Term of Award

Fall 2017

Degree Name

Doctor of Public Health in Community Health Behavior and Education (Dr.P.H.)

Document Type and Release Option

Dissertation (restricted to Georgia Southern)

Copyright Statement / License for Reuse

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


Jiann-Ping Hsu College of Public Health

Committee Chair

Joseph Telfair

Committee Member 1

Julie Reagan

Committee Member 2

Haresh Rochani


TB and HIV are syndemic in Haiti. Haiti is home to many of Latin America’s and the Caribbean’s orphans and vulnerable children. To provide a broader perspective to the TB/HIV problem in the OVC population in rural Haiti, this study utilized a concurrent nested integrated approach. The primary data collection method utilized a KAP survey. The secondary (nested) qualitative data collection method used key informant interviews to gather and explore the contextual and structural factors that potentially influence knowledge, attitudes, and perceptions of TB and/or HIV in orphans and vulnerable children. Children under the care of the Union of Orphanages of North Haiti between the ages of 11-14-years old participated in the quantitative portion of this study. Structural and contextual factors were assessed through key informant interviews of orphan/feeding directors and clinical personnel. The qualitative component is grounded in the ecological perspectives which explicates the interpersonal organizational, and community aspects that potentially influence risk for OVC population.

A total of 101 children answered the overall survey across the seven sites. Eight-five percent of the respondents heard of one or more of the diseases. Of the respondents, 79.2% heard of HIV, 68.3% heard of TB, and 63.3% heard of both diseases. While the overall knowledge, attitude and perception was higher than expected for this population, gaps and stigma still exist. Surprisingly, the younger respondents (11 and 12) were proportional in accurate knowledge, positive attitude and perception compared to the older ones (13 and 14). From a contextual perspective, culture influenced interactions, attitudes, perceptions, and susceptibility. From a structural perspective, positive and negative health infrastructures emerged as themes along with resources, endemic poverty, and distribution of money which influences outreach and education.

This study was important to understand gaps in awareness, knowledge, and the contextual and structural factors that influence risk of acquisition for a vulnerable population. Interventions addressing endemic diseases must start earlier and be ecological in their approach. For public health to truly reach the Sustainable Development goals, the poorest children must be a focus for interventions, skill development, and included in research.

Research Data and Supplementary Material