PORT-AU-PRINCE, Haiti (AP) 鈥 A video showing dozens of people marching toward the office of Haiti鈥檚 prime minister elicited gasps from some viewers as it circulated recently on social media. The protesters, who were HIV positive, did not conceal their faces 鈥 a rare occurrence in a country where the virus is still heavily stigmatized.
鈥淐all the minister of health! We are dying!鈥 the group chanted.
The protesters risked being shunned by society to warn that just months after the administration of U.S. President Donald Trump and $60 billion in overall aid across the globe.
At a hospital near the northern city of , Dr. Eugene Maklin said he struggles to share that reality with his more than 550 HIV patients.
鈥淚t鈥檚 hard to explain to them, to tell them that they鈥檙e not going to find medication,鈥 he said. 鈥淚t鈥檚 like a suicide.鈥
‘We can’t stay silent’
More than 150,000 people in Haiti have HIV or AIDS, according to official estimates, although nonprofits believe the number is much higher.
David Jeune, a 46-year-old hospital community worker, is among them. He became infected 19 years ago after having unprotected sex. 鈥淚 was scared to let people know because they would point their finger at you, saying you are infecting others with AIDS,鈥 he said.
His fear was so great that he didn鈥檛 tell anyone, not even his mother. But that fear dissipated with the support Jeune said he received from nonprofits. His confidence grew to the point where he participated in Monday鈥檚 protest.
鈥淚 hope Trump will change his mind,鈥 he said, noting that his medication will run out in November. 鈥淟et the poor people get the medication they need.鈥
Patrick Jean No毛l, a representative of Haiti鈥檚 Federation of Associations of HIV, said that at least five clinics, including one that served 2,500 patients, were forced to close after the USAID funding cuts.
鈥淲e can鈥檛 stay silent,鈥 he said. 鈥淢ore people need to come out.鈥
But most people with HIV in Haiti are reluctant to do so, said Dr. Sabine Lustin, executive director of the Haiti-based nonprofit Promoters of Zero AIDS Goal.
The stigma is so strong that many patients are reluctant to pick up their medication in person. Instead, it is sent via packages wrapped as gifts to not arouse suspicion, Lustin said.
Lustin鈥檚 organization, which helps some 2,000 people across Haiti, receives funding from the . While their funding hasn鈥檛 been cut, she said that shortly after Trump was sworn in, the agency banned prevention activities because they targeted a group that is not a priority. By that, Lustin said she understood they were referring to gay men.
That means the organization can no longer distribute up to 200,000 free condoms a year or educate people about the disease.
鈥淵ou risk an increase in infections,鈥 she said. 鈥淵ou have a young population who is sexually active who can鈥檛 receive the prevention message and don鈥檛 have access to condoms.鈥
鈥榃e only have medication until July鈥
On a recent sunny morning, a chorus of voices drowned out the din of traffic in Haiti鈥檚 capital, growing louder as protesters with HIV marched defiantly toward the office of Haiti鈥檚 prime minister.
鈥淲e are here to tell the government that we exist, and we are people like any other person,鈥 one woman told reporters.
Another marching alongside her said, 鈥淲ithout medication, we are dying. This needs to change.鈥
Three days after Monday’s protest, the leader of Haiti鈥檚 transitional presidential council, Louis G茅rald Gilles, announced that he had met with activists and would try to secure funding.
Meanwhile, nonprofit organizations across Haiti are fretting.
鈥淚 don鈥檛 know what we鈥檙e going to do,鈥 said Marie Denis-Luque, founder and executive director of CHOAIDS, a nonprofit that cares for Haitian orphans with HIV/AIDS. 鈥淲e only have medication until July.鈥
Her voice broke as she described her frantic search for donations for the orphans, who are cared for by HIV-positive women in Cap-Haitien after forced them to leave Port-au-Prince.
Denis-Luque said she has long advocated for the orphans鈥 visibility.
鈥淲e can鈥檛 keep hiding these children. They are part of society,鈥 she said, adding that she smiled when she saw the video of Monday鈥檚 protest. 鈥淚 was like, whoa, things have changed tremendously. The stigma is real, but I think what I saw 鈥 was very encouraging to me. They can鈥檛 be silenced.鈥
A dangerous combination
Experts say Haiti could see a rise in HIV infections because medications are dwindling at a time that gang violence and are surging.
Dr. Alain Casseus, infectious disease division chief at Zamni Lasante, the largest non-governmental healthcare provider in Haiti, said they expected to see a surge in patients given the funding cuts, but that hasn鈥檛 happened because traveling by land in Haiti is dangerous since and randomly open fire on vehicles.
He warned that abruptly stopping medication is dangerous, especially because many Haitians do not have access or cannot afford nutritious food to strengthen their immune system.
鈥淚t wouldn鈥檛 take long, especially given the situation in Haiti, to enter a very bad phase,鈥 he said of HIV infections. And even if some funding becomes available, a lapse in medication could cause resistance to it, he said.
Casseus said gang violence also could accelerate the rates of infection via rapes or physical violence as medication runs out.
At the New Hope Hospital run by Maklin in Haiti鈥檚 northern region, shelves are running empty. He used to receive more than $165,000 a year to help HIV/AIDS patients. But that funding has dried up.
鈥淭hose people are going to die,鈥 he said. 鈥淲e don鈥檛 know how or where we鈥檙e going to get more medication.鈥
The medication controls the infection and allows many to have an average life expectancy. Without it, the virus attacks a person鈥檚 immune system, and they develop AIDS, the late stage of an HIV infection.
Reaction is swift when Dr. Maklin tells his patients that in two months, the hospital won鈥檛 have any HIV medication left.
鈥淭hey say, 鈥楴o, no, no, no!鈥欌 he said. 鈥淭hey want to keep living.鈥
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Coto reported from San Juan, Puerto Rico.
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