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Colliding Wars: A Systematic Review on HIV Responses in Conflict-Affected Settings.
Mona Ibrahim1, Alhadi Khogali1,2, Eslam Sadeldin3
1University of Oxford Oxford UK.
Public Health Challenges
|April 30, 2026
Summary
Armed conflict increases HIV vulnerability and disrupts essential services, particularly for adolescent girls and displaced populations. Prioritizing people living with HIV in conflict zones is crucial for effective humanitarian response.
Area of Science:
- Public Health
- Epidemiology
- Conflict Studies
Background:
- Armed conflicts pose significant public health threats, exacerbating conditions like violence, poverty, and displacement, which are known drivers of HIV transmission.
- Weakened health systems in conflict zones mirror the social and economic factors that increase vulnerability to HIV.
- Escalating global conflicts necessitate a deeper understanding of their impact on HIV epidemiology and service delivery.
Purpose of the Study:
- To systematically review the association between armed conflict and HIV vulnerability.
- To examine disruptions to HIV services caused by armed conflict.
- To explore adaptive strategies for HIV service delivery in conflict-affected settings.
Main Methods:
- A systematic literature search was conducted across six major databases (MEDLINE, Embase, Scopus, CENTRAL, OVID, CINAHL) up to June 2022.
- Seventeen studies were included after independent screening by six reviewers, with discrepancies resolved through consensus.
- The search encompassed broad terms to capture diverse evidence on conflict and HIV.
Main Results:
- Studies identified heightened HIV risk among adolescent girls, young women, and displaced populations in conflict settings.
- Service interruptions, including treatment gaps and increased loss-to-follow-up, resulted from looting, supply chain failures, and population displacement.
- Adaptive strategies like hybrid delivery models and emergency stock packs show promise but require further documentation.
Conclusions:
- Conflict-induced displacement and health system disruptions are linked to increased HIV vulnerability, with contextual variations.
- Individuals living with HIV in conflict-affected regions face disproportionate risks and require prioritization in humanitarian aid and national health systems.
- Addressing the complex interplay between conflict, displacement, and HIV is essential for effective public health interventions.
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