Innovative HIV care strategies and health system resilience in conflict-affected settings

Armed conflict disrupts HIV care by damaging health infrastructure, displacing populations, interrupting supply chains, and increasing HIV transmission risks. This study examines structural barriers to HIV service delivery in conflict-affected settings and explores adaptive strategies to sustain care. A narrative review approach was used to provide evidence on innovative treatment and prevention models, mental health integration, and policy responses. Key findings show that governance collapse, ART stockouts, workforce shortages, and disrupted data systems undermine HIV care continuity. However, differentiated service delivery, mobile clinics, long-acting injectable ART, community-based models, digital tools, and trauma-informed approaches have shown effectiveness in fragile environments. Integrating mental health into HIV programs addresses the syndemic burden of conflict-related trauma and poor treatment outcomes. Strengthening health systems' resilience, improving donor coordination, and aligning humanitarian and HIV strategies are essential to ensuring uninterrupted care. Delivering HIV services in conflict zones requires flexible, context-specific, and rights-based approaches. A coordinated, multisectoral response is critical to close equity gaps and advance global HIV goals.