Political and socioeconomic instability: how does it affect HIV? A case study in the Democratic Republic of Congo.

Five years ago we reported a low and stable HIV prevalence in selected population groups despite the poor environment and political instability in the Democratic Republic of Congo (DRC). Since then the central government has lost control of almost one third of the country and war is waging across DRC. We hereby report to what extent the ongoing conflict could impact on the stability of HIV prevalence reported in our previous study. From March to May 2002 we conducted HIV serosurveys in four major cities: Kinshasa Mbuji-Mayi Lubumbashi located in the government-held areas and Kisangani under the control of the rebels Rwandan and Ugandan armies. Convenient sampling was obtained among pregnant women attending antenatal clinics tuberculosis patients clinic outpatients blood donors sexually transmitted infection (STI) patients sex workers and internally displaced people (IDP). After informed consent 3090 individuals 2201 women (72.1%) and 889 men (28.8%) were screened for HIV antibody by a rapid assay (Abbott Determine HIV-1/2; Abbott Laboratory Tokyo Japan) or a commercial enzyme-linked immunosorbent assay (Organon Technika Belgium). All reactive specimens were discriminated and confirmed by a line immunoassay (Innolia HIV-1/2; Innogenetics Ghent Belgium). (excerpt)