[Geographic distribution of HIV-1 infection in Central Africa: remarkable discontinuities].

Abstract

The (confirmed) serological data, collected since 1985 and spread in space and in time, allow to draw a geographical image--distribution, dissemination--of HIV 1 infection. These data raise some questions and hypotheses on the nature and the dynamics of the epidemiological factors involved. The geographical distribution of the infection in the global population is heterogeneous. Ever since the first surveys, the virus is widely spread at low level, in the rural as well as in the urban areas, covering a large territory, from Chad to Gabon; later it tends to focus on the large metropolitan and secondary towns. The endemicity is more pronounced in a double urban conglomerate (Kinshasa, Brazzaville) and in two regional foci, the southwest of the Congo and the south of Shaba; in the two towns the prevalence rate does not progress between 1985-86 and 1991-92. The Central African Republic has suffered an active epidemic outbreak, affecting the capital and the whole network of secondary towns. The epidemiological discontinuities noticeable across Central Africa, may represent different stages of the same process or be connected to the stake of different eco-epidemiological systems.