Picturing Risk: A Photovoice Study of Haitian Youths Perceptions of Their HIV Risk
Even before an earthquake devastated Haiti in 2010, HIV incidence among Haitians 15 - 24 years was alarmingly high particularly among girls. However, the response has focused primarily on treatment and support and less so on prevention (UNICEF, 2012). Three years after the earthquake half a million people are still living in tent camps. Experiences in similar contexts suggest increase in HIV prevalence unless preventive steps are taken. A holistic approach which includes prevention is needed to curb the spread of the virus. Our study explored Haitian youth’s perception of their HIV risk and protective factors.
Methods
This paper presents the results of a photo voice project with 48 internally displaced young men and women, 18-24 years in Leogane, Haiti. Photovoice is a qualitative methodology based on the principles of empowerment education and participatory action. It involves a series of steps in which people are given cameras and instructions on their use and using the pictures they take to better understand the realities of their lives. Using this methodology, participants took photographs of people, places or things in their community and wrote stories to help them identify and understand HIV risk and protective factors in their environment. Participants were recruited using a peer driven approach.
Results
A thematic analysis of group discussions and photograph presentations revealed 8 core themes. These were organized in two broad categories - risk and protective factors. Risk factors include knowledge about HIV transmission, poverty, lack of access to and support for condom use, gender based violence and stigma and discrimination against people living with HIV/AIDS. Community strengths and strong spiritual beliefs were identified as protective factors. Findings also pointed to differences in the perception of risk among young men and women; young women were more likely to mention fear of sexual violence and the vulnerabilities of living in a tent. For young men, the lack of employment created difficulty in meeting sociocultural expectations of masculinity, increasing stress, which in turn lead to sexual risk.
Conclusions and implications
In spite of the similarities of HIV risk in low resource countries, the causation patterns behind HIV vulnerabilities are complex. Using photovoice ensures that the lived experiences of Haitian youths are identified and interpreted through their eyes. Given the paucity of knowledge about HIV risks and ways of coping among this population, the findings provide a way to concretize their concerns and perspectives. The results may also be useful to policy makers and service providers in developing intervention programs to raise awareness about HIV transmission and prevention.