Patterns of Drug Use and HIV-Related Risk Behaviors among Incarcerated People in a Prison in Iran

Abstract

Previous research indicates that prisoners in Iran are at risk of drug-related harm, including acquisition of blood-borne infections. In response, several prevention interventions have been introduced into prisons in Iran, such as methadone maintenance treatment (MMT). MMT is now provided to opioid-dependent prisoners in 142 of the 230 prisons and correctional settings in Iran. A baseline behavioral survey was conducted in Karaj Central prison which mainly holds prisoners with drug-related charges. Overall, 203 male prisoners from randomly selected rooms in two prison blocks were interviewed using a structured questionnaire in 2007, just before the introduction of MMT program in this prison. Among participants, 7% reported never having used illicit drugs in their lifetime, but 51% had used non-injecting illicit drugs, and as high as 42% reported having injected an illicit drug. Up to 79% (160/203) of all participants reported using drugs, and about 6% (12/203) reported drug injecting during their current incarceration term. Same-gender sexual practice during current incarceration term was reported by 2.5% (5/203) of all male prisoners. Comparison between injecting and non-injecting drug-using prisoners indicated that drug injectors had higher rates of previous incarcerations, commenced drug use at a younger age, were more likely to have used illicit drugs in the previous week, were more likely to have been treated by a physician for drug addiction, had higher rates of registration for methadone treatment inside prison, and were more likely to have been tested for HIV infection. These study findings provide a behavioral profile of prisoners in regard to drug-related harm and can be considered in any plan to introduce or improve provision of MMT in prisons in Iran or other countries with similar features.

Knowledge, Attitude, and Practice (KAP) Regarding HIV/AIDS Transmission and Prevention Among Inmates in Bushehr Prison, 2009 – 2010

“…In studies that have examined gender differences in the level of KAP regarding HIV in prisons, the percentages of women in the samples were low (11)(12)(13)(14). The present study examined gender differences in KAP concerning HIV/AIDS in equal numbers of male and female inmates.…”

Change in attitudes and knowledge of problem drug use and harm reduction among a community cohort in Kabul, Afghanistan

“…More participants believed that sadness over loss of home and family or imprisonment were reasons for initiating drug use, and this change may also reflect fears surrounding displacement from the family unit. Drug use in prisons has been documented in various settings, including countries bordering Afghanistan, and knowledge of this has potentially permeated into the community (19)(20)(21)(22). Peer pressure increased as a perceived reason to initiate drug use, perhaps due to media coverage of the issue or to respondents' direct experiences (23,24).…”

Outcome assessment of a triangular clinic as a harm reduction intervention in Rajaee-Shahr Prison, Iran

“…A baseline study of prisoners in Karaj Central prison, for example, found that injecting, in comparison to non-injecting drug-using prisoners, were more likely to have been tested for HIV infection [10]; this is useful information. In measuring the outcome of the TC, the current study only considered injection drug use and related risky practices.…”

“…For example, MMT is currently available to opioid-dependent prisoners in over half of the 230 prisons and correctional settings in Iran [10]. With the introduction of TCs and MMT, the total number of prisoners taking part in methadone therapy increased from 100 in 2002 to more than 25,000 in 2009 [1,20].…”