Keyword: HIV

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.

ABSTRACT: Background: Gender-based violence (GBV) and Human Immunodeficiency Virus (HIV) are critical public health issues in Sub-Saharan Africa, disproportionately affecting women. Gender-based violence (GBV)—including intimate partner violence and sexual assault—fuels HIV transmission via trauma, coercion, and healthcare barriers. This syndemic demands urgent, evidence-based solutions to break the cycle of risk.
Objectives: This study aims to explore the prevalence, types, and socio-cultural, economic, and power-related factors linking GBV to HIV risk among women in Sub-Saharan Africa, and to assess the effectiveness of integrated interventions addressing both issues.
Methodology: In carrying out this review, a scoping review design was employed. PubMed, African Journals Online (AJOL), and Google Scholar were searched for peer-reviewed studies conducted across Sub-Saharan Africa focusing on association of GBV and HIV risks. Data was extracted on the prevalence of HIV cases linked to GBV, and interventions addressing such prevalence. A thematic synthesis was used to identify common trends and gaps in the literature.
Findings: This study found GBV prevalence rates ranging from 3.4–89.3% across included studies, with significant geographic and population-based variations. GBV was identified as a major risk factor for HIV, particularly in settings with high economic dependence and gender inequality. Integrated interventions combining HIV care and GBV services were found to improve health outcomes, though access remains limited in rural areas.
Conclusion: This study underscores the urgent need for integrated, multi-sectoral approaches to address both GBV and HIV. Future research should focus on longitudinal studies and the scalability of successful interventions in diverse settings. Policymakers must prioritize these intersections to reduce the burden on women’s health in Sub-Saharan Africa.

ABSTRACT: Background: Serodiscordant couples are relationships where one sexual partner is HIV-positive and the other is HIV-negative. Such couples experience complex relational and psychosocial challenges that significantly influence treatment adherence and health outcomes. Despite biomedical advances such as Antiretroviral Therapy (ART) and Pre-Exposure Prophylaxis (PrEP), the relational dynamics within these relationships remain underexplored in HIV intervention strategies.
Objective: To systematically review how HIV status disclosure and partner reactions impact treatment outcomes among serodiscordant couples.
Method: A systematic review of qualitative and mixed-methods studies published between 2010 and 2025 was conducted using databases including PubMed, PsycINFO, CINAHL, Scopus, and Google Scholar. Studies were appraised using the Critical Appraisal Skills Programme (CASP) Qualitative Checklist, and thematic synthesis was employed to analyze findings.
Findings and Discussion: Ninety four studies met the inclusion criteria. Key themes included HIV status disclosure, communication, partner reactions, partner support and impact on treatment adherence. Challenges such as stigma and fear of rejection hindered disclosure and engagement in care in some relationships. However, support from partners was key in boosting confidence and continuity in care. 
Conclusion: HIV status disclosure is a crucial public health issue, as it has significant impact on the trajectory of serodiscordant relationships, treatment outcomes and psychosocial wellbeing of PLHIV. Building culturally sensitive, couple-centered interventions that emphasizes increased HIV awareness and knowledge is essential for improving health outcomes among serodiscordant couples.