Little Haiti and the AIDS Stigma

In nineteen eighty-two, the United States Centers for Disease Control published a report identifying four groups with elevated risk of AIDS, a disease that had been described in medical literature for less than two years and that was killing people at a rate that public health officials were only beginning to understand. The four groups were intravenous drug users, homosexuals, hemophiliacs, and Haitians. The designation became known informally as the four H's.

The inclusion of a nationality alongside medical risk categories had no epidemiological justification. There was no evidence that being Haitian, as a matter of heritage or national origin, elevated AIDS risk. The cluster of AIDS cases in Haiti reflected poverty, limited healthcare infrastructure, and the same risk behaviors that drove transmission in every population: it did not reflect something inherent to Haitian people. The Centers for Disease Control knew this, or should have. They listed Haitians anyway, and the designation went into official guidance that doctors and public health workers across the country received and repeated.

The consequences in South Florida were immediate and severe. Haitian Americans in Miami, who had been building the Little Haiti community north of Wynwood since the nineteen seventies, faced employment refusals, housing denials, and public discrimination that was now medically authorized by the federal government. Blood banks stopped accepting Haitian donors. Employers stopped hiring Haitian workers. The community that had survived the crossing from Haiti, that had built a neighborhood from nothing, was now officially classified as a public health threat.

The Centers for Disease Control eventually removed Haitians from the list. The legal and social redress came later and was partial. The category, once assigned, proved difficult to un-assign in the minds of people who had read the original guidance. The community in Little Haiti rebuilt around its churches, its Creole-language press, and its mutual aid networks, as communities under that kind of pressure tend to do. The stigma outlasted the science by years.