Our clients were dependent users with a multitude of problems who had little or no contact with treatment agencies before this study. Many clients had made a transition from using opium to using heroin, and some had commenced injecting, placing them at risk for HIV and HCV infection. More women-only drug treatment services are needed to facilitate women's entry into drug treatment.

BackgroundIn general, information about women who use drugs comes from studies performed in the West. Whether women in countries such as Iran are likely to enter drug treatment or how they will respond is not known.PurposeTo examine the short-term impact of methadone maintenance treatment (MMT) on drug use, dependence, social functioning, crime, and human immunodeficiency virus (HIV) and hepatitis C virus (HCV) risk behavior and seroincidence in female drug users in Iran.MethodsWomen were eligible for inclusion in the study if they were assessed as dependent on opiates according to the International Statistical Classification of Diseases and Related Health Problems, tenth revision (ICD-10). The sample comprised 78 female heroin or opium users who attended the Persepolis women’s drug treatment clinic in Tehran between 2007 and 2008. Participants were followed up in 2009/2010. Heroin and the use of other drugs, social functioning, involvement in crime, and involvement in HIV and HCV risk behavior were measured by self-report. The prevalence and incidence of HIV and HCV were measured by serology and self-report.FindingsOf the 78 women recruited, 40 were followed up, and this occurred approximately 7 months later. One in four women reported a history of drug injection. At follow-up there were significant reductions in self-reported heroin use on ICD-10 dependence scores. Subjects with more severe drug dependence at baseline were significantly more likely to be criminally active than less severely dependent subjects. Baseline prevalence for HIV and HCV was 5% and 24%, respectively. At follow-up, no one had acquired HIV infection, but one participant had acquired HCV, giving an incidence rate of 7.1 per 100 person-years.ConclusionThis research provides the first evidence that Iranian female drug users can enter MMT and respond well. Within a few months of entering MMT, improvements occurred in heroin use, levels of dependence, social functioning, and HIV risk behavior. While the incidence of blood-borne viral infections was low, there was a serious risk of HIV transmission among this cohort and also to participants’ needle and sexual contacts. In a country with high levels of drug use, the high levels of HCV among female drug users require more women to enter drug treatment if an HIV epidemic is to be avoided. Many participants had a chronic drug problem and had had little or no previous exposure to MMT. The introduction or expansion of women-only drug treatment services is urgently needed in order to engage more women in treatment.

In Iran women are less likely than men to use drugs, but suffer greater morbidity, are stigmatised, and are less likely to seek treatment. In 2007, we established a clinic in Tehran for drug using women. We report here on our study of the 97 women who registered in the first year of operation. We profiled these women: demographics, drug use, risk behaviour, and use of services. The clinic's services were heavily used. We interviewed clients and staff about the clinic and learned that intensive help is needed for women trying to recover from years of drug use. We conclude that female drug users will make use of harm reduction services if they are provided in a setting designed and operated for women.

Background: Methamphetamine as one of the most prevalent drugs can reduce the efficacy of interventions designed to reduce HIV prevalence such as opioid substitution therapy and other harm reduction interventions. Harm reduction facilities and interventions have mainly been designed for opioid users, but due to the high prevalence of methamphetamine use among the clients, these settings could be appropriate entry points for providing methamphetamine focused harm reduction interventions. Objectives: The present study aimed at examining the effects of the integration of a methamphetamine harm reduction intervention into opioid harm reduction services of drop in centers (DICs) on the high-risk behaviors of the participants. Methods: This prospective study was conducted to evaluate changes in high-risk behaviors associated with methamphetamine use among regular methamphetamine user clients of 10 DICs located in provincial capitals of Iran from September 2014 to March 2015. Participants were evaluated before and after a manual based psychoeducation intervention. Results: In total, 357 clients (18.5% females, and 81.5% males) entered the study; of whom, 60.3% of males and 83.3% of females were daily methamphetamine users at initial assessment. The prevalence of injection in the last 3 months was 8% and 1.6% among male and female participants, respectively. The frequency of sexual intercourse among participants had a significant reduction after intervention. The use of a condom in the last intercourse was increased significantly, moreover, having sexual intercourses without condom under the influence of methamphetamine was reduced, especially among females. Conclusions:The results of the present study provide provisional data on the effectiveness of stimulant harm reduction among clients of DICs in Iran. In addition, our findings revealed that service providers believe that this integration is feasible and the clients found it acceptable. Conducting studies with more rigorous design and longer follow-up is highly recommended.

PurposeThe Pediatric Lower Urinary Tract Scoring System (PLUTSS) is a standardized questionnaire used for screening and evaluation of the response of children with lower urinary tract symptoms (LUTS) to therapy. We presumed that adding the Child Behavior Check List (CBCL) and bladder volume wall index (BVWI) to the PLUTSS would increase its validity in the detection of children with LUTS.Materials and MethodsOne hundred twenty-two children aged 5 to 15 years with LUTS were enrolled in the study. Seventy-two healthy, age-matched children without urinary complaints were considered as controls. The PLUTSS and CBCL were filled out for all children. Sonography was performed to measure BVWI. Chi-square test and likelihood ratio were used to compare frequencies, receiver operating curve (ROC) analysis was used to evaluate the correlation, and Cohen's kappa was used to measure the agreement between variables. p-values <0.05 were considered significant.ResultsBehavior problems were significantly more common in children with LUTS than in healthy children (p<0.05). The frequency of thick, thin, and normal BVWIs did not differ significantly in the two groups (p>0.05). ROC analysis showed that there was no correlation between PLUTSS, CBCL, and BVWI in either the LUTS subgroup or in the controls (p>0.05). The PLUTSS had the highest sensitivity and specificity, and adding the two other tests decreased its validity for the diagnosis of children with LUTS.ConclusionsThe PLUTSS by itself was the best predictor of LUTS. The CBCL and BVWI were not helpful in making a diagnosis; however, the CBCL was useful in the detection of behavior problems in children with non-monosymptomatic enuresis.