RESEARCH ARTICLE


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



Mayada Faisal Nabih Mohammed1, *, Sharifa Ezat Wan Puteh2
1 National AIDS Control Program, Ministry of Public Health and Population, Sana'a, Yemen
2 Department of Microbiology, Faculty of Medicine, Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur, Malaysia


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Creative Commons License
© 2022 Mohammed and Puteh

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the National AIDS Control Program – Ministry of Public Health and Population, Sana'a, Yemen; E-mail:mayadanabih@yahoo.com


Abstract

Introduction:

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

Objective:

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.

Methodology:

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.

Results:

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.

Conclusion:

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

Keywords: Armed conflict, Access to HIV treatment, HIV policies, Investment in HIV, AIDS response, Loss to follow-up (LTFU) of PLHIV.