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Khodayari-Zarnaq R, Ravaghi H, Mosaddegh-Rad AM, Jalilian H, Bazyar M. HIV/AIDS policy-making in Iran: A stakeholder analysis. Int J Health Plann Manage 2021; 36:2351-2365. [PMID: 34455639 DOI: 10.1002/hpm.3313] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 05/03/2021] [Accepted: 08/15/2021] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION The present study aims to identify and analyze HIV/AIDS stakeholders in Iran. METHODS This qualitative stakeholder analysis was conducted in 2018 nationwide, both retrospectively and prospectively. Purposive sampling was applied and followed by snowball sampling until data saturation. Data were analyzed using framework analysis. Also, MAXQDA (Version 11) and Policy Maker software (version 4) was applied. FINDINGS A total of 44 stakeholders were identified and categorized into 23 active and 21 inactive stakeholders. The Ministry of Education and Iran Broadcasting have moderate participation in this regard. Supreme Council of Health and NGOs have low participation. The Ministry of Health (MoH), State Welfare Organization, Blood Transfusion Organization, and the State Prisons are interested in HIV/AIDS policymaking. The MoH is the main body responsible for the stewardship of HIV/AIDS in Iran but does not have enough authority to handle the issue. CONCLUSION Considering multidimensional nature of HIV/AIDS, there are many stakeholders regarding HIV/AIDS control. The process of HIV/AIDS -policy making is fragmented in Iran. Despite multiple active and potential stakeholders in this field, there is no integrated system to involve all stakeholders in the process of HIV/AIDS policy-making. Therefore, given the importance of the issue, an upstream entity is needed to coordinate and mobilize all stakeholders associated with managing and controlling HIV/AIDS.
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Affiliation(s)
- Rahim Khodayari-Zarnaq
- Department of Health Policy and Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran.,Tabriz Health Services Management Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hamid Ravaghi
- Department of Universal Health Coverage/Health Systems (UHS), World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Ali Mohammad Mosaddegh-Rad
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Habib Jalilian
- Department of Health Services Management, School of Public Health, Ahvaz University of Medical Sciences, Ahvaz, Iran
| | - Mohammad Bazyar
- Department of Public Health, School of Public Health, Ilam University of Medical Sciences, Ilam, Iran
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Majzoobi MM, Sobhan MR, Zamani M, Moradi A, Khosravi S, Saadatmand A. The Prevalence of Human Immunodeficiency Virus Infection in Patients with Sexually Transmitted Diseases. Adv Biomed Res 2020; 9:11. [PMID: 32318360 PMCID: PMC7147514 DOI: 10.4103/abr.abr_233_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 01/08/2020] [Accepted: 01/28/2020] [Indexed: 11/05/2022] Open
Abstract
Background: Human immunodeficiency virus (HIV) transmission pattern in Iran has been changed from injection drug to sexual contact. Lack of accurate assessment of HIV in people with sexually transmitted diseases (STDs) in Iran prompted us to conduct this study to determine the frequency of HIV infection in these patients. Materials and Methods: In this cross-sectional study which conducted in 2016–2017, overall, 190 patients with STDs referring to two hospitals of Hamadan were enrolled in the study. All of the patients were examined for HIV in the first visit by rapid test and then 1 and 4 months later by the 4th generation ELISA. A questionnaire including demographic data, clinical manifestations, and high-risk behaviors was completed for all of the referring people. The collected data were analyzed using appropriate statistical tests. Results: Of 190 patients, 126 (66.3%) were female with a mean age of 34.1 ± 10.1 years and 64 (33.7%) were male with a mean age of 30.8 ± 7.8 years. One hundred twenty-eight (67.4%) got married, 73 (38.4%) and 76 (40%) had a diploma and postgraduate education, respectively, 32 (16.8%) mentioned the history of unsafe sex, and 23 (12.1%) had used condoms continuously during sexual contacts. The most common STDs were reported genital warts, 107 patients (56.3%), vaginal discharge (28, 14.7%), and genital ulcer (33, 17.4%). Two (1%) patients were positive for HIV at the first visit. Conclusion: Patients with STDs should be considered as an important source of HIV transmission, so clinicians should pay more attention to screening these patients for HIV infection.
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Affiliation(s)
- Mohammad Mahdi Majzoobi
- Department of Infectious Diseases, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.,Brucellosis Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mohammad Reza Sobhan
- Psoriasis Research Center, Hamadan University of Medical Sciences, Hamadan, Iran.,Department of Dermatology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mehrangiz Zamani
- Department of Obstetrics and Gynecology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Abbas Moradi
- Department of Community Medicine, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Sahar Khosravi
- Department of Infectious Diseases, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ali Saadatmand
- Brucellosis Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
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5
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Danaei G, Farzadfar F, Kelishadi R, Rashidian A, Rouhani OM, Ahmadnia S, Ahmadvand A, Arabi M, Ardalan A, Arhami M, Azizi MH, Bahadori M, Baumgartner J, Beheshtian A, Djalalinia S, Doshmangir L, Haghdoost AA, Haghshenas R, Hosseinpoor AR, Islami F, Kamangar F, Khalili D, Madani K, Masoumi-Asl H, Mazyaki A, Mirchi A, Moradi E, Nayernouri T, Niemeier D, Omidvari AH, Peykari N, Pishgar F, Qorbani M, Rahimi K, Rahimi-Movaghar A, Tehrani FR, Rezaei N, Shahraz S, Takian A, Tootee A, Ezzati M, Jamshidi HR, Larijani B, Majdzadeh R, Malekzadeh R. Iran in transition. Lancet 2019; 393:1984-2005. [PMID: 31043324 DOI: 10.1016/s0140-6736(18)33197-0] [Citation(s) in RCA: 101] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Revised: 11/20/2018] [Accepted: 12/06/2018] [Indexed: 01/19/2023]
Abstract
Being the second-largest country in the Middle East, Iran has a long history of civilisation during which several dynasties have been overthrown and established and health-related structures have been reorganised. Iran has had the replacement of traditional practices with modern medical treatments, emergence of multiple pioneer scientists and physicians with great contributions to the advancement of science, environmental and ecological changes in addition to large-scale natural disasters, epidemics of multiple communicable diseases, and the shift towards non-communicable diseases in recent decades. Given the lessons learnt from political instabilities in the past centuries and the approaches undertaken to overcome health challenges at the time, Iran has emerged as it is today. Iran is now a country with a population exceeding 80 million, mainly inhabiting urban regions, and has an increasing burden of non-communicable diseases, including cardiovascular diseases, hypertension, diabetes, malignancies, mental disorders, substance abuse, and road injuries.
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Affiliation(s)
- Goodarz Danaei
- Department of Global Health and Population and Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, MA, USA; Scientific Association for Public Health in Iran, Boston, MA, USA
| | - Farshad Farzadfar
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran; Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Kelishadi
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Arash Rashidian
- Endocrinology and Metabolism Clinical Sciences Institute, Department of Health Management and Economics, Tehran University of Medical Sciences, Tehran, Iran; Department of Information, Evidence and Research, Eastern Mediterranean Regional Office, World Health Organization, Cairo, Egypt
| | - Omid M Rouhani
- Department of Civil Engineering and Applied Mechanics, McGill University, Montreal, QC, Canada
| | - Shirin Ahmadnia
- Faculty of Social Sciences, Allameh Tabataba'i University, Tehran, Iran
| | - Alireza Ahmadvand
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mandana Arabi
- Scientific Association for Public Health in Iran, Boston, MA, USA; Global Alliance for Improving Nutrition, New York, NY, USA
| | - Ali Ardalan
- School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; Harvard Humanitarian Initiative, Cambridge, MA, USA
| | - Mohammad Arhami
- Department of Civil Engineering, Sharif University of Technology, Tehran, Iran
| | | | - Moslem Bahadori
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Jill Baumgartner
- Institute for Health and Social Policy, Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
| | - Arash Beheshtian
- Cornell Program in Infrastructure Policy, Cornell University, Ithaca, NY, USA
| | - Shirin Djalalinia
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran; Deputy of Research and Technology, Tehran, Iran
| | - Leila Doshmangir
- Health Services Management Research Center, Iranian Center of Excellence in Health Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ali Akbar Haghdoost
- Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Rosa Haghshenas
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Reza Hosseinpoor
- Department of Information, Evidence and Research, World Health Organization, Geneva, Switzerland
| | - Farhad Islami
- Surveillance and Health Services Research, American Cancer Society, Atlanta, GA, USA
| | - Farin Kamangar
- Scientific Association for Public Health in Iran, Boston, MA, USA; Department of Biology, School of Computer, Mathematical, and Natural Sciences, Morgan State University, Baltimore, MD, USA
| | - Davood Khalili
- Scientific Association for Public Health in Iran, Boston, MA, USA; Prevention of Metabolic Disorders Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Kaveh Madani
- Department of Physical Geography, Stockholm University, Stockholm, Sweden; Centre for Environmental Policy, Imperial College London, London, UK
| | - Hossein Masoumi-Asl
- Center for Communicable Diseases Control, Tehran, Iran; Research Center of Pediatric Infectious Diseases, Institute of Immunology and Infectious diseases, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Mazyaki
- Department of Economics, Allameh Tabataba'i University, Tehran, Iran; Institute for Management and Planning Studies, Tehran, Iran
| | - Ali Mirchi
- Department of Biosystems and Agricultural Engineering, Oklahoma State University, Stillwater, OK, USA
| | - Ehsan Moradi
- Department of Civil Engineering and Applied Mechanics, McGill University, Montreal, QC, Canada
| | - Touraj Nayernouri
- Department of Neuroscience, School of Advanced Medical Technologies, Tehran University of Medical Sciences, Tehran, Iran
| | - Debbie Niemeier
- Department of Civil and Environmental Engineering, University of California, Berkeley, CA, USA
| | - Amir-Houshang Omidvari
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Niloofar Peykari
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran; Ministry of Health and Medical Education, Tehran, Iran
| | - Farhad Pishgar
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Qorbani
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Kazem Rahimi
- Scientific Association for Public Health in Iran, Boston, MA, USA; The George Institute for Global Health, University of Oxford, Oxford, UK
| | - Afarin Rahimi-Movaghar
- Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran
| | - Fahimeh Ramezani Tehrani
- Reproductive Endocrinology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nazila Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeid Shahraz
- Scientific Association for Public Health in Iran, Boston, MA, USA; Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA
| | - Amirhossein Takian
- Department of Global Health and Public Policy, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Tootee
- Diabetes Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Majid Ezzati
- MRC-PHE Centre for Environment and Health, Imperial College London, London, UK
| | - Hamid Reza Jamshidi
- Research Institute for Endocrine Sciences, School of Medicine, Department of Pharmacology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Reza Majdzadeh
- Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran; Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran; Community Based Participatory Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Malekzadeh
- Digestive Disease Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran; Non-Communicable Disease Research Center, Shiraz University of Medical Science, Shiraz, Iran
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Karamouzian M, Sadeghirad B, Sharifi H, Sedaghat A, Haghdoost AA, Mirzazadeh A. Consistent Condom Use with Paying and Nonpaying Partners among Female Sex Workers in Iran: Findings of a National Biobehavioral Survey. J Int Assoc Provid AIDS Care 2017; 16:572-578. [PMID: 28974161 DOI: 10.1177/2325957417732834] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES Little is known about the dynamics of condom use among female sex workers (FSWs) in Iran. We investigated the correlates of consistent condom use (CCU) among FSWs, using data from a national biobehavioral surveillance survey in 2010. METHODS A total of 872 FSWs were recruited using a facility-based sampling strategy from 21 sites in 13 cities in Iran. Data were collected through face-to-face interviews using a standardized questionnaire. RESULTS Overall, 33.6% and 17.3% of FSWs reported CCU with paying and nonpaying sex partners, respectively. Consistent condom use with paying partners was significantly associated with temporary marriage, accessing family planning services and history of working in brothels. Conversely, temporary marriage or married status, condom rupture/slippage, and HIV seropositivity remained independently significantly associated with CCU with nonpaying sex partners. CONCLUSION Our findings indicated the urgent need for scaling up condom promotion interventions catered toward FSWs and their sex partners to practice safe sex consistently.
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Affiliation(s)
- Mohammad Karamouzian
- 1 HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.,2 School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Behnam Sadeghirad
- 3 Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.,4 Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Hamid Sharifi
- 1 HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Abbas Sedaghat
- 5 Center for Disease Control (CDC), Ministry of Health and Medical Education, Tehran, Iran
| | - Ali Akbar Haghdoost
- 6 Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Ali Mirzazadeh
- 1 HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.,7 Department of Epidemiology and Biostatistics, Institute for Global Health Sciences, University of California San Francisco, San Francisco, CA, USA
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