The first cases of AIDS in Haiti were recognized in 1978-1979, a period that coincides with the earliest reports of AIDS in the United States. Current data are consistent with the hypothesis that AIDS originated in Africa, came to the United States and Europe, and subsequently was introduced into Haiti by either tourists or returning Haitians. The seroprevalence of HIV among healthy sexually active adults in Port-au-Prince, Haiti, is approximately 10%. This rate of HIV infection is threefold that observed in rural areas. The highest prevalence rates were observed in female prostitutes (53%) and in the male and female spouses of AIDS patients (55%). The types of opportunistic infections and the clinical course in Haitians with AIDS were similar in many respects to those in patients with AIDS in the United States. Important differences were noted in the prevalence of specific opportunistic pathogens in Haiti. It resembled observations on these infections in Africa. During the past 4 years, there has been a progressive decrease in the percent of patients reporting bisexuality and blood transfusions, and an increase in those reporting either a spouse with antecedent AIDS, prostitution, or none of the aforementioned activities. In 1986, heterosexual transmission probably accounted for over 70% of AIDS cases.
