Title:HIV and Religion in the Congo: A Mixed-Methods Study
Volume: 11
Issue: 3
Author(s): Michael Hawkes, Eugenie S. Sivasivugha, Simon K. Ngigi, Claude K. Masumbuko, Jason Brophy and Zacharie T. Kibendelwa
Affiliation:
Keywords:
HIV, religion, condom, mixed methods, sub-Saharan Africa.
Abstract: Objective: To explore the relationship between religious affiliation and HIV infection in a war-ravaged
community in sub-Saharan Africa.
Design: Mixed quantitative and qualitative methods.
Methods: Individuals 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.
Results: Three hundred and eighty individuals attending six clinics were enrolled. Nearly all participants (97%) selfidentified
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.
Conclusions: In 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.
