Journal of School of Public Health and

Background and Aim:  AIDS is a lethal disease, for which there is no treatment or any vaccine to prevent it. The injection-drug use and unprotected sexual behavior are two factors important  in HIV transmission. This study was conducted to determine changes in high-risk sexual and injection-drug use behaviors associated with HIV among drug users referring to Methadone Maintenance Treatment centers in Shiraz, Iran.

Materials and Methods: This before-after interventional study with no control group included drug-users (n=694) referring to all the 7 MMT centers in Shiraz, Iran in 2009. The data were collected by interviewing patients and using a questionnaire. The software used for data analysis was SPSS 15, the statistical test being the Wilcoxon test.

Results: The average age of the clients was 36.5 ± 9.5 years. Most of them were males (% 92.1) and single (% 43.1). 37.3 % of them being injection-drug users. The proportion of the injection-drug users having had at least one shared injection one week before referring to an MMT center was 23.3%, which decreased to 9.2% after one week. Analysis of the data also showed that 25.2% of the addicts had had at least one unprotected sexual contact during the previous month the proportion decreased to 21.0% one month after referring to an MMT center. The reductions in the mean numbers of both shared injections and unprotected sexual contacts were statistically significant (p <0.001).

Conclusion: Considering the effectiveness of the MMT centers in reducing risky behaviors of injection-drug users, it is essential to expand these centers at both the national and regional levels quantitatively and qualitatively and encourage drug-users to refer to them and seek help. This will help greatly in the prevention of HIV.

  Background and Aim: probably after pestilence, HIV/AIDS is most important and severe health threat for public health. Prisons could facilitate the spread of HIV/AIDS and Hepatitis and transmit it to societies. The main strategy to control HIV/AIDS and hepatitis among Injecting Drug Users is Harm Reduction Programs. These programs are conducted in Iran Prisons. The goal of this study is to evaluate Harm reduction Programs including Methadone Maintenance Therapy (MMT) and Needle exchange from the viewpoint of prison staff in Iran including principals, managers, physicians and counselors.

  Materials and Methods : It was a cross sectional study in which 370 prison staff working in prisons all around the country were evaluated to assess their viewpoint and insight about Harm reduction Programs including Methadone Maintenance therapy and Needle exchange.

  Results: A percentage of 95.23 of prison managers and experts had a positive view toward Methadone Maintenance therapy. 70.25 percent had a positive insight toward needle exchange program. The employment type and work experience was significantly (p<0.05) related to the viewpoint of managers and experts towards Methadone Maintenance therapy program. Age was the only factor that had a significant relationship (p<0.05) with Needle exchange program.

  Conclusion: MMT has lots of supporters in prisons. The positive insights of managers and experts towards methadone maintenance therapy program demonstrate the high level of staff’s approval for conducting this program it could be interpreted as a sign of success of program in the country. However there is not a comprehensive approval and collaboration with needle exchange program in prisons. Nevertheless, it is alarming that 42.5% of staff believe that conducting methadone maintenance therapy may increase and intensify addiction in prisons.