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Dual Unsafe Injection and Sexual Behaviors for HIV Infection Among People Who Inject Drugs in Iran

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Abstract

We used two national surveys (2010: N = 1597; 2013: N = 1057) of people who inject drugs (PWID) in past-month to assess the prevalence and population size of PWID with either safe or unsafe injection and sex behaviors, overall and by HIV status. In 2013, only 27.0% (vs. 32.3% in 2010) had safe injection and sex, 24.6% (vs. 23.3% in 2010) had unsafe injection and sex, 26.4% (vs. 26.5% in 2010) had only unsafe injection, and 22.0% (vs. 18.0% in 2010) had unsafe sex only. Among HIV-positive PWID in 2013, only 22.1% (~ 2200 persons) had safe injection and sex, 14.2% (~ 1400 persons) had unsafe injection and sex, 53.1% (~ 5200 persons) had unsafe injection, and 10.6% had unsafe sex (~ 1100 persons). Among HIV-negative PWID in 2013, only 27.5% (~ 22,200 persons) had safe injection and sex, 25.9% (~ 20,900 PWID) had unsafe injection and sex, 23.2% (~ 18,700 persons) had unsafe injection, and 23.3% (~ 18,800 persons) had unsafe sex. HIV-positive and -negative PWID in Iran continue to be at risk of HIV acquisition or transmission which calls for targeted preventions services.

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Acknowledgements

We would like to acknowledge supervisors and field staff from all collaborative universities who provided inputs to the study design and methods, assisted in data collection and implementation of the survey. Our gratitude also goes to the PWID who participated in the survey.

Funding

The study was funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria through UNDP Iran, and by Ministry of Iran. For this paper, we also received support from the University of California, San Francisco’s International Traineeships in AIDS Prevention Studies (ITAPS), U.S. NIMH, R25MH064712. Mohammad Karamouzian is supported by the Vanier Canada Graduate Scholarship and the Pierre Elliott Trudeau Foundation Doctoral Scholarships.

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Authors and Affiliations

  1. HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran

    Aryan Esmaeili, Mostafa Shokoohi, Hamid Sharifi, Mohammad Karamouzian, AliAkbar Haghdoost, Armita Shahesmaeili & Ali Mirzazadeh

  2. Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, ON, Canada

    Mostafa Shokoohi

  3. Golestan Research Center of Psychiatry, Golestan University of Medical Sciences, Gorgan, Golestan, Iran

    Ahmad Danesh

  4. School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada

    Mohammad Karamouzian

  5. Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran

    AliAkbar Haghdoost

  6. Center for Disease Control (CDC), Ministry of Health and Medical Education, Tehran, Iran

    Samaneh Akbarpour

  7. Department of Epidemiology and Biostatistics, University of California San Francisco, 550 16th Street, San Francisco, CA, 94158, USA

    Aryan Esmaeili, Meghan D. Morris & Ali Mirzazadeh

Authors
  1. Aryan Esmaeili
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  7. Armita Shahesmaeili
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  9. Meghan D. Morris
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  10. Ali Mirzazadeh
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Corresponding author

Correspondence to Ali Mirzazadeh.

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Conflict of interest

All authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study. The study was anonymous, and no identifying information was collected during recruitment, informed consent, interview, or HIV testing. A unique identification code was provided to participants to help link survey responses to their test results. Participants were able to receive their HIV test results, post-test counseling, and referrals from the local testing and counseling center by providing their unique identification code. PWID were given 70,000 Rials (equal to ~ 2.5 USD) as an incentive for participating in the study and 15,000 Rials (equal to ~ 0.5 USD) if they returned to receive their test results. The study protocol was reviewed and approved by the Ethics Committee of Kerman University of Medical Sciences (Ethical Code: K/93/205).

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Esmaeili, A., Shokoohi, M., Danesh, A. et al. Dual Unsafe Injection and Sexual Behaviors for HIV Infection Among People Who Inject Drugs in Iran. AIDS Behav 23, 1594–1603 (2019). https://doi.org/10.1007/s10461-018-2345-5

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