Evidence Gaps Across the HIV Care Continuum Among Conflict-Affected Populations in the Middle East and North Africa: A Scoping Review

Abstract This scoping review characterizes the available evidence on HIV prevention, care, and treatment among conflict-affected populations in the Middle East and North Africa (MENA). PubMed, Embase, and CINAHL were searched for English-language, peer-reviewed studies published from January 2000 onward. Eligible studies were empirical research conducted in MENA among conflict-affected populations, including refugees, internally displaced persons, asylum seekers, migrants, returnees, host communities, and other conflict- or crisis-affected residents, and addressing HIV prevention, care, treatment, or related continuum stages. Data were charted by population, setting, and continuum stage. A total of 19 studies were included. Studies were concentrated in Lebanon (n=7), Jordan (n=4), Libya (n=4), and Yemen (n=2), with one from Morocco and one multi-country ecological study. Evidence was concentrated upstream: 15 studies (79%) addressed prevention or HIV knowledge, 14 (74%) testing or diagnosis, six (32%) linkage to care, five (26%) antiretroviral therapy initiation, two (11%) retention, and one (5%) viral suppression. No study reported individual-level viral suppression among conflict-affected or displaced populations. The peer-reviewed research evidence base on HIV prevention, care, and treatment in MENA is overall sparse, geographically narrow, and progressively thins across the HIV care continuum, with the greatest gaps in retention and viral suppression. Research following conflict-affected and displaced populations through treatment and clinical outcomes is needed to support HIV care amid ongoing disruption.