Prevalence of HIV, HCV, and High-Risk Behaviors for Substance Users in Drop in Centers in Southern Iran

Salehi, Alireza; Naghshvarian, Mojtaba; Marzban, Maryam; Lankarani, Kamran Bagheri

doi:10.1097/adm.0000000000000112

Cited by 19 publications

(14 citation statements)

References 10 publications

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“…A number of studies assessed risk factors for HCV exposure using multivariable regression analyses. Risk factors most commonly reported included history and duration of incarceration and multiple incarcerations 50 – 62 , history and duration of intravenous drug use 50 , 51 , 54 , 57 , 58 , 60 – 67 , history of sharing a needle or syringe 55 , 57 , 62 , 68 , 69 , history of tattooing 50 – 52 , 61 , 70 , 71 , history of sharing razors 67 , multiple sex partners 57 , 58 , 66 , 67 , 69 , 70 , 72 , being a man who have sex with men 54 , 62 , 68 , 73 , history of surgery 70 , 73 , history of blood transfusion 56 , 60 , 73 , and history of hemodialysis 74 .…”

Section: Resultsmentioning

confidence: 99%

The epidemiology of hepatitis C virus in Iran: Systematic review and meta-analyses

Mahmud

Akbarzadeh

Abu‐Raddad

2018

Sci Rep

100

112

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The aim of this study was to characterize hepatitis C virus (HCV) epidemiology in Iran and estimate the pooled mean HCV antibody prevalence in different risk populations. We systematically reviewed and synthesized reports of HCV incidence and/or prevalence, as informed by the Cochrane Collaboration Handbook, and reported our findings following the PRISMA guidelines. DerSimonian-Laird random effects meta-analyses were implemented to estimate HCV prevalence in various risk populations. We identified five HCV incidence and 472 HCV prevalence measures. Our meta-analyses estimated HCV prevalence at 0.3% among the general population, 6.2% among intermediate risk populations, 32.1% among high risk populations, and 4.6% among special clinical populations. Our meta-analyses for subpopulations estimated HCV prevalence at 52.2% among people who inject drugs (PWID), 20.0% among populations at high risk of healthcare-related exposures, and 7.5% among populations with liver-related conditions. Genotype 1 was the most frequent circulating strain at 58.2%, followed by genotype 3 at 39.0%. HCV prevalence in the general population was lower than that found in other Middle East and North Africa countries and globally. However, HCV prevalence was high in PWID and populations at high risk of healthcare-related exposures. Ongoing transmission appears to be driven by drug injection and specific healthcare procedures.

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Section: Resultsmentioning

confidence: 99%

The epidemiology of hepatitis C virus in Iran: Systematic review and meta-analyses

Mahmud

Akbarzadeh

Abu‐Raddad

2018

Sci Rep

100

112

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“…To address the issue, skillful interviewers with experience of conducting interviews on sensitive research questions were recruited to lead the interviews. In addition to the above-mentioned limitations, in the present study, the type of sex (Anal, vagi- HIV sero-positivity of the partner 31 (12.9) 33 (20.6) 64 (16) nal, or oral) was not evaluated. CD4 count and viral load of the participants have not been measured as well.…”

Section: Discussionmentioning

confidence: 99%

“…A total of 5% of Iranian female sex workers were found to be HIV positive in 2013, and the infection was significantly associated with having more sex partners and younger age (15). HIV prevalence was 20.2% among a sample of Iranian drug users, and the positives were more likely to be male, share needles, have unsafe sex, and have a history of imprisonment (16). Another study stated that FSWs predictors of unsafe intercourse with people who inject drugs (PWIDs) included higher education, perceived HIV risk, and perceived family intimacy during childhood (17).…”

Section: Introductionmentioning

confidence: 99%

Determinants of Consistent Condom Use Among Iranians Living with HIV/AIDS: Implication for Prevention

Moazen

Hajizadeh

Setayesh

et al. 2017

Int J High Risk Behav Addict

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Background: Individuals that are HIV positive can transmit the infection through unprotected sex. Objectives: The present study aimed to evaluate the prevalence and determinants of consistent condom use among Iranian people living with HIV/AIDS as one of the most stigmatized and hard-to-access groups in this country. Patients and Methods: This cross-sectional study was conducted in Tehran, Iran. A total of 400 heterosexuals living with HIV/AIDS were sampled from 5 behavioral consulting centers through a purposive sampling method. Data were collected through an interviewer-administered questionnaire. Bivariate logistic regression, chi-square test, and multivariate logistic regression model were used as the statistical models in this study. Results: Of all 400 participants, 240 (60%) were men. The mean age was 34.7 for both sexes. During the past year, 335 (83.7%) were sexually active and 269 (67.9%) reported never having used a condom. Consistent condom use (always using condom in sexual intercourse) was reported by 67 (16.7%) of the participants. Consistent condom use was significantly associated with participation in HIV prevention courses (P = 0.003), knowledge of unsafe sex consequences (P = 0.017), condom use as a dual protection method (P = 0.0001), having a HIV-positive sexual partner (P = 0.0001), as well as being in a regular sexual relationship (P = 0.005). Conclusions: Development and improvement of the HIV prevention programs seems necessary to control the transmission of HIV in each community. However, results of the present study emphasize the importance of more attention to some specific programs such as prevention of mother-to-child transmission as a result of the willingness of Iranian people living with HIV/AIDS to child bearing. In addition, more attention should be paid to women as the more vulnerable part of the community to better prevent and control HIV in Iran.

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“…Very little evidence is available on directly measured HIV/HCV incidence among PWID. HCV epidemiological studies have been largely limited to single-centered cross-sectional studies reporting prevalence and with heterogeneous study populations with respect to their risk behaviors (18)(19)(20)(21)(22)(23)(24).…”

Section: Introductionmentioning

confidence: 99%

Barriers and motivators to participation and retention in HIV/HCV cohort studies among people who inject drugs; A community consultation in Iran

Mirzazadeh

Hooshyar²,

Shahesmaeili

et al. 2020

Preprint

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Background The lack of robust estimates of HIV/HCV incidence among people who inject drugs (PWID) in Iran calls for well-designed prospective cohort studies. Successful recruitment and follow-up of PWID in cohort studies may require formative assessment of barriers PWID are faced with in participation and retention in cohort studies and factors they think may facilitate their engagement in such studies. Using a focus group discussion (FGD) format, we conducted a consultation with PWID in southeast Iran to recognize those barriers and motivators. Methods Using targeted sampling, we recruited PWID (aged≥18, injected in last 6 months) from community-based drop-in centers (DICs), homeless shelters, and through outreach efforts to participate in four FGDs (one women-only). Socio-demographic characteristics, injection behaviors and self-reported HCV/HIV testing and diagnosis history were obtained. Then, a semi-structured FGD guide was applied to explore barriers and motivators to participation and retention in cohort studies among study participants. All FGD sessions were recorded and transcribed verbatim, removing any identifying information. The content of FGDs were analyzed by thematic analysis using an inductive approach. Results In total, 30 individuals (10 women) participated in the study. The mean age of participants was 35.4 years (SD 7.6), with majority (73.3%) reporting injecting drug use within the last month. Only 40.0% reported ever being tested for HCV whereas a larger proportion (63.4%) reported ever being tested for HIV. While the majority were willing to participate in cohort studies, breach of confidentiality, fear of positive test results, perceived required commitment, and marginalization were reported as barriers to participation and retention in such studies. Monetary incentive, the thought of a better life, protection from police interventions and trust between health workers and PWID were addressed as motivators of engagement in cohort studies among PWID.Conclusions Strategies to enhance data security and reduce stigma associated with injecting drug use along with involving peer workers in research, providing pre and post-test counselling and education and addressing the needs of more marginalized groups potentially through integrated healthcare programs and housing support are among few approaches that may help address barriers and strengthen the motivators for successful cohort studies among this population.

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Prevalence of HIV, HCV, and High-Risk Behaviors for Substance Users in Drop in Centers in Southern Iran

Cited by 19 publications

References 10 publications

The epidemiology of hepatitis C virus in Iran: Systematic review and meta-analyses

The epidemiology of hepatitis C virus in Iran: Systematic review and meta-analyses

Determinants of Consistent Condom Use Among Iranians Living with HIV/AIDS: Implication for Prevention

Barriers and motivators to participation and retention in HIV/HCV cohort studies among people who inject drugs; A community consultation in Iran

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