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1.
Arch Sex Behav ; 53(9): 3625-3637, 2024 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-39147958

RESUMEN

Paid sex is associated with HIV and other sexually transmitted infections, which are highly prevalent in Sub-Saharan Africa (SSA). However, few data exist on this sexual practice among the general population in SSA, including the Democratic Republic of the Congo, where data on paid sex mainly comes from sex workers. In the DRC, most HIV Voluntary Counseling and Testing (VCT) centers do not discuss paid sex as a risk factor. Thus, we aimed to analyze the prevalence of paid sex, its associated factors and association with HIV among women and men attending HIV VCT at a reference hospital in Kinshasa. From 2016 to 2018, the Observational Kinshasa AIDS Initiative cohort analyzed the impact of HIV VCT on changes in HIV knowledge, attitudes, and sexual behaviors at follow-up. Participants aged 15-69 years were HIV tested and interviewed at baseline and at 6- and 12-month follow-ups. At baseline, participants were asked about their history of "ever" having had exchanged sex for money. At both follow-ups, the frequency of this practice was referred to as "the previous 6 months." Descriptive, bivariate, and multivariate logistic regression analyses were carried out to evaluate the prevalence of paid sex, its associated factors, and the association between paid sex and HIV. Statistical analyses were performed with Stata 15.1. Among 797 participants at baseline, 10% of those sexually experienced reported having ever had paid sex (18% men and 4% women, p < 0.001). At 6 and 12-month follow-ups, 5% and 2%, respectively. Paid sex was significantly and independently associated with being male (aOR = 2.7; 95% CI = 1.4-5.2), working or studying (aOR = 2.8; 95% CI = 1.5-5.0), daily newspaper reading (aOR = 4.4; 95% CI = 1.7-11.2); daily/weekly alcohol consumption (aOR = 3.3; 95% CI = 1.8-6.1), first sexual intercourse before age 15 years (aOR = 2.3; 95% CI = 1.1-5.0), multiple sexual partners (aOR = 4.1; 95% CI = 2.2-7.7), and extragenital sexual practices (aOR = 2.4; 95% CI = 1.3-4.4). A high religiosity (daily/weekly church attendance and praying) was inversely associated with paid sex (aOR = 0.1; 95% CI = 0.0-0.4). The high prevalence of paid sex among people attending HIV VCT in Kinshasa, associated with other sexual and consumption risk behaviors, highlights the need to include paid sex among the risk factors mentioned in HIV prevention counseling.


Asunto(s)
Consejo , Infecciones por VIH , Conducta Sexual , Humanos , Masculino , República Democrática del Congo/epidemiología , Adulto , Femenino , Infecciones por VIH/epidemiología , Persona de Mediana Edad , Prevalencia , Adolescente , Estudios Prospectivos , Consejo/estadística & datos numéricos , Adulto Joven , Conducta Sexual/estadística & datos numéricos , Trabajo Sexual/estadística & datos numéricos , Factores de Riesgo , Conocimientos, Actitudes y Práctica en Salud , Anciano , Prueba de VIH/estadística & datos numéricos , Trabajadores Sexuales/estadística & datos numéricos , Trabajadores Sexuales/psicología
2.
J Med Virol ; 96(3): e29529, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38516764

RESUMEN

Studies on the impact of the COVID-19 pandemic in sub-Saharan Africa have yielded varying results, although authors universally agree the real burden surpasses reported cases. The primary objective of this study was to determine SARS-CoV-2 seroprevalence among patients attending Monkole Hospital in Kinshasa (D.R. Congo). The secondary objective was to evaluate the analytic performance of two chemiluminescence platforms: Elecsys® (Roche) and VirClia® (Vircell) on dried blood spot samples (DBS). The study population (N = 373) was recruited in two stages: a mid-2021 blood donor cohort (15.5% women) and a mid-2022 women cohort. Crude global seroprevalence was 61% (53.9%-67.8%) pre-Delta in 2021 and 90.2% (84.7%-94.2%) post-Omicron in 2022. Anti-spike (S) antibody levels significantly increased from 53.1 (31.8-131.3) U/mL in 2021 to 436.5 (219.3-950.5) U/mL in 2022 and were significantly higher above 45 years old in the 2022 population. Both platforms showed good analytic performance on DBS samples: sensitivity was 96.8% for IgG (antiN/S) (93.9%-98.5%) and 96.0% (93.0%-98.0%) for anti-S quantification. These results provide additional support for the notion that exposure to SARS-CoV-2 is more widespread than indicated by case-based surveillance and will be able to guide the pandemic response and strategy moving forward. Likewise, this study contributes evidence to the reliability of DBS as a tool for serological testing and diagnosis in resource-limited settings.


Asunto(s)
COVID-19 , SARS-CoV-2 , Humanos , Femenino , Persona de Mediana Edad , Masculino , COVID-19/diagnóstico , COVID-19/epidemiología , República Democrática del Congo/epidemiología , Pandemias , Reproducibilidad de los Resultados , Estudios Seroepidemiológicos , Anticuerpos Antivirales
3.
Pan Afr Med J ; 45: 89, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37663637

RESUMEN

Introduction: holoendemic, malaria remains one of the major public health problems in Lomami Province in the Democratic Republic of Congo (DRC). To fight against it, a free mass distribution of long-lasting insecticide nets (LLINs) was organized in July 2019 throughout the province. The present study aimed to assess the incidence of malaria and its impact on anaemia of children from 0 to 59 months in this region before and after this intervention. Methods: we had conducted a retrospective observational study from June to December 2018 and June to December 2019. The data were collected on District Health Information System version two (DHIS2) and analyzed with T-tests to compare the incidence rates before (second semester 2018) and after the distribution of LLINs (second semester 2019). Results: the evolution of malaria cases immediately dropped after the distribution campaign. The incidence rates per 1,000 inhabitants in 2018 and 2019 were 106 and 107 respectively in the general population; 302 versus 305 in children aged 0 to 59 months and 219 versus 209 in pregnant women. The differences in incidence were not statistically significant with p values 0.497, 0.4602, and 0.3097 respectively. However, it was observed that the decrease in malaria cases led to a decrease in anaemia cases in general. Conclusion: the LLIN distribution campaign did not decrease the incidence of malaria. The synergy of preventive interventions to reduce the incidence of malaria remains key.


Asunto(s)
Insecticidas , Malaria , Embarazo , Niño , Humanos , Femenino , Incidencia , República Democrática del Congo/epidemiología , Registros Electrónicos de Salud , Malaria/epidemiología , Malaria/prevención & control
4.
PLoS One ; 14(1): e0210398, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30650137

RESUMEN

BACKGROUND: Sexually transmitted infections can be spread through oral and anal heterosexual sex. There are few data on these practices in Sub-Saharan Africa. We analyzed the prevalence of heterosexual oral and anal sex among HIV Voluntary Counseling and Testing (VCT) attendees in Kinshasa and the associated sociodemographics, perceptions and behavioral factors. METHODS: OKAPI (Observational Kinshasa AIDS Prevention Initiative) prospective cohort study. It evaluates the VCT impact on HIV-related knowledge and behaviors at 6 and 12-month follow-up. Since April 2016 until April 2018, 797 persons aged 15-59 years were HIV tested and replied to a baseline interview, including information about anal and oral sex. Descriptive, bi- and multivariate analyses were performed using baseline data. RESULTS: Among 718 sexually active participants reporting heterosexual sex, 59% had had oral sex, 22% anal sex and 18% both practices. Among participants reporting "not" having had sex, 6% reported oral sex, 3% anal sex and 1% both. Oral sex was associated with a daily use of the Internet/mobile phone, perceiving low community HIV risk, reporting HIV-related behaviors (multiple partners, inconsistent condom use, anal, paid and forced sex) and having been pregnant. Being married-monogamous was inversely associated with oral sex. Anal sex was directly associated with having other risk sexual behaviors. CONCLUSIONS: Oral and anal sex were common among people reporting heterosexual sex in Kinshasa. Perceiving a low community HIV risk and having other sexual risk behaviors are associated with these practices, which are commonly not considered as risky despite their strong association with HIV/STIs. They need to be considered when designing preventive strategies in Kinshasa.


Asunto(s)
Heterosexualidad , Conducta Sexual , Adolescente , Adulto , Estudios de Cohortes , Consejo , República Democrática del Congo/epidemiología , Femenino , Infecciones por VIH/epidemiología , Infecciones por VIH/prevención & control , Educación en Salud , Humanos , Masculino , Persona de Mediana Edad , Embarazo , Prevalencia , Estudios Prospectivos , Asunción de Riesgos , Sexo Seguro , Conducta Sexual/estadística & datos numéricos , Parejas Sexuales , Enfermedades de Transmisión Sexual/epidemiología , Enfermedades de Transmisión Sexual/prevención & control , Adulto Joven
5.
Linacre Q ; 86(2-3): 161-167, 2019 May.
Artículo en Inglés | MEDLINE | ID: mdl-32431404

RESUMEN

BACKGROUND: Forty-four percent of all pregnancies worldwide are unintended. Induced abortion has drawn a lot of attention from clinicians and policy makers, and the care for women requesting it has been covered in many publications. However, abortion challenges the values of many women, is associated with negative emotions, and has its own medical complications. Women have the right to discuss their unintended pregnancy with a clinician and receive elaborate information about other options to deal with it. Continuing an unintended pregnancy, and receiving the necessary care and support for it, is also a reproductive right of women. However, the provision of medical information and support required for the continuation of an unintended pregnancy has hardly been approached in the medical literature. OBJECTIVE: This review presents a clinical approach to unintentionally pregnant patients and describes the information and support that can be offered for the continuation of the unintended pregnancy. DISCUSSION: Clinicians should approach patients with an unintended pregnancy with a sympathetic tone in order to provide the most support and present the most complete options. A complete clinical history can help frame the problem and identify concerns related to the pregnancy. Any underlying medical or obstetric problems can be discussed. A social history, that includes the personal support from the patient's partner, parents, and siblings, can be taken. Doctors should also be alert of possible cases of violence from the partner or child abuse in adolescent patients. Finally, the clinician can provide the first information regarding the social care available and refer the patients for further support. For women who continue an unintended pregnancy, clinicians should start antenatal care immediately. CONCLUSION: Unintentionally pregnant women deserve a supportive and complete response from their clinicians, who should inform about, and sometimes activate, all the resources available for the continuation of unintended pregnancy. SUMMARY: Forty-four percent of all pregnancies worldwide are unintended. Induced abortion has drawn a lot of attention and the care for women requesting it has been covered in many publications. However, abortion challenges the values of many women, is associated with negative emotions, and has its own medical complications. Women have the right to discuss their unintended pregnancy with a clinician and receive elaborate information about other options to deal with it. Continuing an unintended pregnancy, and receiving the necessary care and support for it, is also a reproductive right of women. However, the provision of medical information and support required for the continuation of an unintended pregnancy has hardly been approached in the medical literature. This review presents a clinical approach to unintentionally pregnant patients and describes the information and support that can be offered for the continuation of the unintended pregnancy. Clinicians should approach patients with an unintended pregnancy with a sympathetic tone. A complete clinical history can help frame the problem and identify concerns related to the pregnancy. Any underlying medical or obstetric problems can be discussed. A social history, that includes the personal support from the patient's partner, parents, and siblings, can be taken. Doctors should also be alert of possible cases of violence from the partner or child abuse in adolescent patients. Finally, the clinician can provide the first information regarding the social care available and refer the patients for further support. For women who continue an unintended pregnancy, clinicians should start antenatal care immediately.

6.
PLoS One ; 12(12): e0189632, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-29253857

RESUMEN

INTRODUCTION: Sexual violence, an HIV determinant, is an integrated behavior in the D.R.Congo. We aimed to analyze the prevalence of forced sexual intercourse (FSI) among people receiving HIV Voluntary Counseling and Testing in a hospital in Kinshasa, and its association with socio-demographics, behaviors and HIV status. METHODOLOGY: Case-control study (2010-2012). Two-hundred and seventy-four cases with a new HIV+ test and 1,340 controls with an HIV- test were interviewed about HIV-related knowledge, attitudes and behaviors, including FSI. RESULTS: Thirty-four percent of the participants declared having had FSI (38% of women and 32% of men). Being a woman, aged 25-49 and reporting multiple sexual partners were associated with reporting FSI. For men, being single was protective against FSI; and cohabiting, having a high socioeconomic status, and alcohol consumption increased the odds. For women, being single, divorced/separated and widow was associated with reporting FSI. A significant positive association was found between FSI and an HIV positive test. CONCLUSION: Among our Congolese population, FSI was strongly associated with HIV infection and it was also associated with alcohol consumption and multiple sexual partnerships, other key HIV determinants. These behaviors need to be identified as potential risk factors of FSI during counseling interventions. Researchers, practitioners and decision-makers should work together to get violence prevention integrated into health, social and educational policies.


Asunto(s)
Coito , Infecciones por VIH/epidemiología , Violación , Adolescente , Adulto , Estudios de Casos y Controles , Consejo , República Democrática del Congo/epidemiología , Femenino , Infecciones por VIH/diagnóstico , Seropositividad para VIH , Conductas Relacionadas con la Salud , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Factores de Riesgo , Conducta Sexual/psicología , Parejas Sexuales , Adulto Joven
7.
AIDS Care ; 29(6): 772-781, 2017 06.
Artículo en Inglés | MEDLINE | ID: mdl-27852108

RESUMEN

In the Democratic Republic of Congo no previous studies have assessed the factors associated with different patterns of condom use and with multiple sexual partners, and the association between condom use simultaneously taking into account multiple sexual partnerships, and HIV infection. We carried out a prospective case-control study. From December 2010 until June 2012, 1630 participants aged 15-49 getting HIV Voluntary Counseling and Testing in a hospital in Kinshasa were selected. Cases were new HIV diagnosis and controls were HIV-negative participants detected along the study period. We recruited 274 cases and 1340 controls that were interviewed about HIV-related knowledge, attitudes and behaviours. Among cases there was a high prevalence of multiple lifetime and concurrent sexual partnerships (89.8% and 20.4%, respectively) and most cases never used condoms with only 1.5% using them consistently. Condom use and multiple partnerships were associated with male, single and high-educated participants. An association was found between multiple lifetime partners and 'any condom use' (OR = 2.99; 95%CI: 2.14-4.19) but not with consistent use. Both having two or more multiple concurrent sexual partners or not using condoms were variables similarly and highly associated to HIV risk. The association found between having two or more concurrent sexual partners and HIV was slightly higher (OR = 3.58, 95%CI:2.31-5.56) than the association found between never condom use and HIV (OR = 3.38, 95%CI:1.15-9.93). We found a high prevalence of multiple lifetime sexual partners and an extremely high prevalence of inconsistent condom use, both strongly associated with HIV seropositivity. Local programmes would benefit from comprehensive interventions targeting all behavioural and sociocultural determinants.


Asunto(s)
Condones/estadística & datos numéricos , Infecciones por VIH/epidemiología , Conocimientos, Actitudes y Práctica en Salud , Parejas Sexuales , Sexo Inseguro , Adolescente , Adulto , Estudios de Casos y Controles , República Democrática del Congo/epidemiología , Escolaridad , Femenino , Seronegatividad para VIH , Humanos , Masculino , Estado Civil , Persona de Mediana Edad , Prevalencia , Estudios Prospectivos , Adulto Joven
8.
BMC Public Health ; 16: 606, 2016 07 20.
Artículo en Inglés | MEDLINE | ID: mdl-27439981

RESUMEN

BACKGROUND: Considering the high percentage of couples in which one or both members are HIV negative, the frequency of transmission among non-regular partners and the probabilities of non-disclosure, attention should be paid to people getting a negative HIV test at the Voluntary Counseling and Testing (VCT). Research has shown that a negative HIV test may be followed by a change in sexual behaviours. In Sub-Saharan Africa, where most HIV infections occur, there are few studies that have analysed the factors associated with changes in sexual risk behaviours after a negative HIV test at the VCT clinic. The aim of this project is to evaluate the specific factors associated with changes in sexual behaviours, three months after a negative result in an HIV test, and to analyse the effect of counseling and testing on HIV-related knowledge of participants in an outpatient centre of Kinshasa (Democratic Republic of Congo). METHODS AND DESIGN: Prospective cohort study from December 2014 until March 2016. People 15-60 year old that received VCT at Monkole Hospital (Kinshasa) were followed three months after they got a negative HIV test. In a face-to-face interview, participants replied to a baseline and a follow-up research questionnaire on HIV-related knowledge, attitudes and behaviours. At follow-up respondents were also offered a new HIV test and additional HIV counseling. Four hundred and fifteen participants completed the baseline questionnaire and 363 (87 %) came back for their 3-month follow up. DISCUSSION: This is the first longitudinal study in the DRC that evaluates the factors associated with changes in sexual behaviours after a negative HIV test at the VCT. Participants attending the VCT services within a clinical setting are a good study population as they can be good transmitters of preventive information for other people with no access to health facilities.


Asunto(s)
Infecciones por VIH/psicología , Conocimientos, Actitudes y Práctica en Salud , Tamizaje Masivo/psicología , Asunción de Riesgos , Conducta Sexual/psicología , Adolescente , Adulto , Protocolos Clínicos , Consejo/métodos , República Democrática del Congo , Femenino , Estudios de Seguimiento , Infecciones por VIH/prevención & control , Seronegatividad para VIH , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Parejas Sexuales/psicología , Encuestas y Cuestionarios , Adulto Joven
9.
Sex Transm Infect ; 91(5): 334-7, 2015 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-25416838

RESUMEN

OBJECTIVES: To evaluate the prevalence of HIV-related misconceptions in an outpatient centre of Kinshasa (Democratic Republic of Congo) and analyse the association between these beliefs and HIV infection. METHODS: A case-control study was carried out from December 2010 until June 2012. We assessed 1630 participants aged 15-49 attending a primary outpatient centre in Kinshasa: 762 HIV Voluntary Counselling and Testing attendees and 868 blood donors. A 59-item questionnaire about knowledge, attitudes and practice was administered during a face-to-face interview, followed by an HIV test. Cases and controls were respondents with a newly diagnosed HIV-positive or HIV-negative test, respectively. Unconditional logistic regression was used to analyse the association between misconceptions and HIV seropositivity. RESULTS: 274 cases and 1340 controls were recruited. Cases were more likely than controls to have a low socioeconomic status, no education, to be divorced/separated or widowed. An association was found between the following variables and HIV seropositivity: having a poor HIV knowledge (adjusted OR=2.79; 95% CI 1.43 to 5.45), not knowing a virus is the cause of AIDS (adjusted OR=2.03; 95% CI 1.38 to 2.98) and reporting more than three HIV-transmission-related misconceptions (adjusted OR=3.30; 95% CI 1.64 to 6.64), such as thinking an HIV-positive person cannot look healthy and that HIV is transmitted by sorcery, God's punishment, a kiss on the mouth, mosquitoes, coughs/sneezes or undercooked food. CONCLUSIONS: Despite having access to healthcare services, there are still many people in Kinshasa that have HIV-related misconceptions that increase their HIV risk. Our findings underscore the need for a culturally adapted and gender-orientated basic HIV information into Congolese HIV prevention programmes.


Asunto(s)
Infecciones por VIH/psicología , Conocimientos, Actitudes y Práctica en Salud , Conducta Sexual/psicología , Adolescente , Adulto , Estudios de Casos y Controles , República Democrática del Congo/epidemiología , Femenino , Infecciones por VIH/epidemiología , Infecciones por VIH/prevención & control , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Prevención Primaria , Estudios Prospectivos , Encuestas y Cuestionarios
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