The HIV response in Central African Republic (CAR) is in a particularly critical situation, fuelled by extreme poverty, pervasive violence, a dire shortage of health facilities and health staff, long-existing supply chain issues for lifesaving antiretroviral (ARV) medication, and significant barriers to early detection and care for the people. Most people need to pay to get an HIV test, and then have to pay for several extra tests before being allowed to start treatment. Fewer than half of the estimated 110,000 people living with HIV in the country are on ARV treatment. As a result, HIV remains a leading cause of death in the country.



Last year, around 4,800 people died of HIV/AIDS in CAR, while some 5,500 new cases are confirmed every year.



This deadly cocktail of obstacles, combined with the end of free testing due to lack of funds, as well as with poor information and stigma about the disease, help explain why close to two-thirds of HIV patients in CAR are diagnosed with advanced HIV by the time they start ARV treatment



In Bangui, the capital of CAR, HIV prevalence is twice the national average. Since late 2019, MSF teams provide free medical care and psychological support for patients in an advanced stage of the disease who are also co-infected with tuberculosis (TB) – the only organisation in Bangui to do so. They also implement a referral system between the hospital and peripheral health centres. One year after the start of MSF’s HIV/AIDS project at Bangui’s Centre Hospitalier Universitaire Communautaire, 1,851 patients had been admitted for HIV treatment, including 558 patients newly diagnosed with HIV.