Abstract
BackgroundA huge number of people living with HIV/AIDS lives in developing countries. Thus, strengthening health systems in these countries is a prerequisite for improving disease prevention and care. After three decades of HIV/AIDS policy-making in Iran, conducting a comprehensive analysis on the policy process seems to be essential. In the present study, we aimed to analyse the HIV/AIDS policy-making process in Iran from 1986 to 2016.MethodsThis was a theory-based, multi-method and retrospective study. Interviewing of key informants and review of policy documents were concurrently conducted to identify and include further key informants (39 participants) and documents in the study. Framework analysis was used to analyse data.ResultsThe mean age of participants working in HIV/AIDS policy-making was of 48 years and participants had a mean of 14 years of working experience. Findings were categorized as contextual factors, content of HIV/AIDS policies, actors involved in the policy process, and evidence use in the policy process. Contextual effective factors on the HIV/AIDS policy-making process were categorized into five major themes, namely situational factors, structural-managerial factors, socioeconomic factors, political and legal factors, and international factors. The HIV/AIDS phenomenon in Iran was identified to be deeply rooted in the culture and traditions of society. The HIV/AIDS policy content has, recently, been crystallized in the national strategic plans and harm reduction policies of the country. The policy process has been conducted with a solely governmental top-down approach and is now suffering from poor evidence and lack of sufficient consideration of contextual factors.ConclusionsThere is a great need for change in the approach of government towards the issue and to increase the participation of non-governmental sectors and civil society in the policy process.
Highlights
A huge number of people living with HIV/AIDS lives in developing countries
HIV/AIDS policy context in Iran Keeping in mind the Lichter approach [35] and based on the opinions of participants in our study, the contextual effective factors on HIV/AIDS policy-making in Iran were categorized into five major themes, namely situational factors, structural-managerial factors, socioeconomic factors, political and legal factors, and international factors
Use of evidence in HIV/AIDS policy-making process As the key informants noted, the first problem of HIV/ AIDS policy-making in Iran was a lack of evidence in some specific areas
Summary
A huge number of people living with HIV/AIDS lives in developing countries. We aimed to analyse the HIV/AIDS policy-making process in Iran from 1986 to 2016. Iran was classified among the countries with a low prevalence of HIV/AIDS [1]. Based on the estimations reported by the Ministry of Health (MOH) and international organizations, 80,000 to 120,000 people are living with HIV (PLHIV) in Iran [4]. There has been a decrease in the prevalence rate of HIV among three key populations of people who inject drugs, female sex workers and prisoners [5]. A current study in Tehran has presented a 1.9% prevalence rate of HIV among transgender women [6]. Like Iran, in many developing countries, HIV/AIDS is considered to a public health concern
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