She barely catches her breath after each word.

"My husband died of HIV, that's how I knew I was HIV-positive," she says slowly, touching her neck, swollen with swollen lymph nodes.

"I have six children, who will take care of them if I die? I have to live!" she says.

In the Central African Republic, the second least developed country in the world according to the UN and in civil war for more than eight years, approximately 110,000 people are affected by HIV out of a population of some 5.4 million inhabitants.

But many do not enter this count, for lack of screening.

Supported by Doctors Without Borders (MSF), the community hospital in Bangui is the only place dedicated to so-called "advanced" AIDS patients.

It has 68 beds plus 15 in intensive care.

A foul smell escapes from clogged pipes.

Wearing yellow rain boots, two men throw jumps of chlorinated water.

Around them, six patients watch them in silence.

In this room annexed to the internal medicine department, the hospitalized persons are affected, in addition to HIV, by opportunistic diseases.

HIV-positive for years - most of them without knowing it - they now have a very weakened immune system.

Coma

“Many of our patients arrive in a coma,” laments Dr. Jennifer Stella, manager of MSF teams in the “advanced HIV” project, offering emergency care before referring patients to health centers for treatment. lifetime treatments.

In the Central African Republic, where nearly 70% of the population lives below the poverty line according to the World Bank, the price of screening, between 2,000 and 3,000 CFA francs (3 to 4.5 euros), can be dissuasive.

An AIDS patient sitting on a bed in a hospital in Bangui, January 27, 2022 Barbara DEBOUT AFP

"In Bangui alone, the prevalence of the epidemic is twice as high as the national average," says Jennifer Stella.

And many people are unaware of their HIV status.

"Which explains why two thirds diagnosed with HIV are already at an advanced stage of the disease when they start their treatment", continues the doctor.

“Our mortality rate is between 10 and 15%, some adults weigh 30 kg when they arrive and around 70% are affected by tuberculosis”, she specifies.

Added to the misfortune of their physical condition is the stigma.

Most patients admitted to the community hospital are HIV positive.

But not all.

The former are easily recognizable with a large box of medicines placed at the foot of their bed.

They are mixed "without it being a problem", welcomes Jennifer Stella.

- Hide the disease-

But it's all different once outside.

There, hostility towards people affected by HIV can be pervasive, forcing them to hide their illness.

A few rays of sunlight illuminate the yellow flowery sheet enveloping the puny body of Malika, 43 years old.

"I have always been afraid of the mockery or the judgment of those around me, my illness is a secret", she ends up admitting in a fit of confidence.

His sad look then lights up with a sweet smile.

A woman leaves the kitchen of a hospital in Bangui, January 27, 2022 Barbara DEBOUT AFP

"The only people who know about my illness are my eldest son, in whom I confide easily, and my husband", who is HIV-negative, continues Malika.

His biggest relief: that all his children are negative.

"I learned that I had HIV in 2006 during my pregnancy and, thank God, I took the treatment straight away and none of my children have AIDS," she explains.

The secret remains the surest means of not being rejected by family and friends, testify of the patients and their relatives.

And while elsewhere in the world, campaigns for the prevention and fight against AIDS are displayed in the streets, in the Central African Republic the public authorities pass it over almost in silence.

An AIDS patient on a hospital bed in Bangui, January 27, 2022 Barbara DEBOUT AFP

At the heart of the internal medicine department, the body of a lanky young woman disappears under a white sheet, she no longer has the strength to turn to the caregivers.

"The drugs reduce the viral load and prevent HIV from being transmitted. You can live with AIDS", insists Dr Stella.

Triple antiretroviral therapies are extremely expensive remedies, but at the community hospital everything is "free for HIV patients", as indicated by an inscription on A4 sheets stuck to dilapidated doors, whose brown paint is peeling.

© 2022 AFP