HIV Treatment and Care Services in Yemen: Implications Of Internal Country Conflicts

Yemen has been experiencing an internal conflict since 2011 influencing the HIV treatment program.

This study aims to assess the implications of internal country conflicts on HIV-treatment program performance for policy formulation, programme planning and national resource mobilization.

Secondary data analysis and mixed methods of quantitative and qualitative were used. Data analysis was conducted through SPSS. The sample size was 84 for quantitative and 35 for qualitative.

Mean age of PLHIV was 40.5 (±10.6 SD) years and 64.3% were males, 42.9% married, and 9.5% had HIV-positive children. 84.5% of PLHIV have more than one symptom at the first visit and most of them presented late with clinical stages 3 and 4. HIV/TB co-infection represents 9.5% for pulmonary TB and 2.4 for extrapulmonary TB. Access to ART during the conflict significantly depended on the residence of PLHIV (p < 0.0005) and (95% confidence interval (CI): 2.48 to 1.22) and on the availability of the clinic (p < 0.0005) with (95% CI: 1.007 to 1.953). 41.7% of PLHIV were LTFU, 25.7% gave conflict as the main reason, 66.6% of PLHIV experienced a change in ART regimen per lifetime, and 70.9% of them gave ARV stockout as the main reason. Most PLHIV had difficulty accessing services during conflict. Most PLHIV (13/20) were not comfortable with the quality of service. All HCPs mentioned that the HIV-treatment program is funded only by the Global Fund and experienced shortages of ARVs before and during the conflict.

It is important to have national policies and resources for HIV-treatment programs so one can ensure the sustainability of services.