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.

Introduction: Development of effective antiretroviral therapies (ART) has reduced mortality and increased life expectancy among individuals with HIV infection. Antiretroviral therapy regiments have improved symptoms and quality of life among these patients, whose sexual and reproductive needs, have, therefore, increased as well. In 2010, 20.8% of HIV-infected Iranians acquired the disease through sexual relations. The objective of this study was to define high-risk sexual behaviors among individuals infected with HIV referred to the Triangular Clinics of Universities of Medical Sciences in Tehran.

Materials and Methods: This cross-sectional interview-based survey included 400 HIV-positive individuals selected by consequential sampling.

Results: The majority (60%) of the subjects was males, and 44.2% of men and 51.3% of women with HIV were in the age group 34-25 years. On the whole, 15.6% of the women and 49.6% of the men had high-risk sexual behaviors after diagnosis of HIV infection. Further analysis of the data showed that 62.5%  of HIV-positive individuals were not aware of the risks of unsafe sexual relationship (using no condom) for HIV-positive transmission.. Based on the logistic regression module, it was found that factors strongly associated with high-risk sexual behavior were being male, being single, under high school diploma/graduate degree, alcohol intake and use of hormonal and permanent methods of family planning  (p<0.05).

Conclusion: The findings of this study confirm previous reports showing common high-risk sexual behaviour after diagnosis in HIV-positive populations. Providing suitable health services and advice on fertility and sexual health will result in no- or low-risk sexual life for couples.

  Background and aim: In Iran, HIV prevalence in sex workers is reaching to an epidemic, but still consistent use of condoms is low. This qualitative study aimed to assess barriers to condom use in female sex workers (FSWs).

  Materials and Methods: We conducted individual in-depth interviews with 40 FSWs and 12 partners in the year 2010 in Tehran. The FSWs were purposefully selected from four different groups based on the level of socioeconomic status and history of using substance. Findings were extracted and coded manually and the responses of the groups were categorized and compared.

  Results: Almost all FSWs had not used condoms regularly in the past six months. The main barriers of condom use were: lack of awareness of the modes of transmission of HIV and prognosis of the disease, doubt on the role of condoms in preventing sexually transmitted diseases and HIV, fear of violence or rejection by male customers, reluctance of sexual partners to use condoms due to diminution of sexual pleasure, and believing in health of some customers.

  Conclusions: Increasing awareness of the FSWs through education about HIV, ways to prevent the disease and empowering them on negotiating skills to use condoms as part of harm reduction programs are recommended .