Democratic Republic of Congo: Women Risk HIV in Forced Marriages

The challenge of containing the HIV epidemic in the Democratic Republic of Congo is complicated by cultural mores that often consider rape inevitable in this poor and war-torn country.

"This is a terrible problem in the Congo," said Derick Manegabe, technical director for Fondation Femme Plus (FFP), a national organization for HIV- and AIDS-affected girls and women. "Women are raped by their husbands, and many people don't believe that's a crime. They're raped by armed groups and are afraid to tell because they will be stigmatized," said Manegabe, whose organization provides counseling and education on a broad range of health issues.

The nature of rape in the Congo has shifted dramatically in recent years. Between 2004 and 2008, the proportion of rapes attributed to civilians rose from 1 percent to 34 percent, according to estimates by Oxfam. Rape often is the functional equivalent of a marriage proposal, some observers say.

UN data indicate there are 1.5 million HIV-positive residents in the Congo, nearly 5 percent of the population. In Goma province, still shattered by the effects of the Rwandan genocide, 2,693 people are receiving antiretroviral treatment, while another 29,645 are on the waiting list.

Overwhelmingly, the route of HIV transmission in the Congo is heterosexual contact, and women comprise about 60 percent of those infected. Two percent of pregnant women have access to services to prevent vertical transmission of HIV, and 8 percent are offered HIV testing and counseling.

More than 40,000 infants are born with HIV infection in the Congo each year. FFP has received funding that will vastly increase the number of women receiving antiretroviral therapy next year, Manegabe said.

Congo stepped out in the early 1980s with HIV awareness programs, but that effort was derailed quickly by consecutive civil wars. In recent weeks, President Joseph Kabila has promised to resume the outreach with public-private programs to train health care workers and improve the capacity of the nation's laboratories.

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