When initial cases of a previously unidentified autoimmune disease first appeared in the United States in 1981, health officials and politicians scrambled to identify a laundry list of potential causes. Early cases were found in high proportion among men who have sex with men (MSM), leading the U.S. Centers for Disease Control and Prevention (CDC) to label the mysterious illness Gay-Related Immune Deficiency, or GRID. Soon after, the disease was renamed “acquired immunodeficiency syndrome,” or AIDS, and reconceptualized by epidemiologists as an epidemic that affected a select few “at risk” populations in North America. Known as the “4-H’s”, the identities belonging to homosexuals, haemophiliacs, heroin users, and most importantly for this article, Haitians, came to dominate the politics of HIV and AIDS at the local and international level.
The 4-H label was immensely debilitating for its affected communities, creating and exacerbating stigma for and among the gay and lesbian community, Haitian and otherwise racialized people, and intravenous drug users. Today, the 4-H label has remained influential in shaping Canadian public policy and health outcomes among Haitian Canadians. In the United States, efforts to vilify Haitian Americans have coincided with deportations and detentions that remain illegal under international law. These programs had an extensive effect on the wellbeing of Haitian Canadians and Haitian Americans, altering their health outcomes, ability and motivations to donate blood, and senses of racial belonging in North America.
Impacts of 4-H Policy on Haitian Canadians
Canadian AIDS policy in the early 1980s was often based on the recommendations and actions of their American counterparts at the CDC. This included a decision made by the Canadian Red Cross to issue a warning in 1983, advising the 4-H groups not to donate blood for transfusions. On February 19th, the Red Cross stated that
Haitians should be, and are, allowed to donate blood in Canada provided they meet the existing selection criteria required of all blood donors. However, because of uncertainties currently surrounding this issue… recent immigrants from Haiti are being advised not to become blood donors at this time.
The voluntary self-exclusion remained active until 1988 when the advisory was lifted. Between 1988 and 1994, the Red Cross questionnaire warned donors not to donate blood, who, since 1977, lived in regions where HIV/AIDS cases were frequent, although they did not specifically mention the country of Haiti.
The self-imposed ban radically affected relations between Canada’s Haitian minority and its white majority. The divide was especially significant in Quebec, where immigration between the 1960s and late 1970s brought tens of thousands of Haitian professionals, newly exiled by dictator François Duvalier, to the province. By 2011, Quebec’s Haitian population constituted nearly half of the province’s Black community, ninety-eight percent of whom spoke fluent French and operated as doctors, nurses, and technicians. Later waves brought blue collar workers and relatives seeking to reunite with their families into the province.
Haitian communities were not consulted prior to the advisory announcement. While the policy was not explicitly based on racial exclusion, many Haitian Canadians felt that their status and identities as Black Canadians were being stigmatized to include a racial tendency towards the reproduction of deadly pathogens. According to the Royal Commission of Inquiry on the Blood System in Canada, commonly referred to as the Krever Report, “members of the Haitian community, particularly in Montreal, resented the implicit stigma and discrimination in being described as at high risk.” Canadians of Haitian descent would later denounce “the Red Cross’s position as racist,” with the Quebec Human Rights Commission and the League of Red Cross Societies receiving formal complaints regarding their decision. Haitians protested the decision by rallying near Haitian embassies and consulates in Ottawa, Montreal, and Toronto.
Today, many Black and Haitian Canadians donate exceedingly low amounts of blood, no doubt due to the influence of the 1983 blood ban. Interviews undertaken by Charbonneau and Tran have found that Haitian Canadians widely believe that their blood would be discarded or rejected if donated today, with many more feeling that Quebec’s general population would be averse to using Haitian blood during transfusions and research. These realities have had very real impacts on the viability of Canadian medical research and transfusion practices, especially as it relates to sickle cell anemia, a disease that can be more easily treated with greater access to Haitian blood.
Furthermore, today’s Haitian youth remain overrepresented in Canadian penitentiaries, face extreme racism at the hands of police and everyday Canadians, and suffer poorer health outcomes than white Canadians. One study found that Haitian newborns were up to four times as likely to suffer from severe outcomes related to pre-term births, low birth weights, and small-for-gestational ages. To solve these issues, Canada must reckon with its past by resolving the health and AIDS policies it implemented, as well as the racism that remains baked into the system to this day.
Impacts of United States Policy on Haitians
When the CDC initially began publishing information on HIV/AIDS among the United States Haitian population in the 1980s, their work established the first major report dealing with the disease outside of the MSM or “homosexual” category. Epidemiologists routinely referred to the growing numbers of AIDS cases among Haitians as “a complete mystery”, and to Haitians themselves as “wild cards.” Unlike most other North American patients, it seemed that AIDS cases among Haitians were occurring outside of homosexual relationships and intravenous drug use, with many immigrants telling health officials that they had never even received blood transfusions.
This uncertainty, muddied by overarching sentiments of racism and xenophobia, ultimately resulted in several human rights abuses occurring against Haitian Americans and immigrants entering the United States in the 1990s. When democratically elected President Jean-Bertrand Aristide was ousted during a coup d’état in 1991, hundreds of refugees fled the island to seek asylum in the United States. Rather than accept the refugees, president Bush, and later President Clinton, arrested nearly 300 political prisoners because they were said to have either tested positive for HIV or come into contact with someone who had. These 300 were imprisoned at Guantanamo Bay for nearly two years, where they were kept in tin-roofed buildings and confined by guards and razor wire that surrounded the perimeter. Many of these refugees were subjected to repression and physical violence at the hands of the Marine Corps security police, left without proper medical care, and stripped of their legal rights and refugee status’. The health and wellbeing of several of the Haitian migrants rapidly deteriorated, at which point they were relocated to detention centers on U.S. soil.
In response to the U.S. government’s program at the border, the Council of Europe and the International Consultation on AIDS and Human Rights condemned the government’s actions, writing that “exemptions from observance of human rights could not be justified simply by claiming that they were required for public health reasons.” The World Summit of Ministers of Health Programs followed suite, stating that there was “no public health rationale to justify isolation, quarantine, or other discriminatory measures based solely on a person’s HIV infection status or practice of risk behavior.” Protests erupted across the United States, with activists at the AIDS organization ACT UP, as well as the Emergency Coalition for Haitian Refugees and Shut Down Guantanamo Coalition NY acting as figureheads for the movement. Thousands of protestors took to the streets of New York to combat the illegal detentions. It was only after months of international protest, Haitian mobilization, and a slew of hunger strikes coordinated across the United States that the nearly 300 detainees were ordered to be released by a federal judge in June of 1993.
Today, Haitian communities in Florida and New York face similar difficulties relative to other immigrant populations. These include lower median household incomes and lower rates of healthcare coverage. For instance, Haitians in America are almost two and a half times more likely to live without health insurance.
In the United States, Haitian migrants, naturalized citizens, temporary workers, and Americans of Haitian descent still routinely face racial discrimination. In 2017, after former President Donald Trump claimed that Haitians “all have AIDS,” Homeland Security announced that Temporary Protected Status (TPS) would be discontinued by 2019, shattering many Haitian migrants’ ability to remain in the country. The recent assassination of Haitian President Jovenel Moïse and the simultaneous rise of gang violence in Haiti has caused immense anxiety among Haitian workers in the United States, as they desperately attempt to file for protections to remain in the country. According to Human Rights Watch, the Biden administration has deported 21 planes of people back to Haiti since February first, continuing the cycle of violence that has become a staple of American foreign policy throughout the late 20th and 21st centuries.
In the past thirty years, numerous scholars have written comparative articles studying the impacts of HIV/AIDS and several other historic diseases on communities across North America. The AIDS epidemic was unique in that it garnered little sympathy from the general public. For example, while polio patients in the 1940s and 1950s received extensive care and sympathy from the broader public, HIV and AIDS patients were routinely vilified, since according to author Sandra Panem, “homosexual men, Haitian immigrants, and drug addicts—were not in the mainstream of society.” This lack of sympathy and abundance of vilification carried over into how Haitian AIDS patients were treated in Canada and the United States. In Canada, the Red Cross’ blood ban has affected blood donation patterns in Haitian Canadians to this day, making it harder to treat illnesses like sickle cell anemia and creating distrust between healthcare officials and ordinary Haitian men and women. In the United States, illegal arrests and deportations remain commonplace. These two programs – blood exclusion in Canada and illegal deportation in the United States – have had profound effects on the two countries respective Haitian communities, altering health outcomes, research opportunities, and feelings of racial belonging among identifying members.
Harrison Dressler is a history and political science student entering his fourth year at the University of New Brunswick. He works as a research intern at AIDS New Brunswick.
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 Carmen H. Logie, “Lessons Learned from HIV Can Inform Our Approach to COVID‐19 Stigma,” Journal of the International AIDS Society 23, no. 5 (2020): 1, doi:10.1002/jia2.25504.
 Nseya Mwamba, “Separate but Equal: The Black Racial Classification in the Canadian Blood System” (Master’s thesis, 2019), 1, https://ruor.uottawa.ca/bitstream/10393/39250/3/Mwamba_Nseya_2019_thesis.pdf.
 Johanne Charbonneau and Nathalie Y-Lang Tran, “The Paradoxical Situation of Blood Donation in the Haitian-Quebec Community,” Canadian Ethnic Studies 47, no. 2 (2015): 79, doi:10.1353/ces.2015.0021.
 Ibid, 73-74.
 Canada, Ministère de la Santé et des Services Sociaux, Commission of Inquiry on the Blood System in Canada – Krever Report, vol. 1 (Ottawa: Government of Canada, 1995), 233.
 Johanne Charbonneau and Nathalie Y-Lang Tran, 82-83.
 Ibid, 69.
 Canada, Ministry of the Attorney General., Addressing Hate Crime in Ontario: Final Report of the Hate Crimes Community Working Group to the Attorney General and the Minister of Community Safety and Correctional Services, by Karen R. Mock, Marie Chen, Germaine Elliott, Raja Khouri, Uzma Shakir, Jane Tallim, Howard Shulman, Anne-Marie Stewart, Ijaz A. Qamar, and Bernie M. Farber (Toronto: Ministry of the Attorney General, 2006), https://www.publicsafety.gc.ca/lbrr/archives/cnmcs-plcng/cn29799-eng.pdf.
 Nathalie Auger, Martine Chery, and Mark Daniel, “Rising Disparities in Severe Adverse Birth Outcomes Among Haitians in Québec, Canada, 1981–2006,” Journal of Immigrant and Minority Health 14, no. 2 (2011): doi:10.1007/s10903-011-9460-y.
 Keewhan Choi, “Assembling the AIDS Puzzle: Epidemiology,” in AIDS, Facts and Issues, ed. Victor Gong and Norman Rudnick (New Jersey, MA: Rutgers University Press, 1986).
 Paul Farmer, AIDS and Accusation: Haiti and the Geography of Blame (Berkeley: University of California Press, 2010).
 Karma R. Chávez, “ACT UP, Haitian Migrants, and Alternative Memories of HIV/AIDS,” Quarterly Journal of Speech 98, no. 1 (2012): 63, doi:10.1080/00335630.2011.638659.
 Creola Johnson, “Quarantining HIV-Infected Haitians: United States’ Violations of International Law at Guantanamo Bay,” Howard Law Journal 37, no. 2 (1994): 305.; Karma R. Chávez, 64.
 Karma R. Chávez, 64-65.
 Creola Johnson, 310.
 Ibid, 311.
 Karma R. Chávez, 65-66.
 Kira Olsen-Medina and Jeanne Batalova, “Haitian Immigrants in the United States,” Migration Policy Institute, February 02, 2021, accessed July 14, 2021, https://www.migrationpolicy.org/article/haitian-immigrants-united-states-2018.
 Sarah Baranik De Alarcón, David Secor, and Norma Fuentes-Mayorga, ““We Are Asking Why You Treat Us This Way. Is It Because We Are Negroes?” A Reparations-Based Approach to Remedying the Trump Administration’s Cancellation of TPS Protections for Haitians,” Michigan Journal of Race & Law, no. 26.1 (2020): doi:10.36643/mjrl.26.1.we.
 Alison Leal Parker, “Will US Repeat History by Failing Haitians Again?” Human Rights Watch, March 18, 2021, accessed July 14, 2021, https://www.hrw.org/news/2021/03/18/will-us-repeat-history-failing-haitians-again.
 Sandra Panem, The AIDS Bureaucracy (Cambridge, MA: Harvard University Press, 1988).