Willingness to utilize supervised injection facilities among people who inject drugs in Iran: Findings from 2020 national HIV bio-behavioral surveillance survey

Khezri, Mehrdad; Karamouzian, Mohammad; Sharifi, Hamid; Ghalekhani, Nima; Tavakoli, Fatemeh; Mehmandoost, Soheil; Mehrabi, Fatemeh; pedarzadeh, Marjan; Nejat, Mehdi; Noroozi, Alireza; Baral, Stefan; Shokoohi, Mostafa

doi:10.1016/j.drugpo.2021.103355

Cited by 11 publications

(6 citation statements)

References 13 publications

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“…23 Moreover, shared injection among PWID decreased from 36.9% in the last month in 2010 1 to 4.1% in the last three months in 2020. 3 We also found more than three-fourth of diagnosed cased had a CD4 count ≤ 500 at diagnosed time, and more than 40% had a CD4 count <200 at diagnosis. These figures were almost similar during three time periods which shows continuous problem of late diagnosis of majority of the infected cases.…”

Section: Discussionsupporting

confidence: 59%

“…HIV epidemic in Iran is concentrated among key populations including people who inject drug (PWID) (15.2% in 2010, 10.9 in 2014, and 3.6% in 2020) [1][2][3] and partners of PWID (2.8% in 2010), 4 female sex workers (FSW) (2.1% in 2015), 5 and prisoner (1.2% in 2014), 6 but the prevalence of HIV is very low in the general population (0.15%), 7 blood donors (3 per 100,000 donations from 2003 to 2017) 8 and pregnant women (0.04%). 9 The Joint United Nations Programme on HIV/AIDS (UNAIDS) estimated 59,314 people living with HIV (PLWH) in Iran in 2019, of whom only 22,054 (37%) were diagnosed and reported to the National HIV Case-Based Surveillance.…”

Section: Introductionmentioning

confidence: 99%

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Spatiotemporal epidemiology of HIV between 1997 and 2020 in Kerman, Iran

Mirzaei

Mirzazadeh

Barouni

et al. 2021

Preprint

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Objectives: We assessed the epidemiological and spatiotemporal patterns of HIV cases reported between 1997 and 2020 in Kerman, Iran. Method: We compared the age, gender, modes of transmission, and spatial distribution of newly diagnosed HIV infected people over time (1997-2004, 2005-2012, and 2013-2020). We also mapped the services and spatial distribution for people who were living with HIV in 2020. The nearest neighbor index and kernel density were used to identify the spatial distribution of HIV cases. Chi square for trend, one-sample t-test, and Kruskal Wallis H tests were used to compare the differences over time. Stata 17 and ArcGIS 10.3 were used for HIV surveillance data analysis. Results: A total of 459 (25.6% women) people were diagnosed with HIV during 1997-2020. The proportion of women (from 9.3% in 1997-2004 to 48.3% in 2013-2020, P < 0.001), those infected with HIV through sexual contacts (from 11.6% in 1997-2004 to 50.3% in 2013-2020, P < 0.001), proportion of HIV infected children under 5 years of age (0.8% in 1997-2004 to 5.4% in 2013-2020, P = 0.01), and mean age at diagnosis among men (from 34.9 in 1997-2004 to 39.8 years in 2013-2020, P = 0.004) significantly increased over time. The mean age at diagnosis among women (34.5 years in 2013-2020), and the proportion who diagnosed with CD4 count <200 (36.2% in 2013-2020) did not change significantly over time. The density map of residents with HIV infection had the highest density in the northern and southern edges of the city in 2005-2012. The HIV clusters in 2020 matched with the locations of fixed and mobile services. Conclusion: We observed important changes in HIV epidemiology regarding gender, modes of transmission, number of pediatric cases, and density maps over time which should be considered for precise targeting of HIV prevention, treatment, and outreach programs in this city.

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Section: Discussionsupporting

confidence: 59%

Section: Introductionmentioning

confidence: 99%

Spatiotemporal epidemiology of HIV between 1997 and 2020 in Kerman, Iran

Mirzaei

Mirzazadeh

Barouni

et al. 2021

Preprint

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“…The number of drug users who have received MMT also increased from 476 000 individuals in 201121 to more than 750 000 individuals in 2019 31. Moreover, shared injections among PWID decreased from 36.9% in the last month in 20102 to 4.1% in the last 3 months in 2020 4…”

Section: Discussionmentioning

confidence: 99%

“…The HIV epidemic in Iran is concentrated among key populations, including men who have sex with men (MSM) (7.0% in a meta-analysis study),1 people who inject drugs (PWID) (15.2% in 2010, 10.9% in 2014 and 3.6% in 2020)2–4 and partners of PWID (2.8% in 2010),5 female sex workers (FSWs) (4.5% in 2010 and 2.1% in 2015)6 7 and prisoners (1.2% in 2014) 8. The prevalence of HIV is low among the general population (0.15%),9 blood donors (3 per 100 000 donations from 2003 to 2017)10 and pregnant women (0.04%) 11…”

Section: Introductionmentioning

confidence: 99%

Epidemiology and spatial distribution of people diagnosed with HIV between 1997 and 2020 in Kerman, Iran

et al. 2022

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ObjectiveThis study described the epidemiology and geographical distribution of people diagnosed with HIV in Kerman, Iran, between 1997 and 2020.MethodsWe used case-based HIV surveillance data of all people diagnosed with HIV in Kerman between 1997 and 2020. We compared the age, gender, modes of transmission and spatial distribution of newly diagnosed HIV-infected people in three time periods (1997–2004, 2005–2012 and 2013–2020). The χ2 test for trend, one-sample t-test and Kruskal-Wallis H test were used to compare the differences between the three time periods. We also used ArcGIS to map both HIV services and people living with HIV (PLWH) in 2020. The nearest neighbour index and kernel density were used to identify the spatial distribution of PLWH.ResultsA total of 459 (27.5% women) people were diagnosed with HIV during 1997–2020. The proportion of women (9.3% in 1997–2004 and 48.3% in 2013–2020, p<0.001), HIV infection through sexual contacts (11.6% in 1997–2004 and 50.3% in 2013–2020, p<0.001), HIV infection under the age of 5 years (0.8% in 1997–2004 and 5.4% in 2013–2020, p=0.01) and mean age at diagnosis among men (34.9 in 1997–2004 and 39.8 years in 2013–2020, p=0.004) significantly increased over time. 36.2% of diagnosed cases had CD4 counts under 200 x 10ˆ6/L between 2013 and 2020, with no significant improvement over time. Most newly diagnosed cases of HIV were from the eastern parts of the city. The clusters of PLWH in 2020 matched with the locations of HIV services.ConclusionWe observed important changes in HIV epidemiology regarding gender, modes of transmission, number of paediatric cases and density maps over time in Kerman. These changes should be considered for precise targeting of HIV prevention and treatment programmes.

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“…All data were collected from the fourth national bio-behavioral surveillance survey of Iranian PWID. The cross-sectional survey has been reported in detail previously (Khezri et al, 2021). In brief, by respondent-driven sampling (RDS) method, we recruited 2,663 PWID from 11 major cities in Iran between June 2019 and March 2020.…”

Section: Methodsmentioning

confidence: 99%

HIV Continuum of Care Among People Who Inject Drugs in Iran: A Cross-sectional Study

Ghalekhani

Mirzazadeh²,

Tavakoli³

et al. 2023

J Assoc Nurses AIDS Care

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People living with HIV who inject drugs may have lower access to treatment services. We aimed to assess the HIV continuum of care among people who inject drugs (PWID) in Iran. Data were collected from 2,663 PWID who were recruited via respondent-driven sampling from 11 cities of Iran between June 2019 and March 2020. Participants who tested positive for HIV infection were asked questions to calculate the status of HIV cascade of care. Of 95 PWID living with HIV, 67% were aware of their HIV status, 57% were linked to care service and initiated ART, 49% retained on ART, and only 15% had viral load less than 1,000 copies/ml. About half of the PWID diagnosed with HIV ever started ART and less than one in six were virally suppressed. Strategies to improve linkage to ART programs and ART retention may improve HIV care outcomes among PWID in Iran.

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Willingness to utilize supervised injection facilities among people who inject drugs in Iran: Findings from 2020 national HIV bio-behavioral surveillance survey

Cited by 11 publications

References 13 publications

Spatiotemporal epidemiology of HIV between 1997 and 2020 in Kerman, Iran

Spatiotemporal epidemiology of HIV between 1997 and 2020 in Kerman, Iran

Epidemiology and spatial distribution of people diagnosed with HIV between 1997 and 2020 in Kerman, Iran

HIV Continuum of Care Among People Who Inject Drugs in Iran: A Cross-sectional Study

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