5.3.3.9. HIV / AIDS Congo is marked by an epidemic of HIV / AIDS generalised type. The overall prevalence in the population aged 15-49 years decreased from 4.2% in 2003 to 3.2% in 2009. In general, if in 2003 the highest level of HIV prevalence was 9% in some localities, the situation has changed significantly in 2009: indeed, with the efforts accomplished since then, no locality has an HIV prevalence exceeding 5% in 2009. HIV prevalence is higher with women than with men: 4.1% against 2.1%. Also women are more affected in urban areas (4.6%) than in rural areas (3.3%). The prevalence increases rapidly with age in women, with a minimum of 1.9% at age 15-19, the rate exceeds 5% from 25-29 years and remains above this level for almost all ages up to 45-49 years; With men, at all ages up to 40-44, the prevalence rates are lower than those of women: for the 15-19 years, 0.8% of men are HIV positive, then the rate increases but much more slowly than for women, peaking at 40-44 years (5.7%). The HIV prevalence survey by the Ministry of Health in 2011 found an HIV prevalence rate among pregnant women of 3.6%. According to the 2010 report by UNAIDS, the number of people living with HIV was estimated at 77,000 in 2009, 40,000 women over 15 years and 7,900 children under 15 years. According to the same report, the number of HIV-positive pregnant women is estimated at 1630. The number of deaths attributed to HIV was in the order of 5100. HIV transmission is primarily sexual in adults and vertically for children, in relation to the progress made by the country in transfusion safety. The condom utilisation rate in the last casual sex is low: 29% of women and 28% men. In the age group 15-24, the rate is 40% for men and 26% among women. In the age group 25-29 years, the rate is 41% in women and 26% men. National response to HIV / AIDS Congo was one of the first countries to officially recognise the AIDS epidemic and organise a response at institutional level. The identification of the first cases in 1984 resulted in 1985, in the establishment of a Committee on diagnostic and AIDS Control, replaced in 1987 by the national Programme on AIDS Control (PNLS). Since its creation, the PNLS has established a short-term emergency plan followed by two phases of medium-term plans (1989-1991 and 1996-1998). In 1994, the first outpatient AIDS treatment centre (CTA) in Africa was established in Brazzaville. A second CTA was opened in Pointe-Noire in 1999, after the period of social and political unrest. The introduction in 2002 of a strategic planning process has resulted in the development of the first National Strategic Framework to combat AIDS (CSN) for 2003-2007. In 2008, Congo initiated the 2nd CSN from 2009 to 2013 with the aim of reducing the incidence of HIV infection in the population and reducing the morbidity and mortality from HIV and AIDS. It revolves around the following strategic areas: (i) strengthening prevention services for HIV infection and STIs; (ii) strengthening of services for medical and psychosocial care of people living with HIV; (iii) reducing the impact of AIDS and promotion of human rights; (iv) improving the monitoring and evaluation system, research, epidemiological surveillance and strategic information management; (v) strengthening coordination, partnership and governance. 78