“Condoms don't cross your mind when you're hungry”: Challenges to safe sex in Libyan IDP camps; A qualitative study

Objectives: This qualitative study among internally displaced heterosexual men in post-conflict Libya investigates the attitudes, experiences, and barriers related to condom use within this vulnerable population. Study design: Qualitative study using semi-structured, face-to-face in-depth interviews. Methods: Semi-structured, face-to-face in-depth interviews were conducted with 21 internally displaced (IDPs) male participants, aged 18-35. Participants were selected through purposive sampling, focusing on their displacement status and willingness to discuss sexual health practices. The interviews explored knowledge, experiences, and challenges related to condom use using a guided protocol. Braun and Clarke's thematic analysis framework was used to analyse the data. Results: A total of 21 male heterosexual IDPs, aged 18-35, residing in IDP camps in Tripoli were recruited for the study. Only 9.5 % (n = 2) ever used a condom. Key barriers to condom use included financial constraints, geographic inaccessibility, cultural taboos, and stigma. Risk factors for condomless sex included lower knowledge about HIV and STIs, misconceptions about condom efficacy, lack of sexual health education, fear of social judgment, and negative perceptions about reduced pleasure. The theme of basic needs overriding safer sex practices was highlighted. Conclusions: This study reveals significant gaps in sexual health knowledge and condom use among young displaced men in Libya. Targeted, culturally sensitive interventions are urgently needed to improve sexual health education, promote positive attitudes towards condom use, and enhance access to contraceptives, particularly in post-conflict settings.