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Evidence shows that the prevalence of risky sexual practice, drug abuse, and alcohol consumption behaviors in low and middle income countries such as Iran is not in a favorable condition. Preventive programs against these behaviors in Iran are very rare, and the results are unclear, which may be due to the lack of deeply and systematically understanding of the determinants of these behaviors. Evidence suggests that these behaviors are coincidence. So all of these behaviors were examined together. The present study was conducted aiming at determining the reasons for the occurrence of these behaviors among 15–19-year-old adolescents in Iran. The Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines were followed to review published and unpublished studies in Iran. The databases used were Scopus, PubMed, Web of Science, and Cochrane Library. The query terms were "Synthetic Drug" OR "Designer Drug", AND Adolescents OR Teenagers OR Juvenile, AND Iran. The Joanna Briggs Institute Critical Appraisal Checklist was employed for critical appraisal. The quantitative studies using the regression model to analyze the factors affecting these behaviors were studied as the form of the theme. For analyzing the data, narrative synthesis and thematic analysis were used. Twelve studies were meticulously reviewed. The findings were classified into five main themes (including individual, family, friends, school, and community) and 26 sub-themes. The most frequent main theme and sub-themes were respectively Family, Higher age, Male gender, Weak religious beliefs, Low self-esteem, Anti-social behaviors in family, Mother's employment, Parenting style, Poor intimacy of parents, Absence of parents, Peer pressure, and Lack of appropriate recreation. No primary study has referred to the political, economic, or policy factors affecting such behaviors. The most identified sub-themes belong to family factors. Iran is a country with ideology of Islam; however, being Muslim does not guarantee adherence to all Islamic guidelines. So being Muslim is not a good reason to prevent these behaviors. Iran needs precise policy making in this area through considering family structure. It is also suggested that primary studies referring to the political, economic, or policy factors affecting such behaviors should be carried out.

Determinants of risky sexual practice, drug abuse and alcohol consumption in adolescents in Iran: a systematic literature review