Iranian Journal of

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Background & Objectives: The youth group is more prone to HIV infection. Education is a cornerstone to prevention. This study was conducted to compare the efficacy of peer education and traditional lectureship and distribution of pamphlet on high school students.
Methods: 1500 female high school students, third graders, were selected based on stratified random sampling studying in 21 high schools in Kermanshah. In each high school, 73 third grades were selected as the sample of the study. We designed a questionnaire as an assessment tool for interventions. Peer education was done by 502 students, and AIDS awareness pamphlet was distributed on 500 students, and the rest of students were attended a one-day workshop which was ran by a female physician in their high school.
Results: The mean average age was 16.78 (SD= ± 0.7) years. The mean scores of pretest and post-test in each groups were statistically significant different (P=0.0001). Mean score of difference in workshop by female physician was greater than peer education group, 10.7 and 8.8, respectively. The group whome received their knowledge about AIDS by pamphlet obtained the least mean score than other groups and this was statistically significant (P=0.0001).
Conclusions: The findings of this study indicate that educating students by general practitioners is more effective way to increase students’ knowledge about prevention of AIDS.

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Background & Objective: the number of people with HIV/AIDS in Iran is increasing. Populations' knowledge and awareness are crucial steps to prevent HIV/AIDS epidemic. This systematic review aimed to assess the level of knowledge and attitude toward HIV/AIDS in Iranian population.
Methods: Reviewing related titles in national and international databanks resulted in 62 eligible studies published between 1998 and 2008. To explore the source(s) of heterogeneity, meta-regression model was used.
Results: Due to the methodological diversity of included studies (e.g. their sampling or data collection methods) pooled estimation of the results were hard to be applied. The mean for knowledge score among 24 eligible studies (including 24,011 individuals) varied between 14.7 and 84.0 out of 100. Among those 16 eligible studies (including 11,104 individuals), the reported mean for attitude varied between 32.6 and 78.4 out of 100.
Conclusion: In overall, it seems that the knowledge and attitude in Iranian population still need to be improved however, the results from our systematic review showed a considerable heterogeneity among the results that can be originated from the diversity of target populations and/or their methodology of included studies. Planning for further targeted programs and modifying public education for more effective schemes are necessary to be emphasized, as there was not a significant change in the level of knowledge or attitude based on the included studies.

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Background & Objectives: The epidemic of HIV has been become worldwide. Infected people with HIV which are most intravenous drug users (IDUs) and/or people who have unsafe sex are important source of transmission of infection to other persons in a community. Since there is little known about the knowledge and attitudes of HIV positives about HIV in Iran, therefore we decided to measure the level of knowledge and attitudes of this group in Golestan province in compare with individuals with risky behavior.
Methods: This cross-sectional study was conducted on 54 HIV+ persons and 134 people with high risk behavior individuals in 2007 year. Results: Our study showed that HIV- (High risk group) cases had higher education level (P=0.034). Rate of jobless was higher in HIV+ persons (P<0.001). HIV+ cases had lower income (P=0.037). Both groups had moderate knowledge and poor attitude on HIV/AIDS. Level of attitude in HIV+ positive persons was lower than high risk group (P=0.05).
Conclusion: It is concluded that these susceptible persons and also infected individuals with HIV regardless of their socio-economic levels need more continuous education in structured programs.

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  Background & Objectives : Children who work or live on the street are one of key populations at risk for HIV and hard to reach for study or providing services. Here, as a methodological paper, we present the methods and steps of a rapid assessment and response (RARE) project conducted among street children in Tehran.

  Methods : We applied a mixture of qualitative (literature review, focus group discussion, in-depth interview) and quantitative (structure interview) methods to collect data from key informants in non-governmental and governmental agencies as well as street children. We applied targeted sampling to recruit key informants and time location sampling to recruit street children.

 Results: The study was conducted in eight steps to recognize the involved stakeholders, define target population (street children) and to guide on how to approach them (steps 1 to 2: Initial Consultation, Study Area Profile), to map the venues and gathering spots and ethnographic findings crucial for further recruitment into surveys (steps 3 to 5: Contextual Assessment, Population and Setting Assessment, Health Issues Assessment), assess the risk behaviors (step 6: Assessment Behavior Risk and Health), evaluate the response (step 7: Intervention Assessment), and develop an operational plan for improving the services (step 8: Developing an Action Plan).

  Conclusion: RARE is a participatory mix research method with sufficient flexibility to study complex health problems such as stigmatized HIV risk behaviors among high risk and hard to reach populations and also to assess the health sector response.

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Background and Objectives: People living with HIV (PLHIV) experience severe psychological pressure in most communities; however, this pressure is more prominent in women. Therefore, it is very important to monitor different aspect of psychological pressure and psychosocial supports in this group of patients. Based on this need, in this study, we assessed the status of mental health, hope, and social support in female PLHIVs visiting health centers of Kerman, Iran.
Methods: In a triangulation study comprising a combination of qualitative and quantitative components, PLHIV women were recruited and their information were collected using Goldberg’s General Health Questionnaire, Sarason’s Social Support Questionnaire, and the Miller’s Hope Scale.
Results: Our findings showed that female patients’ status improved markedly after visiting the health centers (hope: 92%, general health: 80%, social support: 93%). In addition, the results showed a strong positive the correlation between general health and hope (r=0.61, P<0.0001).
Conclusion: Our results showed that such multi-disciplinary service providing centers may substantially improve the quality of life and general health of these women who rigorously need social support.

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Background and Objectives: The pandemic of HIV/AIDS is spreading rapidly in the Middle East, in particular in Iran. Designing an educational program involves assessment of the educational needs of people with valid and culture-based tools. This study was conducted with the aim of psychometric analysis of an instrument for assessment of HIV/AIDS knowledge based on the Iranian culture in different population groups.
 
Methods: In this psychometric analysis, 58 items related to AIDS knowledge were prepared based on a literature review. Then, the face validity  and content validity of the instrument was determent by the impact item score, content validity ratio (CVR), and content validity index (CVI). The reliability of the scale was assessed by Cronbach’s alpha coefficient and test-retest.
 
Results: Based on face validity and content validity, the research scale had 44 items with an item impact score > 1.5, a CVR > 0.49, and a CVI > 0.79. The Scale had three sections, general knowledge about HIV/AIDS (9 items), knowledge about HIV transmission (25 items), and knowledge about HIV/AIDS prevention (10 items). The Scale also had a high reliability (Cronbach’s alpha coefficient=0.77-0.91, ICC=0.88)
 
Conclusion: The results of the study showed the instrument was a valid and reliable scale for measurement of knowledge about HIV/AIDS.

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Background and Objectives: The results of recent studies suggest that model-based health education programs are more effective in changing health behaviors. Interventional programs based on health education theories can be used to explain individual and psychological behavioral determinants in order to reduce the risk of HIV/AIDS. This study was conducted with the aim of psychometric analysis of an HIV scale based on model, population and culture of Iran.
 
Methods: We used qualitative and quantitative methods during August 2015 to December 2017. The items were generated based on a literature review and interviews with an expert panel. After providing a primary list of the instrument items, we used content and face validity. The first step of the study was done in a sample of medical and non-medical college and high school student from Zanjan. The exploratory factor analysis, internal consistency reliability, and test-retest reliability of the scale were measured.
 
Results: Fifty-eight items were generated from interviews with experts and review of the literature. After measuring the face and content validity, the items decreased to 53 items. The exploratory factor analysis discovered five factors (perceived susceptibility, severity, benefits, barriers, and self-efficacy), including 30 items for high school students and 31 for university students, that predictive more than 58% of the observed variance. The Cronbach’s alpha coefficient for the sub-scales ranged from 0.80 to 0.86, and the ICC was above 0.86.
 
Conclusion: The results showed that the HBM was a valid and reliable tool for measuring the HIV/AIDS beliefs and could be used in future investigations.

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Background and Objectives: Cervical cancer is one of the five most common cancers in Iranian women. Considering the impact of HIV on cervical cancer and the low rate of cervical cancer screening in HIV positive women, this study was conducted to review the barriers to cervical cancer screening in HIV positive women.
 
Methods: In this systematic review, data were retrieved from Magiran, SID, Irandoc, Prequest, OVID, ScienceDirect, PubMed, Web of Science and Scupos databases from January 2000 to January 2018. The following keywords and their combination were used: cervical cancer screening, Pap smear, HIV-positive women, and barriers. The NOS (Newcastle-Ottawa Scale) checklist was used to evaluate the quality of the selected articles and the articles that scored more than six were included in the study.
 
Results: From 145 selected articles, 21 were included in the review based on the inclusion criteria. The most common reported screening barriers were the costs of test, lack of awareness, low education level, younger age, lack of information about screening centers, and fear of sampling. 
 
Conclusion: Considering the barriers to cervical cancer screening, increasing the level of awareness of the HIV-positive women, preparing free Pap smear services, and providing easier access to health centers for this high risk group could lead to early detection of cervical cancer.

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Background and Objectives: Iran is one of the Middle Eastern countries that implemented the HIV / AIDS control and surveillance program many years ago. The purpose of this study was to review the HIV / AIDS surveillance system in Iran.
 
Methods: This was a review research to assess the processes, structures and achievements of the HIV/AIDS surveillance system in Iran. The information sources of this study included data from the surveillance system, reports and documentation, and published guidelines, reviewing existing structures and views of managers and practitioners of the HIV/AIDS surveillance system in Iran.
 
Results: In Iran, all cases with HIV / AIDS as well as people with high risk behaviors are referred to behavioral disease counseling centers in order to receive health care services. Harm reduction in people with risky behaviors in the form of counseling centers, drug addicts' centers, and women's counseling centers in collaboration with governmental and non-governmental organizations, and attention to the second generation of HIV/AIDS surveillance, particularly conducting behavioral studies, are other components of the HIV / AIDS surveillance system in Iran
 
Conclusion: Although the HIV / AIDS surveillance system in Iran has a large structure with many achievements in reducing new HIV cases, especially in some high-risk groups such as injecting drug users, as well as reducing HIV transmission from infected mothers to their children, strengthening this surveillance system, especially for sexual high-risk groups, is essential for controlling HIV/AIDS in the country.

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