Journal of School of Public Health and

There are about 200,000 injecting drug users (IDUs) in Iran. HIV/AIDS is closely associated with IDU in Iran. The objective of this study was to explore unhealthy sex behavior and the interventions for its control in IDUs.
A qualitative method was employed. Six districts in Tehran with a population of 400,000 were selected. These districts differed in socioeconomic characteristics, urban structure, IDU prevalence and crime rates. A total of 81 key informants from different sectors and 154 IDUs were selected by purposeful, opportunistic and snowball sampling, and interviewed individually or in groups. Ethnographic observations were done to study life situation in the subjects.
In one district no cases of IDU were found. In others, sexual promiscuity in IDUs was reported to be common. IDUs report sexual relationship to be more common with sex wrkers. In most of these areas, access to commercial sex is believed to be easy. Sex workers, themselves are commonly drug users, half of them are actually IDUs. Safe sex (e.g., use of condoms) is not a common habit. Homosexual relationship seems to be uncommon in IDUs and there were no reports of condom use in this type of contact. According to IDUs, dealing with this problem would require financial support and drug distribution for preventing sex work, and settlement and organization of sex workers as a prelude to effective sex education and promotion of condoms.
Expansion of injecting drug use and its relationship with blood-borne infections in recent years necessitates rapid interventions for controlling injection drug use and the associated risks. As unhealthy sex behavior seems to be common in IDUs, sex education, free condom distribution in drug abuse treatment centers and other health facilities (with the use of outreach methods) is highly recommended.