Abstract
Studies of sexual and gender minorities in Haiti and globally typically involve HIV research and programming with men who have sex with men. We conducted focus groups with individuals in Haiti’s Cité Soleil slum whose assigned gender at birth matched neither their gender identity nor contextual heteronormative constructions of gender roles, i.e. transwomen and transmen. The Yogyakarta Principles provided the study framework. Focus group participants offered emic perspectives on overall well-being, identities, biopsychosocial strengths and HIV-protective and risk factors. We found that gender expression that conflicts with contextual norms evoked recurring, humiliating and intentionally injurious sexual assaults against participants, heightening their HIV risk; participants endured beatings, shootings, stabbings, stonings and socio-political violence. Lack of confidentiality and stigma hinder participants’ access to scarce HIV resources. Indistinct boundaries between sexuality, gender identity and gender expression merged with traditional gender-based roles to perpetuate sexual violence towards transwomen by cisgender heterosexual men and by transmen towards cisgender heterosexual women. Despite resignation to omnipresent violence, participants showed resilience regarding gender identity. Needed are integrated socio-behavioural and health programmes to challenge existing gender inequities while providing training on human rights and HIV risk reduction for Haitian sexual and gender minorities.
Acknowledgements
Special thanks to Berlande Blaise for her support in transcribing audio recordings of the focus groups and to Paul Phycien, president of OREZON Cité Soleil and his staff for their support in recruitment. A very special thanks to the study participants for their courage and transparency in sharing their experiences.
Disclosure statement
No potential conflict of interest.
Notes
1 Kouraj (Courage) is a self-described group of ‘masisi activists’ who advocate for the rights and dignity of vulnerable Haitian sexual and gender minorities.
2 SEROvie is a Haiti-based organisation for prevention of HIV among men who have sex with men.