Research Priorities for Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome in Iran: A Mixed-Methods Study Combining a Systematic Review and Delphi Consensus Approach

Abstract

Background: In 2022, human immunodeficiency virus (HIV) affected 39 million globally, with Iran experiencing a concentrated epidemic. This study aimed to identify and prioritize critical HIV/ AIDS research areas to address existing gaps in the Iranian context. Methods: Researchers at Isfahan University of Medical Sciences employed a three-phase approach between May 2018 and March 2023. The first phase involved developing an HIV research matrix tailored to international guidelines and the Iranian context. In the second phase, a systematic review of HIV-related studies in Iran was conducted following the PRISMA protocol to assess quality and relevance. The third phase utilized a three-round Delphi method to collect expert feedback, which was used to prioritize research areas based on their importance and feasibility. Results: A systematic review of 6,310 sources yielded 745 documents for full-text analysis. Key research domains identified included prevention, diagnosis, care and treatment, epidemiology, and co-infections. Quantitative analysis indicated that 23 of studies focused on co-infections, while ethical issues were addressed in only 0.04. Qualitative assessment revealed that 54 of reviewed studies were of low quality. Subsequent expert consultation and multi-criteria decision analysis ranked laboratory research and co-infections as the highest priorities. Specific sub-areas identified included molecular epidemiology and interventions addressing stigma and discrimination. Despite being highly cost-effective and urgently needed, research on stigma-related interventions exhibited a significant gap. Conclusion: The study identified 11 main research areas and 60 sub-areas as priorities for HIV/AIDS research in Iran, highlighting the need for strategic funding and research planning. Ethical considerations and laboratory improvements are essential for enhancing public health outcomes and addressing emerging challenges in the HIV epidemic.