Exploring the experiences and perspectives of Iraqi healthcare providers on the challenges and determinants of HIV management: a qualitative study

A Physician non-adherence to guidelines and resource constraints hinder optimal HIV care and patient outcomes; however, little is known about providers’ experiences in Iraq. This qualitative study explored physicians’ practices, challenges, and suggestions for improving HIV management across three Iraqi HIV centers. From February to April 2025, we conducted semi-structured face-to-face interviews in Arabic with 17 physicians (minimum six months of experience in managing HIV patients), using an expert-validated guide. Thematic analysis identified four themes: clinical management of HIV patients, healthcare professionals’ roles, patient adherence to anti-HIV therapy, and healthcare services for HIV patients. Most physicians reported following Iraqi Ministry of Health and WHO protocols, with tenofovir–lamivudine–dolutegravir (TLD) favored as first-line therapy for its efficacy and tolerability. Major barriers to patient adherence included stigma, shame, low health literacy, misconceptions, and follow-up challenges. Although providers deemed existing services satisfactory, they recommended establishing specialized dental, surgical, and psychiatric clinics, and expanding patient education, psychosocial support, and engagement to enhance comprehensive care. In conclusion, current HIV treatment align with international standards; meanwhile addressing sociocultural barriers and resource gaps through supportive services may improve adherence and health outcomes for people living with HIV in Iraq.