Chicago Tribune (CT) - SUNDAY, November 20, 1994; Edition: CHICAGOLAND NORTH Section: NEWS Page: 6 Word Count: 905
Rogers Worthington, Tribune Staff Writer

"That's it. I'm out of rubber gloves," said Pfc. Brian St. Louis, a medic with the 10th Mountain Division.Army medics have willingly treated Haitians who seek help. But the sterile latex gloves, which medical workers now use universally when handling blood, are even more critical in Haiti, where the number of AIDS carriers is far more concentrated than at home.

The rate of infection is estimated to be about 10 percent of sexually active people in Port-au-Prince, and 5 percent in the countryside.

At the last count in 1992, Haiti had nearly 5,000 cases of full-blown AIDS in a population of nearly 7 million. Underreporting, however, is estimated to run from 50 to 70 percent.

For several years, Haiti's former military government made no attempt to gather statistics or do much of anything to combat AIDS. Embargos imposed on Haiti by the United States and the international community slowed the arrival of medical supplies and otherwise hindered what little effort there was.

While the growth rate of AIDS is believed to have plateaued in Port-au-Prince, it is believed to have increased in rural areas and among women and children in both urban and rural areas.

U.S. military leaders have issued orders prohibiting troops from having sex with the local population-especially prostitutes-or even from spending their free time off base.

"Medically, the penalty can be death," said Lt. Col. Larry Godfrey, chief medical officer for U.S. soldiers in the multinational task force.

Because Haiti was one of the first countries in which human immunodeficiency virus (HIV) was reported, Haitians long have been stigmatized by the disease. They were part of the much repeated phrase: "The four H's of HIV infection: Hemophilia, homosexuals, heroin and Haitians."

Yet Haiti ranks far behind the 30 percent infection rate in several African nations, such as Rwanda and Zimbabwe.

In terms of percentage of population infected per million, Haiti ranks behind Honduras, 11 Caribbean nations and the U.S., according to statistics compiled by the Pan American Health Organization.

But this by no means minimizes the extent of the disease in Haiti. A U.S. Census Bureau study in April projected that by the year 2010, AIDS would lower life expectancy in Haiti by 15 years, from 59 to 44.

The leading cause of death among sexually active Haitian adults is AIDS; and in 1992, 60 percent of urban hospital beds were occupied with patients infected with HIV, according to a Cornell University study published last year by Drs. Jean Pape and Warren Johnson.

The study's most worrisome statistic is the rate of HIV infection in mothers of hospitalized infants. In Port-au-Prince, that number had gone from 10 percent in 1986 to 16 percent in 1991, and in rural areas from 3 percent to 6 percent in the same five years.

"In countries (such as Haiti) where heterosexual relations are the predominant means of AIDS transmission, women of child-bearing age are a very good indicator of what's going on in the society at large," said Dr. Tim Dondero, chief of international activity, HIV/AIDS division, at the Centers for Disease Control and Prevention in Atlanta.

AIDS is primarily transmitted through heterosexual sex, with urban prostitutes playing a seminal role, AIDS researchers say.

According to one study of prostitutes who work in bars in Port-au-Prince and Gonaives, a city to the north, 72 percent carry HIV, said Dr. Pascale Frison, a researcher working with InterAide, a non-profit French group.

"Because their numbers are so large-between 800 and 3,500-they are spreading disease," Frison said.

A campaign encouraging the use of condoms is now under way. Billboards show a woman with her arms around a man's neck, and an open condom dangling from her fingertips. The caption reads, "Kapot bay piezi avi," or "Condoms bring pleasure for life."

The U.S. Agency for International Development has been underwriting the marketing of condoms in Haiti since 1990, and the United Nations Population Fund has been subsidizing their sale at a price of three for 1 gourde-about 7 cents.

Subsidies are necessary because condoms cost more than some prostitutes earn from a customer.

But making affordable condoms available is only half the solution. The other half has been to encourage their purchase, and more critically, their use.

Among a group of men in the Cornell study, only 14 percent said they used condoms even though they were well aware of the risk. Up to 37 percent of men in the same group said they'd had recent contact with prostitutes.

"Women, our surveys show, would like to use condoms, but they're afraid their men will leave them, and they won't have any money for the kids," one US AID official said.

In an attempt to appeal to both men and women, one ad embraced birth control as well as all sexually transmitted diseases. The ad showed a goalie diving for a puck and the caption read, "Nothing gets past Panther Condoms."

CAPTION: PHOTOS: A 2-year-old HIV-positive baby lies in a Port-au-Prince hospital. The rate of AIDS infection in mothers of hospitalized infants has increased from 10 to 16 percent between 1986-91. Rubber gloves are used by officials (above) even in frisking suspects. AP photos.

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