The impact of armed conflict on the prevalence and transmission dynamics of HIV Infection in Libya

Abstract

The interrelationships between HIV/AIDS and armed conflict are a complex phenomenon and studies are rarely devoted to this area of research. Libya is the second-largest country in Africa that has been evoked with war since NATO intervention in 2011. The country has also experienced one of the largest HIV outbreaks associated with the Bulgarian Nurses saga. The effect of the armed conflict on the dynamic spread of HIV is not well known. The objectives of this study were to determine the impact of armed conflict on the epidemiological situation of HIV infection in Libya and analyze the transmission dynamics of HIV strains during the conflict. We investigated the movement of HIV-infected people during the Libyan armed conflict and analyzed the HIV subtypes reported from 2011 to 2020 and followed up the infected cases all over the country. The patterns of HIV spread within the Libyan regions were traced and risk factors were determined during the conflict period. A total of 4539 HIV/AIDS patients were studied from the four regions during the Libyan conflict. Our data analysis indicated that Benghazi the biggest city in the Eastern region was the significant exporter of the virus to the rest of the country. Viral dissemination changes were observed within the country particularly after 2015. A major virus- flow from the Eastern region during the armed conflict associated with internally displaced people. This resulted in a dissemination of new HIV strains and accumulations of HIV cases in Western and Meddle regions. Although, there were no significant changes in the national prevalence of HIV/AIDS. Our data highlights the factors that complicated the spread and dissemination of HIV during the armed conflict which provides a better understanding of the interaction between them. This could be used to plan for effective preventive measures in tackling the spread of HIV in conflict and post-conflict settings.