La Pauvreté - Déterminant Majeur Et Conséquence De L’Épidémie Du Vih/Sida Dans Une Contrée Frontalière En Afrique Australe Cas De La Frontière De Kasumbalesa (République Démocratique Du Congo – Zambie) (Poverty - Major Determinant and Consequence of the HIV/AIDS at a Border in Southern Africa - Case of Kasumbalesa Border Post (Democratic Republic of Congo - Zambia))

Abstract

This thesis aims to evaluate the interaction between poverty and the HIV/AIDS in the border city of Kasumbalesa. Cross-sectional surveys were conducted among households, truckers from Southern Africa, the population in general, people living with HIV/AIDS from October 2008 to April 2009 for the collection of different information that has been analyzed depending on the specific objectives described in this work. We found that the poverty threshold for a household per year is 213,747.2 FC equivalents to 3776 U.S dollars. 77.73% of households live in poverty, 37.05% of households living in deep poverty and 21.66% living in severe poverty. Also, 88% of girls aged 11 to 24 years old live in poverty with a coefficient of variation of inequality of poverty by area of residence of 49.98%. The depth of poverty among girls aged 11 to 24 years is around 42.23% and the severity of poverty among girls aged 11 to 24 years is around 25.03%. These situations of poverty in this population get this people in open and hidden prostitution throughout the border of Kasumbalesa with a very high risk of being contaminated with HIV. In the fight against the spread of HIV/AIDS, it is recommended to start from the state of knowledge of people to adapt the messages for information, education and communication (IEC). Broadly speaking, as regards the results of our study, knowledge on HIV/AIDS improved slightly compared to other studies done in specific areas, such as Kapolowe. The main modes of transmission remain largely known by the population. But some beliefs, such as the transmission of the virus in public toilets by a mosquito bite or due to touch a PLWIH remained at a significant level suggesting that the mechanisms underlying the transmission of the virus remain poorly controlled by some. The belief of the HIV/AIDS transmission through particular supernatural means such as witchcraft is widespread, about 44% (from 37.12% to 50.88% : C.I 95%) of people still believe that HIV/AIDS can be transmitted by supernatural means and a significant 6.5% (from 3.08 to 9.92%: C.I 95%) people do not know whether the virus can be transmitted through supernatural means. Furthermore, we found that the border city of Kasumbalesa is one of the great doors of the HIV/AIDS epidemic by truckers from southern Africa. Indeed, the prevalence of HIV infection among truckers who reported having had at least one sexual intercourse during their stay at the border of Kasumbalesa is 37.07%. Considering poverty as a result of the HIV/AIDS, we have been interested to people living with HIV/AIDS. In this regard, we found that 85.45% of households of persons living with HIV live in poverty. 42.18% of PLWIH experiencing a deep or intense poverty and the index of severity of poverty among people living with HIV/AIDS is about 25.8%. Also 86% of AIDS orphans live in poor households, 43.57% of AIDS orphans live in a state of deep poverty and 27.04% of AIDS orphans live in severe poverty. Concerning the nutritional status of people living with HIV using the Body Mass Index criteria and the ideal weight method we have found: 18.18% of PWLIH have severe malnutrition, 3.64% had moderate malnutrition and 27.27% have a marginal malnutrition. These results suggest that poverty is the major determinant of the HIV/AIDS and its consequences in gathering the others. Indeed, the socio-economic conditions of sexual relations are important determinants of the dynamics of HIV infection. The low ability of women to negotiate sex relation with less risk is a key element of this dynamic. The vulnerability of women is also in economic terms (sex workers or occasional sex relations against retribution, sex between young girls and mature men, women seeking to cover the basic needs with paid sex relation).