Increased HIV in Greater Kinshasa Urban Health Zones: Democratic Republic of Congo (2017\u20132018)

Mohammad Pour,Mary A Rodgers,Michael G Berg,Carole P Mcarthur,Franklin Baer,John Hackett Jr,Joanna Scott,Samuel Mampunza,Gavin A Cloherty,Kamlendra Singh,Linda James

doi:10.1186/s12981-020-00322-y

Abstract

BackgroundDiagnosis of people living with HIV (PLHIV) is the first step toward achieving the new Fast Track Strategy to end AIDS by 2030: 95-95-95. However, reaching PLHIV is especially difficult in resource-limited settings such as the Democratic Republic of Congo (DRC), where reliable prevalence data is lacking. This study evaluated the prevalence of HIV in patients in the urban Kinshasa area.MethodsIndividuals seeking healthcare were tested for HIV between February 2017 and July 2018 at existing Kinshasa urban clinics. The study was conducted in two phases. Case finding was optimized in a pilot study phase using a modified cell phone-based Open\\Data Kit (ODK) collection system. HIV prevalence was then determined from data obtained between March–July of 2018 from 8320 individuals over the age of 18 years receiving care at one of 47 clinics in Kinshasa.ResultsThe prevalence of HIV in our study was 11.0% (95% CI 10.3–11.6%) overall and 8.14% in the subset of N = 1240 participants who were healthy mothers seeking prenatal care. These results are in sharp contrast to President's Emergency Plan for AIDS Relief (PEPFAR) estimates of 2.86%, but are consistent with data from surrounding countries.ConclusionWhile this data is sub-national and reflects an urban healthcare setting, given the large population of Kinshasa and rapidly changing age demographics, the results suggest that HIV prevalence in the DRC is substantially higher than previously reported.

Highlights

The Democratic Republic of the Congo (DRC) consists of 26 provinces, with 15% of the total Democratic Republic of Congo (DRC) population living in the largest province of Kinshasa
The DRC National AIDS Control Program estimates that only 10% of people living with HIV who are eligible for an anti-retroviral therapy program, are enrolled [4]
A cell phone-based Open\Data Kit (ODK) adopted during the implementation phase greatly improved the accuracy and reliability of data collection compared to recording by hand

Summary

Introduction

The Democratic Republic of the Congo (DRC) consists of 26 provinces, with 15% of the total DRC population living in the largest province of Kinshasa. Pour et al AIDS Res Ther (2020) 17:67 only 9% of adults in the DRC knew their HIV status. This was due in part to the limited availability of HIV counseling and testing [4]. The DRC National AIDS Control Program estimates that only 10% of people living with HIV who are eligible for an anti-retroviral therapy program, are enrolled [4]. It is critical to identify HIV positive people and connect them with anti-retroviral therapy to reduce viral loads and prevent the spread of HIV. This study evaluated the prevalence of HIV in patients in the urban Kinshasa area

Methods

Results

Discussion

Conclusion