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Abstract: Background: Significant progress has been made in the fight against HIV/AIDS across the world. However, in sub-Saharan countries, there remain numerous obstacles to achieving treatment goals. The aim of this study was to identify factors underlying vulnerability to malnutrition among people living with HIV (PLWHIV) under antiretroviral treatment (ART) in resource-limited settings. Methods: A cross-sectional study was carried out in May 2010 in Kinshasa, the capital of the Democratic Republic of Congo. Baseline characteristics of PLWHIV were analyzed, and statistical analyses were performed in order to compare proportions of low weight, low mid-upper arm circumference, and low body mass index. Further analyses were performed to compare means of anthropometric characteristics according to sociodemographic, socioeconomic, and clinical characteristics. Multiple regression analyses were used to assess vulnerability determinants for malnutrition following adjustment. Results: We identified specific sociodemographic characteristics, socioeconomic level and clinical characteristics (i.e. autonomous activity, appetite, asthenia level, and HIV clinical stage) that were significantly associated with malnutrition in PLWHIV. Conclusions: Determining factors underlying vulnerability to malnutrition may be helpful to health providers in poor income settings for more effectively target patient interventions. [Copyright &y& Elsevier]