Twenty percent of urban children have neither their father nor mother in their household. Youth who experience the absence of one or both parents tend to fare worse in school than their peers (World Bank 2003). Besides the observed orphans a large number of children also live in the streets. These youth are not likely to be represented in the ECVH household survey, and therefore some of the worst-off youth are not accounted for in the results. Because this very vulnerable group is of obvious concern, more research and data collection in the area are encouraged. Street children are at very high risk of taking part in prostitution or gangs, which they may see as their only escape from isolation and destitution.

In conclusion, a large proportion of youth in Haiti lacks the family support they need. Eighty-six percent of youth find that family disintegration is a very serious problem in Haiti; a shocking 94.6 percent of youth living in the metropolitan area have this opinion. Living without both or with just one parent in the household is likely to have negative effects on a youth’s self-esteem and learning abilities. Moreover, a perhaps more important determinant for youth being at risk is whether the household lives in peace and harmony. The antithesis of this, domestic violence and insecurity in general, are examined in detail in Section 6. Optimal family planning is often not achieved, in part because of lack of information. Youth engaging in early unprotected sexual activity may be the beginning of a family, but also the end of it, as HIV/AIDS is widespread.

# **Risky Sexual Behavior**

The health sector or rather the lack of health services, information, etc. in Haiti is negatively affecting youth. Only 50 percent of youth feel they are in good health and for the cohort aged 35–44 the proportion is merely 26 percent. HIV/AIDS has reached epidemic proportions, with the highest incidence outside Africa. 5.2 percent of persons between the ages of 15 and 19 have HIV/AIDS; men and women are equally affected. As negative outcomes, 210,000 were living with HIV/AIDS and an estimated 23,000 died from AIDS in 1999 alone, thus limiting the society’s advancement (UNAIDS 2000). Disturbingly, because 74,000 are expected to have become orphans because of these AIDS-related deaths, intergenerational issues should be of obvious concern (World Bank 2003). Youth undertake high risk behavior by early and frequent unprotected sex with multiple partners. In spite of this and the alarming figures above, only three percent of youth report they have been tested for AIDS; for rural youth the percentage is less than two. Only two out of three youth view AIDS as a serious problem. This may to some extent be explained by lack of knowledge because more than five percent of youth have never even heard of AIDS. Youth in rural areas have nearly twice the incidence as that of metropolitan youth; 6.3 and 3.4 percent, respectively, have heard of AIDS. Prostitution is common for youth in Haiti and places a large group at risk. During the years after these surveys were conducted the situation is expected to have improved somewhat. At a recent UN General Assembly Special Session on HIV/AIDS,<sup>34</sup> Haiti was recognized for progress in scaling up treatment with support from the Global Fund to Fight AIDS,

> 34 June 2, 2005, New York Times (Lawrence K. Altman).

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