Fig. 1

The Central African Republic (CAR) is shown in a regional context (a), with the country divided by prefectures. The study area is indicated by the box in the south east of CAR. The town of Zemio is shown in context (b), within Haut-Mbomou prefecture and adjacent to Mbomou prefecture. Nearby towns where patients were drawn from for the HIV treatment program (Rafai, Djema and Mboki) and the Bas-Uele province of the Democratic Republic of the Congo are also shown. The majority of patients were drawn from around the town of Zemio, including internally displaced person and refugee camps resulting from conflict in 2010 by the Lord’s Resistance Army. Grey lines indicate the road network in the CAR. The number of patients recruited into the cohort from each location is indicated by the size of the points (n = 1631). A time series of civilian deaths / injuries and abductions by armed groups in the patient catchment area details the evolution of the conflict in this region from October 2011 – May 2017 (c)