Date of Award

January 2026

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

Jasmine Abrams

Abstract

Background: Haiti has the highest maternal mortality rate in Latin America and the Caribbean, where pregnant women face substantial structural, social, and economic barriers to care. Women living with HIV encounter additional challenges, including stigma, breaches of privacy, and discrimination within healthcare settings. Although prior research has examined maternal health and HIV related stigma in Haiti, little is known about how HIV status differentially shapes pregnant women’s perceptions of barriers to maternal healthcare.Methods: This study draws on data from seven focus groups conducted in rural communities in Haiti’s Centre Department between 2018 and 2019. Participants included 65 pregnant women, representing those living with and without HIV. The team conducted the focus groups in Haitian Creole, then transcribed, translated, verified, and analyzed them using a deductive, framework-guided qualitative approach grounded in the Six Domains of Healthcare Quality Framework. Results: HIV negative participants described three primary barriers to care: (1) Structural challenges such as long wait times and provider shortages, (2) Social and economic judgment rooted in classism, and (3) Fear based avoidance of healthcare facilities. Participants living with HIV identified four additional barriers: (4) HIV related stigma and judgment, (5) Privacy concerns stemming from visible separation of HIV services, (6) Emotional and financial burdens of care, and (7) Communication and trust failures with providers. Conclusions: HIV status meaningfully shapes how pregnant Haitian women perceive and navigate maternal healthcare. While all participants faced structural and class based obstacles, women living with HIV experienced intensified stigma, compromised privacy, and reduced trust in providers. Addressing these inequities will require strengthening health system capacity, reducing stigma within clinical settings, and promoting respectful, confidential, and patient centered maternal care.

Comments

This is an Open Access Thesis.

Download
Open Access

This Article is Open Access

Share

COinS