Social determinants associated with risky sexual behaviors among men who inject drugs in Kermanshah, Western Iran

Sexual Behaviors in Iranian Working Children and the Correlated Risk Factors: Result of the Large-Scale Rapid Assessment and Response (RAR) Survey

This study aimed to investigate the sexual behaviors among working children and the associated factors. This cross-sectional study was conducted on a sample of 1937 working children in the 10-18 age range in 15 provincial capitals in 2019-20 (Feb-May); the Response rate was 94.9%. Univariate and multivariable logistic regression was used to examine the variable of sexual behaviors. Adjusted odds ratios (AOR) and 95% confidence intervals (CI) are reported. The prevalence of sexual behaviors in working children was 4.2%. The results showed a significant difference between those who reported sexual behaviors and those who did not in terms of age, identity document (ID), running away from home, alcohol use, and substance use. There was a statistically significant relationship between fathers' unemployment and sexual behaviors among working children. Furthermore, we found that having divorced parents could increase the odds of sexual behaviors by 3.74 times. The findings showed that related welfare and support organizations should design and implement effective and continuous training and interventions to raise awareness and reduce the prevalence of high-risk sexual behaviors in working children. They should also provide family counseling and promote parental supervision of children.

Predictors of COVID-19 vaccine uptake among people who use substances: a case study in Tehran

BACKGROUND

Vaccination is one of the most effective ways to manage infectious disease epidemics such as Covid-19. However, the low rates of vaccination in populations at risk including people using illicit substances, hinders the effectiveness of preventive vaccines in reducing transmission. The aim of this study was to investigate the rate of Covid-19 vaccination and its related factors among people who use substances in Tehran, Iran.

METHODS

Between July and December 2022, 386 people who use substances aged ≥ 18 years old were recruited by convenience street-based sampling in Tehran. The outcome variable in this study was self-reported completion of at least two doses of the Covid-19 vaccine. Logistic regression was used to investigate the factors related to Covid-19 vaccination. Data were analyzed using SPSS software version 20 at the 0.05 level of significance. As a measure of risk, 95% Confidence interval (CI) was used. The level of significance was considered at 0.05.

RESULTS

Almost three-quarters (n = 286) of the participants reported receiving at least two doses of the Covid-19 vaccine (95% CI, 70.2-79.3). Those participants with high school diplomas were 1.17 times more likely than less educated participants to report having had 2 vaccinations (OR of 1.17, CI 95%: 1.03-1.81). Participants with a higher mean score of having a positive attitude towards Covid-19 vaccination were more likely to have received a vaccination (OR of 1.12, CI 95%: 1.08-1.17). Ethnicity was also an influential variable, people with non-Fars ethnicity were less likely to be vaccinated than those of Fars ethnicity (OR of 0.33, CI 95%: 0.13-0.81). People with higher-than-average monthly income were more likely to report vaccination than those with low monthly incomes (OR of 1.27, CI 95%: 1.09-1.8). Also, participants reporting less access to vaccination centers had a lower chance of reporting having been vaccinated than those who reported high access to vaccination centers (OR of .17, CI 95%: .08-.36).

CONCLUSIONS

Covid-19 vaccine uptake was found to be relatively high among people using illicit substances in this study. Higher levels of education, Fars ethnicity, higher income levels, having a positive attitude towards vaccination and access to vaccination centers were the most important predictors of Covid-19 vaccination in this study.

Exploring the determinants of health service utilization among people living with HIV: a qualitative study in Iran

BACKGROUND

Health service utilization among people living with HIV is vital for their survival and quality of life. This study aims to exploring the determinants influencing health service utilization among people living with HIV.

METHODS

We conducted a qualitative study involving 16 men and women aged 18-64 living with HIV in Tehran. Data were collected between September and December 2021 through semi-structured interviews conducted via telephone and online platforms, utilizing the purposeful sampling method. Data were analyzed by MAXQDA-2018 software using conventional content analysis approaches and the Granheim and Landman method.

RESULTS

Two main themes, seven categories, and 21 subcategories were obtained from the interviews. The main themes included facilitators of health service utilization (positive personality traits, social factors, and structural-behavioral determinants) and inhibitors of health service utilization (personal conditions, insufficient knowledge and understanding of the disease, negative consequences of disease disclosure, and difficult access to services).

CONCLUSION

This study underscores the need to invest and expand specialized services for people living with HIV by policy makers, while simultaneously increasing public awareness to reduce the social stigma.

Understanding the epidemiological HIV risk factors and underlying risk context for youth residing in or originating from the Middle East and North Africa (MENA) region: A scoping review of the literature

Introduction

HIV is the second leading cause of death among young people globally, and adolescents are the only group where HIV mortality is not declining. Middle East and North Africa (MENA) is one of few regions seeing rapid increase of HIV infections (31.0%) since 2001. MENA youth are at particular risk of HIV due to dearth of research and challenges in accessing services.

Objective

The purpose of this scoping review is to establish the epidemiological HIV risk factors and underlying risk context for youth residing in or originating from the MENA region.

Methods

Online database searches were conducted using combination of search terms. Screening 5,853 citations, published between 1990–2019 with age groups 16 to 29, resulted in 57 studies included across 18 MENA countries.

Results

‘Key populations’ engage in risky behaviors, including: overlapping risky behaviors among youth who inject drugs (PWID); lack of access to HIV testing, condomless sex, and multiple sex partners among young men who have sex with men (MSM); and high and overlapping risk behaviors among young sex workers. Challenges facing other youth groups and bridging populations include: peer pressure, inhibition about discussing sexual health, lack of credible sex education sources, low condom use, and lack of access to HIV protection/prevention services, especially testing.

Conclusion

Poor surveillance coupled with scarcity of rigorous studies limit what is known about epidemiology of HIV among youth in MENA. Homophobia, stigma around PWID, and illegal status of sex work promote non-disclosure of risk behaviors among youth and curtail serving this population.

Alcohol consumption in Iran: A systematic review and meta-analysis of the literature

ISSUES

Alcohol production, marketing and consumption are illegal in Iran. This systematic review examines the lifetime and last 12-month prevalence of alcohol consumption among the general and young population in Iran.

APPROACH

We searched Web of Science, PubMed, Embase, Scopus and Iranian scientific databases (i.e. Scientific Information Database and Magiran) for relevant publications in English and Persian from inception to 12 May 2019. Following a random-effects meta-analysis, we estimated the pooled prevalence of alcohol consumption among the general population and young people (<30 years old). Meta-regression was used to identify potential sources of heterogeneity.

KEY FINDINGS

Of the 2400 identified records, 62 met the inclusion criteria. The overall pooled prevalence of lifetime alcohol consumption among the general population and young people was 13.0% [95% confidence intervals (CI) 10.0, 16.0]. The overall pooled prevalence of last 12-month alcohol consumption was 12.0% (95% CI 7.0, 18.0) for the general population and 15.0% (95% CI 9.0, 22.0) for young people. The prevalence of alcohol consumption varied from 0.03% to 68.0% in different regions, 0.3% to 66.6% among males and 0.2% to 21.0% among females.

IMPLICATIONS

Our findings highlight the need for public health surveillance of alcohol use in Iran.

CONCLUSION

These estimates show that, on average, one in eight people in the general population have ever consumed alcohol in Iran, indicating that alcohol consumption is not an uncommon practice in the country.