Jean Rejane Geralda’s main prob­lem isn’t receiv­ing her AIDS med­ica­tions — she hasn’t missed a dose — it’s putting some sort of roof over the head of her daugh­ter, Shara.

Ger­alda, like hun­dreds of thou­sands across post-earthquake Haiti, has been unable to obtain even a basic tent or tar­pau­lin from relief agen­cies. As the rainy sea­son approaches, Ger­alda sleeps on an uncov­ered mat­tress with her new­born child in the back yard of her quake-damaged home.

“My bed is right on the ground,” Ger­alda said, a sit­u­a­tion in stark con­trast to her AIDS-related med­ical care, where “I am able to get every­thing I need.”

Geralda’s sit­u­a­tion high­lights the fact that AIDS care in Haiti, by some mea­sure, has rebounded faster from the Jan. 12 earth­quake than the coun­try as a whole. But the post-quake con­di­tions still present pre­ven­tion chal­lenges — threat­en­ing what had been steady progress for a nation that accounts for half of all AIDS cases in the Caribbean.

QUIET SUCCESS

In recent years, Haiti’s bat­tle to reduce that num­ber was a quiet suc­cess story. U.S.-backed AIDS pro­grams brought the inci­dence of the dis­ease down from 10 per­cent to 2.2 per­cent at the time of the Jan. 12 earth­quake. Though restor­ing these pro­grams has proved eas­ier than pro­vid­ing shel­ter to the 1.3 mil­lion peo­ple left home­less by the quake, inter­na­tional health orga­ni­za­tions still worry that the dis­as­ter has dealt a severe blow to AIDS treat­ment and pre­ven­tion efforts.

Pre­ven­tion is a chal­lenge in the tent cities. At the city’s largest encamp­ment, where an esti­mated 45,000 crowd the site of an old mil­i­tary air­port, the occa­sional free con­dom dis­tri­b­u­tion is not enough, said Dr. Kobel Dubique, who coor­di­nates a clinic there.

A three-pack of con­doms in Haiti costs about 15 gour­des — less than one dol­lar — but that’s still more than many quake-battered Haitians can afford. “We need to be dis­trib­ut­ing more con­doms,” Dubique said. “And free. Free, free, free.”

Dubique said secu­rity in the tent cities must also be strength­ened, as there have been at least four con­firmed rapes at the camp where he works. One woman was raped twice. Camp dwellers them­selves have orga­nized into secu­rity details to reduce crime, but these secu­rity “patrols” are unarmed.

Refugee International’s Emi­lie Parry, back from a recent visit to Haiti, warns that the impromptu set­tle­ments around the city present great risks.

“There’s no light­ing,” she said. “Women are being attacked sex­u­ally and oth­er­wise … they feel very vulnerable.”

On a pos­i­tive note, doc­tors and admin­is­tra­tors boast that they were able to restore ser­vices to nearly all HIV/AIDS patients receiv­ing anti­retro­vi­ral treat­ments within days of the quake. At the GHESKIO clinic, Dr. Ser­ena Koenig reports that all but 5 per­cent of the 14,000 patients on anti­retro­vi­ral drugs before the quake were con­tin­u­ously being treated.

Of the rest, she said, the Haiti Min­istry of Health and doc­tors at the clinic believe some died and the oth­ers are in the coun­try­side, where they are eli­gi­ble to con­tinue their drug therapies.

SUPPLY IN PLACE

HIV/AIDS treat­ment avoided inter­rup­tion because, accord­ing to the U.S. Cen­ters for Dis­ease Control’s Dr. Steven Har­ris, there was already a three-month sup­ply on the island. More­over, the U.S. pro­gram had spon­sored an elec­tronic data­base of AIDS patients — a rar­ity in Haiti’s Min­istry of Health — which allowed for greater ease in track­ing the patients after the disaster.

Clin­ics that were destroyed or dam­aged shifted to tents or other tem­po­rary quar­ters. At the Gen­eral Hos­pi­tal in Port-au-Prince, where Ger­alda receives care for both her­self and her new­born, blue and white tents ser­vice about 50 HIV/AIDS patients per day.

That’s down from the pre-quake norm of 80 per day, but the num­ber of return­ing patients is con­tin­u­ally grow­ing. By next week, the hos­pi­tal plans to have its in-house computer-tracking sys­tem up and run­ning again and should be able to bet­ter pin­point those patients that have gone missing.

Mean­time, Ger­alda receives free med­i­cine at the CDC-sponsored facil­ity. Giralda hadn’t planned on get­ting preg­nant — she says she was prac­tic­ing safe sex — but with the help of AIDS med­ica­tions that she took dur­ing preg­nancy and now admin­is­ters to her new­born, there’s a good chance that the child can avoid con­tract­ing the disease.

“I get very good care here,” she said.