Contribution of Community-Based Organizations of People Living with HIV to the HIV/AIDS Response in Kasai Oriental Province, Democratic Republic of the Congo: A Cross-Sectional Analytical Study

Abstract

Community-based organizations (CBOs) play a pivotal role in the HIV response by strengthening prevention, HIV testing, treatment adherence, psychosocial support, and retention in care for people living with HIV (PLHIV). Despite their recognized contribution, limited evidence is available on their performance in the inland provinces of the Democratic Republic of the Congo, particularly in Kasai Oriental Province. This study aimed to assess the level of community-based interventions received by PLHIV and to identify the sociodemographic, clinical, and organizational factors associated with these interventions. A cross-sectional analytical study was conducted from 24 April 2026 to 24 June 2026 among 136 people living with HIV receiving services from 10 community-based organizations in Kasai Oriental Province, Democratic Republic of the Congo. Data were collected using a structured questionnaire administered through KoboToolbox. Statistical analyses were performed using IBM SPSS Statistics version 26. Descriptive statistics were used to summarize participants' characteristics. Associations between independent variables and the level of community-based interventions were assessed using the chi-square test, followed by bivariate and multivariable logistic regression analyses. Statistical significance was established at p < 0.05. A total of 136 participants were included in the study. Most participants were female (67.6%), 40 years of age or older (72.1%), unmarried (52.2%), and had at least a secondary level of education (62.5%). More than half had been living with HIV for 120 months or longer (55.1%) and had received antiretroviral therapy for at least 120 months (51.5%). Based on the composite intervention score, 55.9% of participants received a high level of community-based interventions, whereas 44.1% received a low level. In the multivariable logistic regression analysis, no independent factor was significantly associated with the level of community-based interventions. However, participants aged 40 years or older (aOR = 0.46; 95% CI: 0.21–1.02; p = 0.057) and those with secondary or higher education (aOR = 0.53; 95% CI: 0.26–1.10; p = 0.090) showed a tendency to be less likely to receive a high level of community-based interventions than their counterparts. Community-based organizations play a critical role in HIV care and support in Kasai Oriental Province. Nevertheless, nearly one out of every two beneficiaries still receives an insufficient level of community-based interventions. Strengthening the institutional capacity of community-based organizations, ensuring sustainable funding, and improving their integration into the national health system are essential to enhance the quality and coverage of community-based interventions and to accelerate progress toward national and global HIV control targets.