[Determinants of non-compliance with antiretroviral therapy in adult patients in Kinshasa]. / Déterminants de la non-observance au traitement antirétroviral chez l'adulte à Kinshasa.

INTRODUCTION: the purpose of this study was to identify the determinants of non-compliance of persons living with HIV with antiretroviral treatment in Kinshasa. METHODS: we conducted a cross-sectional study in Kinshasa from 1st May to 31st August 2015. The study population was composed of patients aged at least 18 years living with HIV who had been treated with antiretroviral drugs for at least 3 months. Adherence Index (subjective method) and prescription refills (objective method) were used to assess compliance. Determinants of non-compliance were identified by logistic regression model. RESULTS: the 400 patients living with HIV had a median age of 43 years (18-75). Global non-compliance rate was 25.5%. Objective non-compliance rate was higher than that of subjective non-compliance (29% vs 21%, p = 0.01). Payment for consultation [adjusted odds ratio (AOR): 1.70; 95% confidence interval (95% CI): 1.02-2.81; p = 0.042), adverse reactions (AOR: 2.23; 95% CI: 1.33-3.75; p = 0.002) and the lack of awareness that missing a dose may worsen disease (AOR: 4.16; 95% CI: 1.04-16.68; p = 0.045) were determinants of non-compliance. Having trusted person was a protective factor versus non-compliance (AOR: 0.54; 95% CI: 0.39-0.93; p = 0.004). CONCLUSION: the rate of non-compliance with antiretroviral treatment is high in Kinshasa. The evaluation of determinants is necessary to establish strategies for improving compliance.

[Care providers' knowledge and willingness to prescribe pre-exposure prophylaxis (PrEP) in Kinshasa, Democratic Republic of Congo (DRC)]. / Connaissance et volonté de prescrire la prophylaxie pré exposition (PrEP) par les prestataires des soins de santé à Kinshasa, République Démocratique du Congo (RDC).

INTRODUCTION: reducing the incidence of new HIV infections is a public health goal. The purpose of this study was to evaluate the knowledge and willingness to prescribe PrEP in Kinshasa. METHODS: we conducted a cross-sectional analytical study among care providers of 4 health facilities where HIV treatment was offered in the city of Kinshasa from April to October 2017. Univariate and multivariate logistic regression analyses were carried out to identify the factors associated with knowledge and willingness to prescribe PrEP. RESULTS: eighty-five care providers responded at the survey. Less than one quarter of care providers knew PrEP before the survey and half of them were willing to prescribe it. Reluctance was due to resistance (83%). Factors associated with the knowledge of PrEP were the specialty of infectious disease and the expertise in addressing HIV. Factors associated with the willingness to prescribe PrEP were an age greater than 40 years, the specialty of infectious disease and the expertise in addressing HIV. CONCLUSION: the knowledge of the PrEP in Kinshasa was low and only half of care providers were willing to prescribe it. Being an infectious diseases specialist and an expert in HIV was associated with the knowledge and the willingness to prescribe PrEP. Education programs should strengthen the knowledge on PrEP and address concerns leading to reluctance to prescribe it.

Factors associated with acceptability of HIV self-testing (HIVST) among university students in a Peri-Urban area of the Democratic Republic of Congo (DRC).

INTRODUCTION: this paper examines the acceptability of HIV self-testing (HIVST) by students in a university in the DRC and identifies factors associated with uptake of HIVST. METHODS: a cross-sectional study was conducted with a sample of 290 students from Kikwit University. Data were summarized using proportions and predictions of acceptability of HIVST by logistic regression. RESULTS: the average age of students was 22.5 years, with the majority of the students being male (57%). Just over half the students sampled, reported being sexually active (51.8%). One hundred and sixty four (75%) reported that they had one sexual partner and fifty-six (25%) two or more sexual partners in the past year. Sixty-six percent had used condoms during their last sexual encounter. The acceptability of HIVST was high (81.4%) and 66.1% of students stated that they would confirm the self-test at a local health facility. The knowledge about the importance of the self-test (OR 5.02; 95% CI:1.33-18.88; p=0.017), the perception that counseling pre and post-test were important (OR 2.91; 95% CI:1.63-5.19; p < 0.0001) and the willingness to realize the test with a partner (OR 2.46; 95% CI:1.43-4.23; p=0.034) were factors associated with HIVST. CONCLUSION: the acceptability of HIVST was high and therefore its implementation is feasible in our country. However, prior to implementation, additional factors such as cost; access of HIVST; false reassurance of the test; missed early infections in the window period, limited counseling and linkage to care options, need to be considered.