Is AIDS related to social determinants of health in Iran? A systematic review

Introduction: AIDS is a global challenge. By looking deeper into the nature of AIDS and its transmission, it can be concluded that AIDS is a social phenomenon rather than a completely biological disease and the results of studies show a significant relationship between the risk of HIV infection and some underlying factors such as demographic, social, economic and cultural factors. Today, these structural and social factors are known as social determinants of health (SDH). The current systematic study aimed to identify SDH related to AIDS in Iran, in order to adopt appropriate strategies to prevent AIDS in Iran. Methods: All studies in Persian or English focusing on the relationship between societal health and AIDS conducted in Iran were systematically reviewed from PubMed, Scopus, Embase, Web of Science and internal databases (IranMedex, SID and Magiran) by December 2018. In order to evaluate the quality of the articles, the STORBE checklist was used and, after reviewing the articles, finally, out of a total of 964 articles, 18 papers were selected to enter into the study. Results: In this systematic review, 12 articles were performed on people at risk for AIDS, while 6 articles were conducted on patients with positive HIV/AIDS. Based on the WHO model, the determinants of social well-being in this study were structural determinants of heath; (gender, educational level, occupational status, income and housing) and intermediate determinants of heath (marital status, high-risk behaviors, awareness, attitude about AIDS, social support status, access to the Internet and satellite, and history of child sexual abuse). Conclusion: The main risk factors for HIV infection in Iran (intravenous opium and unsafe sexual intercourse) were related to social, economic and behavioral factors. Therefore, it is essential to consider SDH as the key factors in the emergence and control of AIDS by health policy-makers and relevant authorities for the prevention of AIDS.