Les infections par le VIH dans l'espace africain. Une mise en question géographique.

Abstract

An analysis and a «study» of the datas known on the situation and the evolution of infections by HIV state that three epidemio- logical phenomena are simultaneously understood. Endemic forms of the HIV1 and of the HIV2 have been noticed since the beginning of the 80' s on the Western side of Africa : prevalences discovered are rare, sometimes a bit more numerous ; they seem to be stable ; they are undifferentiated in the regional space. Geographical and epidemiological proximities observed between one and the other endemy, several indications gathered from the recent past, collected knowledge on the natural history of both HIV and its relations with that of the SIV (the monkey's virus) put forward the hypothesis that the Atlantic side of the continent could be a more or less ancient area of both infections. The noticeable stability of both preceding epidemiological phenomena contrasts with the powerful dynamism of an epidemy of the infection by the HIV1 appeared at the latest at the end of the 70' s. Based first in the Center East-Africa, it has quickly spread around its initial areas, moreover (it has spread) over Central Africa and over Southern Ivory Coast. The epidemy is selective in the space. It develops in small cities, as well as in big cities, and also in rural sites, characterized by a great economic and human liveliness. The origin of this epidemy, its relations with the endemic form of the HIV1 observed, moreover are not clearly established. It could be distinguished by the nature of the concerned virus.