Tuberculosis and HIV co-infection and associated socioeconomic factors among adults in Kinshasa, Democratic Republic of the Congo: a facility-based cross-sectional study

The Democratic Republic of Congo (DRC) is among the countries with the highest burden of tuberculosis (TB) and HIV co-infection. Given the paucity of the potential drivers of TB–HIV co-occurrence, this study aimed to explore the factors associated with TB–HIV co-infection. A cross-sectional study was conducted from January to November 2024 at reference centers for the management and follow-up of people living with HIV (PLHIV) in the city of Kinshasa. We used a structured questionnaire to collect data on sociodemographic and economic characteristics, as well as on social stigma experience. Logistic regression analysis was employed to identify factors associated with TB and HIV co-infection using adjusted odds ratio (AOR) with its 95% confidence interval (95% CI) and p -value < 0.05. Among the 400 HIV-positive individuals included in this study, 229 (57.3%) were co-infected with TB and HIV. In the final multivariable model, the following factors were found to be significantly associated with TB and HIV co-infection: being male; having no formal or primary education; experiencing unemployment or self-employment; residing in a household of 5–8 people or more than 8 people; and having a monthly income below 50,000 Fc (≈ 17.9 USD) or ranging from 50,000 to 200,000 Fc (≈ 71.4 USD). Addressing the dual burden of HIV-TB co-infection requires a multidimensional and evidence-based approach, encompassing community-based health promotion and behavioral change interventions, professional training and income-generating initiatives, and community-based screening and early detection efforts in overcrowded living environments.