Instructions to writer: this is a peer respond, please respond to Olga and Ethan with a minimum of 150 words to each peer and at least 1 academic resource to each peer.

Must meet the following: You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts.  All replies must be constructive and use literature where possible.

Just need a peer respond, based on this case, reply directly to Olga and Ethan, don’t work on the case, I added it as a guide

The St. Fleur family is well respected in the Haitian community because they are religious with great moral values. They moved to the United States because of political issues in Haiti. Ronald, the youngest son of this family, is 27 years old and lives at home with his mother and father. Recently, he began having fevers and subsequently developed pneumonia. He was admitted to the hospital, where laboratory tests were HIV positive. Ronald was in shock when the doctor informed him that he was HIV positive. He confessed to the doctor that he was gay, but he could not tell his family. He said that he did not want to bring shame to the family. Because he couldn’t be in a formal relationship disowning to his family and the Haitian community’s view of homosexuality, he has been very promiscuous over the years.

1. What are Haitians’ views of homosexuality?

2. If Ronald’s parents were to learn of his positive HIV status, how might they react if they are religious and traditional?

3. Identify three major culturally congruent strategies a healthcare provider can implement to address HIV prevention practices in the Haitian community?

This is Olga ’s Discussion Post ↓Module 4 Discussion: Providing HIV Prevention and Care Services for Haitian Americans 

Haitians’ Views on Homosexuality 

Haitian society in general is not accepting of homosexuality, as heterosexuality is considered the norm, and the attitudes towards homosexuals are characterized by hostility and rejection, even from family members who often force them to leave their homes. According to Dévieux et al. (2022), gender and sexuality norms are influenced by Christianity and patriarchal constructs that define what the roles of men and women should be. Consequently, homosexuals are often victims of violence, leading many to lead double lives. Additionally, HIV has become a great source of stigma for homosexual men who often lack the kind of support needed to get needed medical care, thus leading to depression and psychological distress associated with isolation (Dévieux et al., 2022). The goal as an advanced nurse practitioner is to provide culturally sensitive care for patients of Haitian origin in the context of HIV prevention and treatment. 

HIV Positive Status and Family Reaction

Ronald will not have to face the difficult and violent situations that homosexuals must deal with in Haiti when it comes to healthcare options and society in America. However, his relationship with family and other Haitians within the community will likely be affected when they learn about his sexual orientation and HIV status. Given that his family shares the societal values of traditional Haitian families, he may be subjected to verbal abuse, humiliation and abandonment (Dévieux et al., 2022). According to Dévieux et al. (2022), strong religious convictions will also influence how families react, as generally many religious organizations condemn homosexuality as a sin. In this context, Ronald may be subjected to moral judgment and negative attitudes regarding his status.  

Culturally Congruent Strategies to Address HIV Prevention Practices in the Haitian Community 

Cultural differences must be considered when providing HIV prevention services for Haitian Americans, as extended family involvement in most aspects of life is the norm. Questions that are used for HIV screening purposes may not be answered in an honest manner if another person is present. Additionally, providers should utilize an approach that ensures the patient does not feel judged or discriminated against. (Pardo et al., 2021).  

For foreign-born patients, the language barrier may deter them from seeking care or clearly understanding instructions, leading to decreased satisfaction and negative outcomes (Medina-Martínez et al., 2021). Non-creole speaking providers must ensure that medical translator services are readily available, and steps taken to ensure that the patient understands clearly.  

Written materials in the form of brochures should be offered, and organizations where a sizeable Haitian community exists should prioritize hiring professional staff members that speak the language (Pardo et al., 2021). This is especially important when providing information about medication regimes such as the use of pre-exposure prophylaxis (PrEP) (Bracho-Sanchez et al., 2022).  

Conclusion 

Providing HIV care and preventative services for patients of Haitian origin requires an understanding of their cultural values, as well as a need to address language barriers. Steps need to be taken to reduce health inequalities that affect patient outcomes, while considering other needs such as mental health and access. Nursing professionals must adapt to the constant changes in diversity in order to provide competent and respectful care that is patient-centered and leads to optimal outcomes.

This is Ethan’s Discussion Post ↓Discussion 4: Haitian Family Case Study

        Haiti, a nation that shares an island in the Caribbean with the Dominican Republic, is characterized by political upheaval for the last several decades. After a physician named Francois Duvalier, elected president in 1957, declared himself president-for-life in 1964, coups and protests ensued (Purnell, 2013). The unrest resulted in a large number of Haitians migrating to the United States. As Haitians have integrated into the United States, their values and methods have clashed with American culture. For example, it is not uncommon for Haitian parents to feel conflicted in how to parent in America due to the fear of how their authoritarian methods might be perceived. In some cases, a parent’s physical punishment will be considered child abuse. Furthermore, Haitian culture is significantly shaped and formed by spiritual and religious beliefs. The purpose of this discussion post is to examine Haitian views on homosexuality, the response that the traditionally religious community would have towards homosexuality, and strategies that healthcare providers should consider in communicating about Human Immunodeficiency Virus (HIV).

Haitian Views on Homosexuality

        Homosexuality is highly stigmatized in Haitian culture due to social and religious norms (Dévieux et al., 2022). The primary religion in Haiti is Catholicism with Protestantism gaining popularity (Purnell, 2013). For many individuals, their belief system includes the adoption of voudou. The discrimination may be perpetuated with violence by members of the community with little penalty from the legal system. Therefore, it is common for individuals to not disclose their taboo sexuality, even with their family. In the event that their family does know, it will likely be denied if other members of the community inquire.

The Reaction of Religious Parents

        One of the first things to consider in regards to Ronald disclosing information about his sexuality and HIV diagnosis is how Haitians perceive the family unit. The importance of family cannot be understated in Haitian culture. The family unit, both nuclear and extended, makes decisions together, often lives together, and shares honor and shame together (Purnell, 2013). It is important to understand this dynamic as it relates to this case study. It is very likely that Ronald will feel that he will upset his family and bring dishonor upon them. If Ronald’s parents are highly religious and traditional, they will likely be outraged by his confession of being gay and his HIV diagnosis. It is also possible that his parents may attribute his HIV diagnosis as a warranted punishment for his promiscuous behavior, as many Haitians believe illness has a spiritual etiology.

Healthcare Provider Strategies

        The first thing a healthcare provider should do when considering strategies for HIV prevention practices in Haitian communities is to acknowledge the challenging dynamics that arise from the topic of homosexuality within Haitian culture. Providers should understand the weight that the family carriers in Haitian society and the discrimination that follows disclosing homosexuality. Providers should be empathetic and ask patients questions directed towards how patients perceive their sexuality within the context of their family and culture. Second, research has suggested that sexual stigma is associated with greater HIV risk behaviors (Dévieux et al., 2022). Therefore, providers should educate patients with basic prevention strategies such as avoiding instances of unprotected sex and having multiple sex partners. Finally, homosexual men should be encouraged to seek out screening for sexually transmitted diseases.

Conclusion

        Haitian culture, like many other cultures, has distinguishable values, beliefs, and topics that are seen as taboo and distasteful. In Haitian culture, the topic of homosexuality is avoided, denied, and stigmatized. This is the result of various cultural factors including religious beliefs and social values. It is imperative that healthcare providers understand the various cultural beliefs and stigmas that their patients have been formed by and ask clarifying questions directed on how the patient perceives their own situation within the context of their culture.