Theme: Epidemiology & Public Health Research Year: 2024
Background: The prevalence of HIV and related risk behaviors among people who inject drugs (PWID) in Iran is a critical area of concern. This study aimed to measure the prevalence and covariates of HIV-related risk behaviors among PWID in Iran, with a focus on recent behaviors and associated factors.
Methods: A respondent-driven bio-behavioral surveillance survey was conducted among PWID from July 2019 to March 2020 in 11 major cities. The survey assessed PWID’s recent (i.e., last three months) HIV-related risk behaviors using a four-level categorical variable: Only unsafe injection, only unsafe sex, dual HIV risk, and safe injection and sex. Multinomial logistic regression models were utilized to characterize HIV-related risk behaviors, and relative risk ratios (RRR) with 95% confidence intervals (CI) were reported.
Results: The analysis included 2562 PWID. The prevalence of dual HIV risk was 1.6%, only unsafe injection was 8.0%, and only unsafe sex was 12.5%. Dual HIV risk was significantly and positively associated with multiple partnerships (RRR = 13.70; 95% CI: 3.60, 52.20). Only unsafe sex was significantly associated with multiple partnerships (RRR = 6.36; 95% CI: 4.15, 9.74), receiving free needles (RRR = 2.08; 95% CI: 1.18, 3.67), and self-perceived risk for HIV (RRR = 2.59; 95% CI: 1.55, 4.32).
Conclusion: While the low prevalence of dual HIV risk among PWID is encouraging, the prevalence of unsafe sex is concerning. This highlights the need for expanding sexual health education and care services, as well as tailored interventions aimed at reducing high-risk sexual activities among PWID.