HIV/AIDS in Conflict-Affected Countries, 2024-2025
AI Summary
Analysis of 22 conflict-affected countries found no strong association between conflict severity and HIV prevalence, incidence, or progress toward 95-95-95 targets.
None of the 22 countries met all three 95-95-95 targets; Cameroon achieved 95% awareness of HIV status.
Sustained external funding from PEPFAR and the Global Fund likely mitigated conflict impacts; reinforce HIV monitoring for resource allocation and post-conflict preparedness.
J Epidemiol Glob Health. 2026 May 8. doi: 10.1007/s44197-026-00546-7. Online ahead of print.
ABSTRACT
BACKGROUND: Conflict reverses development gains and can intensify HIV challenges by driving displacement, poverty, sexual violence, and the collapse of health systems. These conditions may disrupt HIV testing, treatment initiation, and continuity of care. Given recent alerts of an increase in armed conflicts to historic highs, we conducted an ecological analysis of the strength of the relationships between conflict severity and HIV outcomes in select conflict-affected countries.
METHODS: We identified conflict-affected countries listed in all three data sources as of August 2025-the Armed Conflict Location and Event Data, Uppsala Conflict Data Program, and the World Bank. We extracted the most recent data from the Joint United Nations Programme on HIV/AIDS (UNAIDS) data on HIV incidence, prevalence, and the 95- 95-95 targets (95% of all people living with HIV have been diagnosed, 95% of those diagnosed are receiving antiretroviral therapy, 95% of those on antiretroviral therapy have achieved viral suppression). We used Pearson correlation to assess the strength of associations between conflict severity and HIV indicators.
FINDINGS: In the 22 countries included in the analysis, HIV prevalence ranged from 0.1% in Syria and Iraq to 11.6% in Mozambique. None of the countries met all three 95-95-95 targets based on available UNAIDS data, although Cameroon achieved 95% awareness of HIV status. We did not identify strong associations between conflict severity and HIV prevalence, incidence, or progress toward the UNAIDS 95-95-95 cascade targets.
INTERPRETATION: HIV indicators in conflict affected countries are within the range reported for other countries. We hypothesize that sustained external funding from the U.S. President’s Emergency Plan for AIDS Relief and the Global Fund to Fight AIDS, Tuberculosis, and Malaria, may have helped minimize potential effects of conflict on UNAIDS 95-95-95 cascade targets in countries with high preexisting HIV burden. Strengthening the monitoring of HIV indicators can help resource allocation and preparedness of health systems in the post-conflict reconstruction period.
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