Social Determinants of Health and Its Impact on HIV and Nutritional Deficiencies: Review of Macro-Level Insights, Emerging Determinants and Research Gaps

Social Determinants of Health (SDH) impact the incidence and progression of HIV and nutritional deficiencies in developing economies, particularly in Sub-Saharan Africa. While extensive research has focused on micro studies, it has neglected the macro impact. This review addresses these gaps by examining the literature on SDH's role in HIV and nutritional health, emphasising emerging determinants and gender-sensitive issues. Peer-reviewed studies from Google Scholar, Scopus, and Web of Science focused on six SDH indicators: income, education, employment, stigma and social exclusion, healthcare access, and housing and sanitation. Additional factors, including food security, food price fluctuations, and gender inequality, were examined. Findings reveal the connection between SDH and health impact. Structural determinants like income inequality, limited education, and poor housing conditions worsen HIV risks and nutritional deficiencies. Emerging determinants such as food insecurity and fluctuating food prices also influence HIV-related behaviours and nutrition, particularly in poverty regions. Gender inequality emerged as a determinant, with women disproportionately affected due to power imbalances, economic dependency, and restricted healthcare access. The review pointed out the gaps in macro-level analyses on how SDH may affect HIV and nutrition, stressing the need for expanded, gender-focused research. Policymakers and health practitioners should prioritise SDH interventions focusing on structural inequalities, emerging determinants like food security, and gender disparities to enhance sustainable health systems.