This chapter describes the main challenges in the prevention and treatment of sexually transmitted infections (STIs), including HIV, in the Middle East and North Africa (MENA), with a focus on forcibly displaced populations. It presents an overview of the epidemiology of HIV and other STIs, describes the availability of sexual health services (SHS), and discusses barriers to SHS accessibility. MENA has the world’s highest increase in HIV incidence, primarily affecting key populations. The region also has a high burden of curable STIs, most likely due to limited access to screening and treatment. Data on HIV and STIs among forcibly displaced populations in MENA are scarce, but suggest high prevalence mainly among refugees who are part of key populations, including men who have sex with men. Though some MENA states have integrated SHS into primary care settings, services remain insufficient to meet current needs. Various barriers to access persist, including conservative societal norms, fragmented health systems, prolonged conflict, and pervasive stigma around sexuality and sexual health. For refugees in MENA, who are already vulnerable to adverse sexual and reproductive health outcomes, accessing SHS poses additional challenges. A multifaceted approach is urgently needed to meet the region’s evolving STI disease burden and sexual health needs, including among its large forcibly displaced population.