Sexual Health Determinants During the Life Course and Migration of Haitian-Origin People in French Guiana: Protocol for the Parcours d'Haïti Biographical and Transdisciplinary Study.
Alcouffe L, Tareau M, et al. • JMIR research protocols • 2025
The Parcours d'Haïti study describes a mixed-methods, transdisciplinary protocol to assess HIV risk, sexual behaviors, and broader health determinants among Haitian-origin people residing in French Guiana, using biographical, epidemiological, qualitative, and phylogenetic components.
Key Findings
Background
French Guiana faces unique social and demographic challenges related to migration, with Haitians representing one of the three largest foreign communities in the region and facing specific barriers to health care access and elevated HIV exposure.
French Guiana is an overseas territory located in the Guiana Shield in South America.
Haitian people face 'specific barriers to health care access and prevention' and are described as 'a population exposed to HIV infection.'
The study aims to 'update knowledge on the health of the Haitian population residing in French Guiana.'
Methods
The study employs a mixed-methods design combining quantitative epidemiological and biographical analysis, qualitative substudies, and a phylogenetic component to understand HIV transmission and health determinants.
The quantitative component assesses 'the frequency of sexual behaviors that expose Haitian individuals to HIV risk after arriving in French Guiana' and their association with living conditions.
The biographical component uses 'a detailed grid that tracks key life events since birth.'
The qualitative component includes '3 substudies based on semistructured interviews and focus groups with Haitian people and health care professionals.'
A phylogenetic component 'describes the distribution of clades of the Pol gene in the viruses of people living with HIV.'
The study targets Haitian individuals 'aged 18 to 60 years who have lived in French Guiana for more than 3 months.'
Methods
Recruitment of this partially hidden population used an innovative community-based method involving Haitian Creole-speaking peer investigators serving as community health mediators.
Recruitment targeted 'key locations frequented by the Haitian community.'
Data collection was 'carried out by Haitian Creole-speaking peer investigators (community health mediators).'
Study materials 'were cocreated with local stakeholders.'
The method involved 'all local actors' to reach a 'partially hidden population.'
Data collection and recruitment occurred 'over 20 months between 2021 and 2023.'
Results
The main anticipated reasons for migration among Haitian people in French Guiana include insecurity and fleeing violence.
Upon arrival, Haitian people 'likely experience significant economic hardship and social isolation.'
This is described as an anticipated result based on the study's design and prior knowledge.
These findings are expected to inform understanding of the social determinants of health in this population.
Results
Mental health deterioration is anticipated among Haitian migrants, with expected high rates of posttraumatic stress disorder.
The qualitative substudies aim to deepen understanding of 'mental health among Haitians.'
Mental health deterioration is listed among the anticipated results.
'High rates of posttraumatic stress disorder' are expected to be found.
Results
People living with HIV are expected to face heightened vulnerability compared to HIV-negative individuals, even though all Haitian migrants already struggle with precarious living conditions.
The study anticipates that people living with HIV will show 'heightened vulnerability compared to HIV-negative individuals.'
This is expected despite the baseline context that HIV-negative Haitian migrants 'already struggle with precarious living conditions.'
The quantitative component specifically explores the 'association of this risk with their living conditions.'
Results
Haitian people in French Guiana are expected to encounter numerous barriers to accessing health care, including administrative complexity, language issues, and financial and mobility constraints.
Anticipated qualitative findings indicate barriers such as 'administrative complexity, language, and financial and mobility issues.'
The qualitative substudies aim to deepen understanding of 'health care access' and 'use of traditional and biomedical care.'
These findings are expected from the semistructured interviews and focus groups component of the study.
Results
Anthropological results are expected to reveal beliefs in the magical-religious origins of HIV and reliance on plants and traditional medicine for its treatment among Haitian people.
The anticipated anthropological results 'are expected to emphasize the magical-religious origins of HIV.'
Use of 'plants and traditional medicine for its treatment' is expected to be documented.
A qualitative substudy specifically addresses 'use of traditional and biomedical care.'
Results
Phylogenetic results are anticipated to show a high prevalence of Caribbean B HIV subtypes among people living with HIV in the Haitian community in French Guiana.
The phylogenetic component describes 'the distribution of clades of the Pol gene in the viruses of people living with HIV.'
'High prevalence of Caribbean B HIV subtypes' is the anticipated finding.
This component links the HIV strains circulating in French Guiana to Caribbean origins consistent with the Haitian migration background.
What This Means
This paper describes the design and protocol of the Parcours d'Haïti study, a large research project conducted in French Guiana between 2021 and 2023 to better understand the health of Haitian migrants living there. Haitians are one of the largest foreign communities in French Guiana and face significant challenges including poverty, social isolation, language barriers, and elevated risk of HIV infection. The study uses a combination of approaches: detailed life history interviews tracking events since birth, surveys on sexual behavior and living conditions, focus groups and in-depth interviews with community members and health workers, and genetic analysis of HIV strains circulating in the community. Importantly, the research was co-designed with community members and conducted by Haitian Creole-speaking community health workers to reach a population that is often difficult to access through traditional research methods.
This research suggests that Haitian migrants in French Guiana face layered and compounding health challenges. People are expected to have migrated primarily due to insecurity and violence, and upon arrival face economic hardship, social isolation, and high rates of post-traumatic stress disorder. Those living with HIV are expected to be even more vulnerable than their HIV-negative counterparts. The study also anticipates documenting that Haitian people encounter significant obstacles when trying to access formal health care — including complex administrative requirements, language difficulties, and financial and transportation barriers — and that many turn to traditional plant-based medicine and hold beliefs about HIV rooted in magical-religious frameworks.
The practical importance of this work lies in its potential to reshape health policies and services in French Guiana to better serve the Haitian community. By understanding the specific barriers, cultural beliefs, and social circumstances that shape health outcomes for this group, public health officials and health care providers could develop more culturally appropriate and accessible HIV prevention and care strategies. The anticipated finding of high rates of Caribbean B HIV subtypes would also help clarify how HIV is spreading within and between communities, which is essential for designing effective public health responses.
Alcouffe L, Tareau M, Brun Rambaud G, Lucarelli A, Boutrou M, Thorey C, et al.. (2025). Sexual Health Determinants During the Life Course and Migration of Haitian-Origin People in French Guiana: Protocol for the Parcours d'Haïti Biographical and Transdisciplinary Study.. JMIR research protocols. https://doi.org/10.2196/63586