• Michael Hawkes, Eugenie S Sivasivugha, Simon K Ngigi, Claude K Masumbuko, Jason Brophy, and Zacharie T Kibendelwa.
• University of Toronto, Toronto, ON, Canada. michael.hawkes1@gmail.com
• Curr. HIV Res. 2013 Apr 1; 11 (3): 246-53.

ObjectiveTo explore the relationship between religious affiliation and HIV infection in a war-ravaged community in sub-Saharan Africa.DesignMixed quantitative and qualitative methods.MethodsIndividuals attending HIV voluntary counseling and testing clinics in Butembo in Eastern Democratic Republic of the Congo (DRC) completed a questionnaire and were tested for HIV infection. Risk factors for HIV seropositivity were explored, with attention to religious affiliation as a potential risk factor. Structured interviews of key informants were used to complement quantitative data.ResultsThree hundred and eighty individuals attending six clinics were enrolled. Nearly all participants (97%) self-identified as Christian (44% Catholic; 53% non-Catholic Christian). Twenty-eight patients (7.4%) tested positive for HIV. Age>30 years (adjusted OR 47 [95%CI 2.9-770, p=0.007), married status (adjusted OR 3.7 [95%CI 1.1-13, p=0.037), and Catholic religion (adjusted OR 2.7 [95%CI 1.1-6.8, p=0.030) were independent risk factors for HIV seropositivity in a multivariable logistic regression model. Rates of HIV were higher among Catholic than non-Catholic Christian participants in both single and married participants. The proportion of participants reporting condom use as a primary prevention modality did not differ significantly between religious groups; however, within both Catholic and non-Catholic Christian groups, increasing church attendance was associated with decreased use of condoms. Qualitative data highlighted divergent views toward condom use among Catholic health workers.ConclusionsIn this cross-sectional survey in Eastern DRC, Catholic (relative to non-Catholic Christian) religious affiliation was associated with an increased risk of HIV. Increasing dialogue between biomedical practitioners and religious leaders may strengthen HIV prevention efforts in SSA.

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