIDS-related signs and symptoms?
• How were these first signs and symptoms recorded and reported?
• What factors could account for the concentration of the reported signs and symptoms within that geographical sphere?
• Has there been a reconsideration of this geographical delineation in the literature as of late? If so, why?

Literature Review:

As indicated above, a recent study on the origin of AIDS published by Michael Worobey, from the University of Arizona, has garnered a lot of attention in the media. For instance, the major national newspapers such as the New York Times, the Los Angeles Times, the Chicago Sun Times and the French newspaper Le Monde, have all reported on the study; and headlines such as “HIV’s path out of Africa: Haiti, the U.S. , then the world” have circulated on the web.

In the study, Worobey and his colleagues advance the claim that Haiti was the “stepping- stone” toward the introduction of the virus onto the American soil, and that “the predominantly heterosexual epidemic in this country can be explained by a single introduction linked to Haiti.” The study was done comparing blood samples from five Haitian immigrants living in Florida – who had left Haiti shortly after 1975 – with other non-Haitian blood samples depicting 117 HIV-1 subtype B sequences from a total of 19 countries. Following statistical analysis of the various sequences of the blood sampling, Worobey et al. conclude that these five Haitian immigrants, carriers of the HIV-1 virus “progressed to AIDS by 1981 and hence were presumably infected with HIV-1 before entering the United States.” Additionally, Worobey and his colleagues indicate that the virus probably traveled to Haiti in the mid 1960’s with the returning of Haitian intellectuals who had gone to central Africa, especially the Congo, to help in the education of the former French colonies.

The Worobey study is a sharp contrast to established scientific findings on the path of AIDS to the Americas, and to Haiti in particular. For instance, in a study published by Johnson and Pape (1989), two Cornell University scholars, scientific data collected through their own research clearly established that AIDS “… came to the United States and Europe, and subsequently was introduced into Haiti by either tourists or returning Haitians.” This study further revealed that in 1978-1979, when the earliest reports of AIDS-related symptoms were being reported both in Haiti and in the United States, most of the newly infected Haitians were “sexually active adults in Port-au-Prince”, and that the seroprevalence of HIV in Port-au-Prince was three times that reported in the rural areas. Additionally, the paper noted that the primary modes of infection were through bisexuality, prostitution, and blood transfusions.

The story of how AIDS entered the U.S. population, over the years, has also followed other paths, away from Haiti. In an article published in the American Medical News (October 23, 1987), a young Canadian airline steward named Gaeton Dugas was thought of as the person who “may have brought AIDS to the United States.” This conclusion was fueled by information published in the book “And the Band Played On”, in which author Randy Shilts had indicated that Dugas had contracted the HIV virus from Paris and propagated its spread into the U.S. population.

In light of these varied theories on the origin of AIDS, and its dissemination into the United States, it might be useful to obtain some foundation of the concepts of HIV/AIDS, to report on the definition of each term, and to address their causal relationships as part of the groundwork for an honest analysis of the data reported above.

HIV, or Human Immunodeficiency Virus, is known as a lentivirus (or slow virus) that affects and attacks the immune system. People affected with the HIV virus, for example, will have a significant decrease in their CD4+T cells, those cells responsible for maintaining a healthy immune system. HIV progresses through various stages based on the decreasing amount of CD4+T cells in the blood, until the immune system is compromised and the emergence of infections, such as pneumonia and Kaposi’s sarcoma, a form of skin cancer, renders the affected person increasingly more febrile. AIDS, then, is identified at that stage, and may progress to the point of leading to death.

Data Analysis:

Worobey indicated in his report that the five patients whose blood samples were collected for the study “were presumably infected with HIV-1 before entering the United States.” How that rendered “presumption” was developed and became operational was never firmly established in the paper. These five patients entered the United States “after 1975”, thus several years before the apparition and the diagnosis of the AIDS-related symptoms. Were these patients infected prior to their entry into the U.S., or did they contract the virus after taking residency in Florida? If the infection occurred following their entry, this could explain the similitude of their virus subtypes with the strains most commonly identified in the United States, as reported in the study.

Secondly, one would expect a sampling of far more patients than the five mentioned in the study, before Worobey and his colleagues would conclude so definitely on the findings from his data. For a scientific study to reach a certain level of statistical significance in a correlational study – such as the one proposed in this study – the number of subjects studied usually is superior to 35 (Ravid, 2005). Studying only five patients, therefore, can only render findings that are statistically insignificant.

Thirdly, the possibility of contamination was not even slightly indicated in the report. The high incidence of sampling contamination can be exemplified by the 1985 research study of two noted Harvard researchers, Phyllis Kanki and Myron Essex, who had reported on linking HIV to a virus found in green monkeys in Africa. Both Essex and Kanki, according to Allan Cantwell, later indicated that “their blood tests probably had been contaminated and that their results were invalid.” However, the link to HIV/AIDS as having originated in Africa had already been established.

Fourthly, the Worobey study did not seek to invalidate other reports that AIDS cases were concurrently being reported in the United States during the same time these cases were being identified in Haiti and elsewhere. As reported above, Johnson and Pape (1989) indicated that the time period of 1978-1979 was the period identified for the first incidence of AIDS-related symptoms both in Haiti and the United States. Worobey also indicated in his study that the same strains of HIV found in Haiti and in the U.S. had also been reported in Brazil and in Trinidad & Tobago, but Worobey dismissed these findings as insignificant.

And finally, the path from the Congo to Haiti was never satisfactorily explained in the study. Many Haitians who had migrated overseas during the early 1960’s did so out of intense political persecutions from the Duvalier regime, and those who had gone to the Congo would not have been able to promptly return to Haiti after only a couple of years abroad (Diederich, 2005). In fact, many of them did not return until after the death of François Duvalier in 1971, and the easing of political tensions in the country.

Moreover, the Congo had many diplomatic relations with other nations in the Americas and in Europe. Many of these returning nationals, if infected with the virus, could have easily transmitted it to their own populations. Hence the incidence of the early reporting symptoms documented simultaneously in several countries, if Africa as the originator of the virus can be postulated.

In light of these obvious limitations in the study, one could find an easy way toward rendering a verdict of “inconclusive” to this study. Unfortunately, some of the hesitant steps reported in the wording of the study (such as “presumably”, or “may have entered Haiti”, etc.), have been replaced in the media reporting on the study by more certain, definite words, such as “HIV went directly from Africa to Haiti”, signaling an outright evidence linking Haiti to the first HIV virus in the U.S. . The damage is incalculable for the country and its people.

Conclusion and Recommendations:

Haiti is indeed an intrinsically complex culture with a distinct linguistic, spiritual, and sociocultural worldvision. Though having gained its independence on its own merit, Haiti had to monetarily compensate France for reported war violence committed during the slave rebellion, leading to the Haitian revolution, before it could join the international community. This heavy indemnity profoundly crippled the burgeoning economy of the nation and rendered it powerless in sustaining its own subsistence for several decades.

Acclaimed as the number two generator of revenue in Haiti during the late 1960’s and early 1970’s, tourism was primarily what made Haiti known to the world during that time period, through its magnificent beaches and bays, its sumptuous palaces and chateaux, and the vivacity of everyday life out in the streets. The AIDS scare introduced to the nation through these contacts has eclipsed this revenue from the national economy, and scarred its people on almost every front.

Several national and international institutions are working diligently in Haiti in order to limit the incidence of AIDS in the population, while treating those who have already contracted the virus. It would be beneficial to the country if a revival of sort – a new presentation of this nation to the world – could be envisaged. Some of the paths toward this endeavor could incorporate the following:

• The creation of a Haitian cultural center in each of the major metropolitan areas in the United States, serving as an education tool to those who would want to know about the history and the culture of this nation
• The presence of trained cultural representatives of the Haitian culture at major cultural events in each state, leading symposiums and colloques about its traditions and culture
• The organization of initially small cruises to Haiti, with both Haitians living abroad and tourists as participants, for the purpose of helping foreign nationals rediscover the nation
• The creation of one or two major resorts in Haiti, possibly with foreign aid, for the purpose of re-launching tourism in Haiti
• The creation of a special fund and the awarding of scholarships to gifted Haitian students in the sciences, the Arts and sports to travel and study abroad, especially in the U.S. and Canada
• The adoption of a sister-city partnership between the major Haitian cities and those of the rest of Americas and Europe for the purpose of cultural exchanges

In so doing, we may well be on our way to rediscovering the Haiti known to many in years past as the “Pearl of the Antilles.”

 

References

Aries Rising Press, online: http//ariesrisingpress.com/about/

Cantwell, A. (1988). The Hepatitis-B vaccine trials (1978-1981). In Aids & the Doctors of Death. Los Angeles, CA: Aries Rising Press.

Diederich, B. (2005). Le Prix de Sang: François Duvalier (1957-1971). Port-au-Prince, Haïti : Henri Deschamps.

Farmer, P. (2003). The Uses of Haïti. Monroe, ME: Common Courage Press.

http//www.aegis.com/aidsline/1991/aug/m9180986

Johnson, W.W., & Pape, J.W. (1989). Aids in Haiti. Immunology Series, 44, 65-78

Ravid, R., & Oyer, E. (2005). Practical Statistics for Educators. Lanham, MD: University Press of America.

Worobey, M. et al. (2007).The Prevalence of HIV/AIDS in the Americas and the World. Proceeds of the National Academy of Sciences.