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High HIV Prevalence in a Respondent-Driven Sampling Survey of Injection Drug Users in Tehran, Iran

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Abstract

Iran is facing unprecedented dual drug use and HIV epidemics. We conducted a cross-sectional survey to obtain HIV prevalence and risk behavior data from injection drug users (IDU) in Tehran. We used respondent-driven sampling (RDS) to recruit IDU through successive waves starting with 24 “seeds,” conducted anonymous face-to-face interviews and HIV testing and counseling, and used RDSAT to adjust data. During 44 weeks, 1,726 study referral coupons resulted in 645 (37 %) IDU referrals, of whom 548 (85 %) were enrolled. From those enrolled, 84 % were incarcerated, 47 % employed, 55 % single, 27 % under 30 years of age, and 26 % homeless. The adjusted HIV prevalence was 26.6 % (95 % confidence interval 21.3–32.1), and was higher among certain IDU subgroups (e.g., those who sharing injection paraphernalia). Our estimates of HIV prevalence were higher than some other estimates; however, repeated surveys using similar methodology are needed to monitor the trend of HIV epidemic over time.

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Acknowledgments

We would like to thank to the directors of the drop-in centers, Aeen Mehr I, Aeen-Mehr II, and Azadi, the Boo-Ali Triangular Center, and the Persepolis Institute for their collaboration, and the staff of the IRCHA, who provided logistical support throughout the study. We also would like to express our gratitude to Dr. Azarakhsh Mokri and Dr. Mohsen Vazirian at the Iranian National Center for Addiction Studies at TUMS who provided their expertise, and to Dr. Hossein Kayvan who conducted serological tests. This research project was supported by a Grant from the World Health Organization-Eastern Mediterranean Regional Office/Tropical Disease Research Programme small grant (Small Grants AMS Code 1: 43119022 and AMS Code 2: 43119040), TUMS Office of the Deputy of Research (Grant No. 3895-55-02-85); and the John P. Dowdle Endowment and the Russell M. Grossman Medical Research Fund of the School of Public Health, University of California, Berkeley.

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Authors and Affiliations

  1. Institute for Health Policy Studies, University of California, 3333 California Street, Suite 265, San Francisco, CA, 94118, USA

    Mohsen Malekinejad

  2. Global Health Sciences, University of California, San Francisco, USA

    Mohsen Malekinejad & George W. Rutherford

  3. Iranian Research Center for HIV and AIDS, Tehran University of Medical Sciences, Tehran, Iran

    Minoo Mohraz, Gholamreza Akbari & Parastoo Khairandish

  4. Division of General Pediatrics, School of Medicine, University of California, San Francisco, USA

    Nooshin Razani

  5. San Francisco Department of Public Health, San Francisco, USA

    Willi McFarland

  6. Department of Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

    Housien Malekafzali

  7. Center for Disease Management, Iranian Ministry of Health and Medical Education, Tehran, Iran

    Mohammad M. Gouya

  8. Santa Clara County Public Health Department, Santa Clara, USA

    Asieh Zarghami

Authors
  1. Mohsen Malekinejad
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  2. Minoo Mohraz
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  7. Housien Malekafzali
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Correspondence to Mohsen Malekinejad.

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Malekinejad, M., Mohraz, M., Razani, N. et al. High HIV Prevalence in a Respondent-Driven Sampling Survey of Injection Drug Users in Tehran, Iran. AIDS Behav 19, 440–449 (2015). https://doi.org/10.1007/s10461-014-0904-y

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  • DOI: https://doi.org/10.1007/s10461-014-0904-y

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