Epidemiology & Health Data Insights (ISSN 3080-8111) is an international, open-access, peer-reviewed journal that advances epidemiology by integrating health data science. It fosters multidisciplinary collaboration to address global health challenges through evidence-based research, promoting equity and guiding healthcare policy. The journal covers a wide range of topics including disease surveillance, predictive modeling, public health interventions, and big data applications, with an editorial team of experts in epidemiology, biostatistics, and public health.

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CURRENT ISSUE

Volume 2, Issue 4, 2026

(Ongoing)

Review Article

Understanding How Social Factors Influence Health Outcomes for Women Living with HIV in Sub-Saharan Africa: A Systematic Review

Evelyn Foster-Pagaebi, Buniminaki Nimi James, Tamunomiebi Douglas, Amavie Oboku-Aganaba, Kitgak Bala Simon, Pagaebi Garcia Ezeke, Uchechi Ekezie, Elishama Tamunomiebi Douglas

Epidemiology and Health Data Insights, 2(4), 2026, ehdi039, https://doi.org/10.63946/ehdi/18472

ABSTRACT: Background: The health outcomes of women living with the Human Immunodeficiency Virus (HIV) in sub-Saharan Africa remain poor, despite global efforts to improve access to antiretroviral therapy. Social determinants have been identified as key factors contributing to these disparities, however, evidence remains limited. This systematic review aims to synthesize evidence on the association between social factors and health outcomes among women living with HIV in sub-Saharan Africa.
Methods: A systematic review was conducted following the PRISMA 2020 guidelines. Peer-reviewed articles published between January 2015 and November 2025 were identified through an extensive literature search in PubMed/Medline, Web of Science, and Google Scholar. The search yielded 1,589 studies, of which 23 were included in the final analysis. A thematic approach was used to synthesize eligible studies that examined one or more social factors and reported health outcomes.
Results: Twenty-three studies were included in the review, comprising 13 quantitative (11 cross-sectional and 2 cohort) and 10 qualitative studies across sub-Saharan Africa. After quality appraisal, 20 studies were rated as high quality, while 3 were moderate. None was classified as low quality. The main social factors influencing treatment outcomes included HIV-related stigma, socioeconomic status, gender norms, intimate partner violence, healthcare access, cultural and religious beliefs, and social support. These factors were consistently linked to late testing, poor antiretroviral therapy adherence, low retention in care, low viral suppression, and adverse mental health outcomes. Conversely, social support networks, peer-based interventions, and community- and faith-based care were associated with improved ART adherence, empowerment, and quality of life.
Discussion: These findings emphasize that social determinants do not function in isolation but through interconnected structural, community, and interpersonal pathways, creating both risks and protections for health outcomes.
Conclusion: Intersecting social and structural determinants of health impact outcomes among women living with HIV in sub-Saharan Africa. Addressing these factors requires integrated, gender-responsive, and community-empowering strategies beyond biomedical treatment alone.