No updated information is available on drug use and injecting drug use for recent years in Libya. The level of the HIV epidemic in the general population is not clearly known. There are several reports and estimations, from 0.13% resulted from population survey in 2005 up to the 2008 estimation of 1.13% (Libya MoH, 2012; The Telegraph, 2011). Two outbreaks of HIV, one in children in Benghazi (1998), and the other among PWIDs in detention have brought HIV into political attention. PWIDs have been recognized as the main at risk group for HIV infection. However a report of high HIV prevalence among PWIDs in detention (Dolan, et al., 2007; Groterath, et al., 2002) and a high proportion of PWIDs in newly identified HIV cases in 2001 (The World Bank, 2005) have been the source of this assumption. Moreover, a 2003-4 study in Tripoli had revealed a high prevalence of unsafe injection among PWIDs (Libya MoH, 2010). Recently, a BBS was conducted in Tripoli and included PWIDs. The study showed that within a sample of 328 PWIDs tested, 87% have HIV (Libya MoH, 2012). The case report statistics, before the political conflicts, were indicating an increasing a trend toward sexual transmission (Libya MoH, 2012).

Libya still does not have an approved National program for HIV/AIDS. A draft program was developed in 2010, but not adopted (Libya MoH, 2012). CSOs working for the fight against HIV exist in the country. There is an AIDS NGO Network in Libya, in addition to other active NGOs working on HIV/AIDS, especially on the health and discrimination faced by children infected with HIV. A PLHIV group also exists (Libya MoH, 2012). Despite a relatively active civil society in Libya, the engagement of NGOs in prevention, treatment and care remains limited and their potential is not yet fully realized (Libya MoH, 2010). Only one VCT center is available in Tripoli (Libya MoH, 2012). ART is available in three cities (Libya MoH, 2012).

The country reports that a national strategic plan on harm reduction has been developed and approved (Libya MoH, 2012). In addition, a project to improve drug treatment and support civil society in outreach services is planned in cooperation with UNODC (Libya MoH, 2012). In the past, introducing condom and needle exchange programs in prisons was intended (Butler, 2008), however, for the time being, there is no NSP and OST in the country.

Libya has been faced with civil war since February 2011 and in the post-conflict situation struggles with security and competing priorities. The primary HIV preventive mechanisms, such as blood safety, are disrupted and the country is highly susceptible to an HIV outbreak (Libya MoH, 2012). Development of NASP and active implementation with serious involvement of CSOs should be a high priority for the country.