The Role of Social Determinants and Risky Behaviors in HIV/AIDS Transmission: A Review

Abstract

HIV/AIDS remains a pressing global health challenge, particularly in developing nations such as Indonesia. Transmission is strongly shaped by social determinants and high-risk behaviors. This review examines the role of these factors in HIV/AIDS spread, drawing on ten recent national and international studies, including systematic reviews, observational research, and cross-national surveys. Key populations identified are men who have sex with men (MSM), sex workers, injecting drug users (IDUs), and prisoners. The main social determinants associated with heightened vulnerability include low education, unemployment, unmarried status, and minority sexual orientation. Risky behaviors consistently linked to HIV infection involve unprotected sex, multiple partners, anal intercourse, and injecting drug use with shared needles. The intersection of these social and behavioral factors creates compounded risks, reinforcing patterns of vulnerability in key populations. Effective prevention requires strategies that address both domains simultaneously. Community-based programs should promote safer sexual practices, expand condom access, and strengthen harm reduction services for IDUs. Equally critical are educational initiatives, stigma reduction, and ensuring inclusive, non-discriminatory healthcare access. By integrating social and behavioral approaches, HIV/AIDS interventions can more effectively curb transmission and reach populations most at risk.