Background: The trade of prostitution is familiar with unprotected sex, which is the main cause of sexually transmitted diseases (STDs), especially human immunodeficiency virus (HIV). Underground sexual relationship includes bargaining (having sexual intercourse with or without a condom) between prostitutes and their clients. Qualitative studies are rare on this subject. Objectives: This study aimed to explore the quality of bargaining between prostitutes and their clients requesting for unprotected sex, according to the experiences of street Female Sex Workers (FSWs). Patients and Methods:This was a conventional content analysis to explore the themes based on 18 FSWs referral to a Drop-In Centre (DIC) of Shiraz, Iran. Transcribed data was analysed by identifying condensed meaning units, subthemes, and themes. Results: The study showed that all participants were aware of risks of unprotected sex and emphasized the use of condoms in their sexual relationships. Nevertheless, most clients had requested unprotected sex and thus each sex plan was a bargaining scenario between prostitutes and clients. Prostitute bargaining level for using a condom by the client was negatively influenced by price for each session, while factors such as having a pimp, older age of the prostitute, health literacy, and craving of the client had a positive effect on this balance of power. An important point is that the prostitutes' resistance was related to their awareness of STDs, which effects the bargaining level for protected sex. Conclusions: Since, in the current setting, prostitution is an underground trade, it was not possible to have full access to all the dimensions of this subject. Thus, it seems that gaining awareness could play a pivotal role in the promotion of the bargaining power and minimization of related hazards. In addition, the context of the study needs customized models based on Islamic Shari'a for solving the problem.
Background Air pollution exposure can trigger a wide range of thyroid dysfunction in different population groups. This systematic review and meta-analysis aimed to find the association between air pollution and thyroid dysfunction in the general population and neonate, pregnant and cancerous people. Methods Electronic databases, including Web of Science, PubMed, Scopus, and Embase, were searched for all published articles from 27 October 2021. The Newcastle Ottawa Scale checklist was used to assess the quality of individual studies. Relevant demographic data and the intended results of the selected studies were extracted, and their adjusted odds ratios were pooled using random and fixed effect analysis based on the heterogenicity index. Results After applying the search strategies, twenty-six articles were included in our study. Overall, the association between air pollution and thyroid cancer, neonatal hypothyroidism, maternal thyroid function, and thyroid function in the general population was discussed in four, eight, ten, and four studies, respectively. There was a significant association between PM2.5 exposure and maternal hypothyroxinemia with pooled OR of 1.241 (95%CI, 1.089–1.415), p-value < 0.001. No positive relationship existed between NO2 exposure and maternal hypothyroxinemia with pooled OR of 1.007 (95%CI, 0.840–1.207), p-value = 0.941. The investigation of the relationship between PM2.5 exposure and congenital hypothyroxinemia showed a significant association between them, with pooled OR of 1.017 (95%CI, 1.002–1.032), p-value = 0.024. Conclusions Air pollution could influence thyroid function, especially in pregnant women and newborn infants. This study and similar investigations provide evidence of air pollution toxicity for healthcare systems.
Background and aims:In each society, the health of women in different periods may be endangered by an unequal distribution of resources, facilities, and gender prejudices. The present study evaluated the time trend of Iranian women's health between 1990 and 2013.Methods:This narrative review includes an integration and descriptive summary of the existing evidence on trends and criteria of different aspects of women's health from social determinant point of view. The evidence was drawn from peer-reviewed, cross-national or large-scale studies, official sources of the Ministry of Health, reviews, and online scientific databases published between 1990 and 2013.Results:The average life expectancy of Iranian women has increased from 44.15 years in 1960 to 75.75 years in 2012; in most deprived provinces of Iran, however, this criterion is about 67.3 years, and in the capital it is 75.8 years. In 2011, 43.37% of DALYS, 36.21% of YLL, and 1.92% of YLD were dedicated to women; these figures were 3.63% lower than they were in 2003. Although a significant reduction has occurred in maternal mortality rate, which dropped from 83 to 23 per 100,000 between 1990 and 2013, there is no equal distribution in maternal mortality across the country as manifested by the unfavorable conditions of border provinces (SD=19.2). The prevalence of HIV/AIDS is an alarming health problem among Iranian females, increasing approximately 546% between 2007 and 2015. As for mental health, depression in women was ranked first among diseases in 2011 compared to a second place ranking in 2003. As regards social health, the delinquency of women has increased in recent years compared to men with women committing more crimes related to drugs and actions against virtue. The annual report of the United Nations for the gender gap index in 2013 ranked Iran as 130 among 136 countries (from 0.622 in 2000 to 0.584 in 2013).Conclusion:Generally, over the last three decades, the health indices of Iranian women have grown in aspects of physical, mental, and social health. Remarkable differences can be seen among female health indices based on geographic location and in comparison with men. To promote an improved health status for Iranian women, the root causes of the discrepancies must be identified and a comprehensive national plan must be established.
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