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

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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.

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References

  1. UNAIDS. Islamic Republic of Iran Country Report on Monitoring of the United Nations General Assembly Special Session on HIV and AIDS Declaration of Commitment.: Office of the Under-secretary for Health, Ministry of Health and Medical Education, Centre for Diseases Management.; 2006.

  2. Razzaghi EM, Rahimi MA. Injection drug use in Tehran. Tehran: Tehran University of Medical Sciences; 2005.

    Google Scholar 

  3. Zamani S, Kihara M, Gouya MM, et al. High prevalence of HIV infection associated with incarceration among community-based injecting drug users in Tehran, Iran. J Acquir Immune Defic Syndr. 2006; 42(3): 342–346.

    Article  PubMed  Google Scholar 

  4. Zamani S, Kihara M, Gouya MM, et al. Prevalence of and factors associated with HIV-1 infection among drug users visiting treatment centers in Tehran, Iran. AIDS. 2005; 19(7): 709–716.

    Article  PubMed  Google Scholar 

  5. Jahani MR, Kheirandish P, Hosseini M, et al. HIV seroconversion among injection drug users in detention, Tehran, Iran. AIDS. 2009; 23(4): 538–540.

    Article  PubMed  Google Scholar 

  6. Farnia M, Ebrahimi B, Shams A, Zamani S. Scaling up methadone maintenance treatment for opioid-dependent prisoners in Iran. Int J Drug Policy. 2010; In press.

  7. Health and Treatment Headquarter of Iran Prison Organization. An overview on HIV/AIDS in prisons of Islamic Republic of Iran. Tehran: Iran Prison Organization; 2006.

    Google Scholar 

  8. Eshrati B, Asl RT, Dell CA, et al. Preventing HIV transmission among Iranian prisoners: initial support for providing education on the benefits of harm reduction practices. Harm Reduct J. 2008; 5: 21.

    Article  PubMed  Google Scholar 

  9. Razzaghi E, Nassirimanesh B, Afshar P, Ohiri K, Claeson M, Power R. HIV/AIDS harm reduction in Iran. Lancet. 2006; 368(9534): 434–435.

    Article  PubMed  Google Scholar 

  10. Cook TD, Campbell DT. Quasi-experimentation: design and analysis issues for field settings. Boston: Houghton Mifflin Company; 1979.

    Google Scholar 

  11. Fisher AA, Laing JE, Stoeckel JE, Townsend JW. Handbook for family planning operations research design. 2nd ed. New York: Population Council; 1991.

    Google Scholar 

  12. Zamani S, Farnia M, Tavakoli S et al. A qualitative inquiry into methadone maintenance treatment for opioid-dependent prisoners in Tehran, Iran. Int J Drug Policy. 2009. doi:10.1016/j.drugpo.2009.03.001.

  13. Singleton N, Farrell M, Meltzer H. Substance misuse among prisoners in England and Wales. Int Rev Psychiatry. 2003; 15(1–2): 150–152.

    Article  CAS  PubMed  Google Scholar 

  14. Griffiths P, Nilson M, Carpentier C, Merino PP. Treating drug users in prison—a critical area for health promotion and crime reduction policy. Lisbon: European Monitoring Centre for Drugs and Drug Addiction (EMCDDA); 2003.

    Google Scholar 

  15. Alizadeh AH, Alavian SM, Jafari K, Yazdi N. Prevalence of hepatitis C virus infection and its related risk factors in drug abuser prisoners in Hamedan–Iran. World J Gastroenterol. 2005; 11(26): 4085–4089.

    PubMed  Google Scholar 

  16. Stover H. An overview study: assistance to drug users in European Union prisons. Lisbon: European Monitoring Centre for Drugs and Drug Addiction (EMCDDA); 2001.

    Google Scholar 

  17. Jurgens R, Ball A, Verster A. Interventions to reduce HIV transmission related to injecting drug use in prison. Lancet Infect Dis. 2009; 9(1): 57–66.

    Article  PubMed  Google Scholar 

  18. Thaisri H, Lerwitworapong J, Vongsheree S, et al. HIV infection and risk factors among Bangkok prisoners, Thailand: a prospective cohort study. BMC Infect Dis. 2003; 3: 25.

    Article  PubMed  Google Scholar 

  19. Buavirat A, Page-Shafer K, van Griensven GJ, et al. Risk of prevalent HIV infection associated with incarceration among injecting drug users in Bangkok, Thailand: case-control study. BMJ. 2003; 326(7384): 308.

    Article  PubMed  Google Scholar 

  20. Dufour A, Alary M, Poulin C, et al. Prevalence and risk behaviours for HIV infection among inmates of a provincial prison in Quebec City. AIDS. 1996; 10(9): 1009–1015.

    Article  CAS  PubMed  Google Scholar 

  21. Macalino GE, Vlahov D, Sanford-Colby S, et al. Prevalence and incidence of HIV, hepatitis B virus, and hepatitis C virus infections among males in Rhode Island prisons. Am J Public Health. 2004; 94(7): 1218–1223.

    Article  PubMed  Google Scholar 

  22. Pont J, Strutz H, Kahl W, Salzner G. HIV epidemiology and risk behavior promoting HIV transmission in Austrian prisons. Eur J Epidemiol. 1994; 10(3): 285–289.

    Article  CAS  PubMed  Google Scholar 

  23. Stark K, Bienzle U, Vonk R, Guggenmoos-Holzmann I. History of syringe sharing in prison and risk of hepatitis B virus, hepatitis C virus, and human immunodeficiency virus infection among injecting drug users in Berlin. Int J Epidemiol. 1997; 26(6): 1359–1366.

    Article  CAS  PubMed  Google Scholar 

  24. Dolan KA, Wodak A. HIV transmission in a prison system in an Australian State. Med J Aust. 1999; 171(1): 14–17.

    CAS  PubMed  Google Scholar 

  25. Taylor A, Goldberg D, Emslie J, et al. Outbreak of HIV infection in a Scottish prison. BMJ. 1995; 310(6975): 289–292.

    CAS  PubMed  Google Scholar 

  26. Power KG, Markova I, Rowlands A, McKee KJ, Anslow PJ, Kilfedder C. Sexual behaviour in Scottish prisons. BMJ. 1991; 302(6791): 1507–1508.

    Article  CAS  PubMed  Google Scholar 

  27. van Haastrecht HJ, Bax JS, van den Hoek AA. High rates of drug use, but low rates of HIV risk behaviours among injecting drug users during incarceration in Dutch prisons. Addiction. 1998; 93(9): 1417–1425.

    Article  PubMed  Google Scholar 

  28. Abeni D, Perucci CA, Dolan K, Sangalli M. Prison and HIV-1 infection among drug injectors. In: Stimson G, Des Jarlais DC, Ball A, eds. Drug injecting and HIV infection. London: UCL Press; 1998: 168–182.

    Google Scholar 

  29. Gaughwin MD, Douglas RM, Liew C, et al. HIV prevalence and risk behaviours for HIV transmission in South Australian prisons. AIDS. 1991; 5(7): 845–851.

    Article  CAS  PubMed  Google Scholar 

  30. Hammett TM. Sexually transmitted diseases and incarceration. Curr Opin Infect Dis. 2009; 22(1): 77–81.

    Article  PubMed  Google Scholar 

  31. WHO/UNODC/UNAIDS. Substitution maintenance treatment in the management of opioid dependence and HIV/AIDS prevention: position paper. Geneva: World Health Organization, United Nations Office on Drugs and Crime, Joint United Nations Programme on HIV/AIDS.; 2004.

  32. Latkin CA, Vlahov D, Anthony JC. Socially desirable responding and self-reported HIV infection risk behaviors among intravenous drug users. Addiction. 1993; 88(4): 517–526.

    Article  CAS  PubMed  Google Scholar 

  33. Shrestha S, Smith MW, Broman KW, Farzadegan H, Vlahov D, Strathdee SA. Multiperson use of syringes among injection drug users in a needle exchange program: a gene-based molecular epidemiologic analysis. J Acquir Immune Defic Syndr. 2006; 43(3): 335–343.

    Article  PubMed  Google Scholar 

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Acknowledgment

We gratefully acknowledge the study participants who shared their personal experiences with us. We also thank the staff of Karaj Central prison, the Iran Prison Organization, and the UNODC-Country Office for the Islamic Republic of Iran for their support during the course of this study. Special thanks go to Gelareh Mostashari who was a great source of technical support throughout the course of this study. The contributions of Shabnam Asghari, Ali Feizzadeh, Behnam Farhoudi, Bahman Ebrahimi, and Nazanin Rabei were much appreciated. We would also like to thank Linh Pallos and Jane Koerner for their valuable comments on the manuscript. This study was supported by a grant from the UNODC–Country Office for the Islamic Republic of Iran.

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Authors and Affiliations

  1. Department of Global Health and Socio-epidemiology, Kyoto University School of Public Health, Kyoto, Japan

    Saman Zamani, Masako Ono-Kihara & Masahiro Kihara

  2. The Iran Prison Organization, Tehran, Iran

    Marziyeh Farnia, Behrouz Abbasi Alaei & Mehran Gholizadeh

  3. The United Nations Children’s Fund (UNICEF)-Iran, Tehran, Iran

    Alireza Torknejad

  4. AIDS/Addiction Research and Intervention Association, Tehran, Iran

    Farzad Kasraee

  5. EBM Research Center, Kyoto University Graduate School of Medicine, Kyoto, Japan

    Koji Oba

Authors
  1. Saman Zamani
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  2. Marziyeh Farnia
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  3. Alireza Torknejad
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  4. Behrouz Abbasi Alaei
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  5. Mehran Gholizadeh
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  6. Farzad Kasraee
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  7. Masako Ono-Kihara
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  8. Koji Oba
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  9. Masahiro Kihara
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Correspondence to Saman Zamani.

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Zamani, S., Farnia, M., Torknejad, A. et al. Patterns of Drug Use and HIV-Related Risk Behaviors among Incarcerated People in a Prison in Iran. J Urban Health 87, 603–616 (2010). https://doi.org/10.1007/s11524-010-9450-8

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  • DOI: https://doi.org/10.1007/s11524-010-9450-8

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