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Zareie B, Rasouli MA, Gouya MM, Akbarpour S, Hadavandsiri F, Rezaei E, Moradi Y, Soltani A, Moradi G. Drug use patterns and related factors among female sex workers in Iran in 2019-2020: results from Integrated Bio-Behavioral Surveillance-III (IBBS-III). Arch Public Health 2023; 81:120. [PMID: 37391840 DOI: 10.1186/s13690-023-01143-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 06/23/2023] [Indexed: 07/02/2023] Open
Abstract
INTRODUCTION Drug use is highly prevalent among female sex workers (FSWs). Some forms of drug use, such as injecting drug users (IDU), put them at greater risks for HIV and blood born disease (BBD). In this study, the pattern of drug use and its related factors among Iranian FSWs were investigated. MATERIALS AND METHODS This cross-sectional study was performed based on the data of the integrated bio-behavioral surveillance-III (IBBS-III) on FSWs in 8 cities of Iran using the respondent-driven sampling (RDS) method conducting in 2019-2020. Of the 1515 FSWs participating in the IBBS-III study, 1,480 answered questions about drug use. To calculate the prevalence of drug use lifetime and in the past month, weighted analysis was used. Univariate and multivariate logistic regression was used to investigate the factors related to drug use. RESULTS The prevalence of lifetime drug use and the prevalence of current drug use (single and poly drug use) among FSWs were estimated to be 29.3% and 18.86%, respectively. According to multivariate regression analysis, the odds ratio (odds) of lifetime drug use showed a statistically significant association with lower education (AOR = 1.18; 95% CI: 1.07-1.3), being a direct sex worker (AOR = 1.77; 95% CI: 1.21-2.61), working in team houses or hangouts (AOR = 1.51; 95% CI: 1.10-2.06), a history of intentional abortion (AOR = 1.41; 95% CI: 1.07-1.87), condom use in the last sex (AOR = 1.61; 95% CI: 1.19-2.17), a history of imprisonment (AOR = 3.05; 95% CI: 2.25-4.14), HIV positive tests (AOR = 8.24; 95% CI: 1.66-40.9), alcohol use (AOR = 1.69; 95% CI: 1.29-2.29), and finding sexual clients in places such as parties, shopping malls, streets, and hotels, or by friends (AOR = 1.46; 95% CI: 1.01-2.12). CONCLUSION Given that drug use among FSWs is about 14 times higher than that of the Iranian general population, it is imperative that drug reduction programs be integrated into service packages. Specifically, prevention programs should be prioritized for occasional drug users within this population as they are at a greater risk of developing drug use issues compared to the general population.
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Affiliation(s)
- Bushra Zareie
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mohammad Aziz Rasouli
- Clinical Research Development Unit, Kowsar Hospital, Kurdistan University of Medical Sciences, Sanandaj, Iran
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Mohammad Mehdi Gouya
- Iranian Center for Communicable Diseases Control, Ministry of Health and Medical Education, Tehran, Iran
| | - Samaneh Akbarpour
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Hadavandsiri
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Elham Rezaei
- HIV/ STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Kerman University of Medical Sviences, Kerman, Iran
| | - Yousef Moradi
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Ali Soltani
- Department of Restorative Dentistry, Faculty of Dentistry, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Ghobad Moradi
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.
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Mozafari M, Mayer KH. Social change and HIV in Iran: reaching hidden populations. Lancet HIV 2018; 4:e282-e283. [PMID: 28668183 DOI: 10.1016/s2352-3018(17)30113-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2017] [Accepted: 06/13/2017] [Indexed: 10/19/2022]
Affiliation(s)
- Masoud Mozafari
- Cellular and Molecular Research Center, Iran University of Medical Sciences, Tehran, Iran; Department of Tissue Engineering & Regenerative Medicine, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, Iran; Nanotechnology and Advanced Materials Department, Materials and Energy Research Center, Tehran, Iran.
| | - Kenneth H Mayer
- Department of Global Health and Population, Harvard School of Public Health, Boston, MA, USA; The Fenway Institute, Fenway Health, Boston, MA, USA; Department of Medicine, Harvard Medical School, Boston, MA, USA
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Estimating the Population Size of Female Sex Worker Population in Tehran, Iran: Application of Direct Capture-Recapture Method. AIDS Behav 2017. [PMID: 28623569 DOI: 10.1007/s10461-017-1803-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
There is no reliable estimate of the size of female sex workers (FSWs). This study aimed to estimate the size of FSWs in south of Tehran, Iran in 2016 using direct capture-recapture method. In the capture phase, the hangouts of FSWs were mapped as their meeting places. FSWs who agreed to participate in the study tagged with a T-shirt. The recapture phase was implemented at the same places tagging FSWs with a blue bracelet. The total estimated size of FSWs was 690 (95% CI 633, 747). About 89.43% of FSWs experienced sexual intercourse prior to age 20. The prevalence of human immunodeficiency virus infection among FSWs was 4.60%. The estimated population size of FSWs was much more than our expectation. This issue must be the focus of special attention for planning prevention strategies. However, alternative estimates require to estimating the number FSWs, reliably.
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Ahmadi K, Javadinia SA, Saadat SH, Ramezani MA, Sedghijalal H. Triangular relationship among risky sexual behavior, addiction, and aggression: A systematic review. Electron Physician 2017; 9:5129-5137. [PMID: 28979752 PMCID: PMC5614302 DOI: 10.19082/5129] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 04/28/2017] [Indexed: 12/14/2022] Open
Abstract
Background Risky sexual behavior (RSB), addiction, and aggression are three important personal and social factors which influence each other. Objective To overview the potential relationship among RSB, addiction, and aggression to conduct an interactive model for the pathology and management of human behavior. Methods This review article was carried out by searching studies in PubMed, Medline, Web of Science, Ebsco, IEEE, Scopus, Springer, MagIran, and IranMedex databases from the year 1993 to 2013. The search terms were violence, aggression, drug abuse, substance abuse, illicit drug, psychoactive drug, intravenous drug users, addiction and high-risk sexual relationships, unprotected sex, high risk sexual behavior, and sexual risk-taking. In this study, forty-nine studies were accepted for further screening, and met all our inclusion criteria (in English or Persian, full text, and included the search terms). Results Forty-nine articles were included; 17 out of 26 studies showed a significant correlation between addiction and risky sexual behavior, 15 out of 19 articles indicated a statistically significant correlation between aggression and addiction, and 9 out of 10 articles reported significant correlation between aggression and risky sexual behavior. Conclusion According to the results, the triangle hypothesis of sex, addiction, and aggression led to the definition of the relationship among the variables of the hypothetical triangle based on the reviewed studies; and the proposed dual and triple relationship based on the conducted literature review was confirmed. This is not a meta-analysis, and there is no analysis of publication bias.
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Affiliation(s)
- Khodabakhsh Ahmadi
- Ph.D. in Counseling Psychology, Associate Professor, Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Seyed Alireza Javadinia
- Resident of Radiation Oncology, Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Hassan Saadat
- M.D., Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mohammad Arash Ramezani
- Ph.D., Associate Professor, Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Homa Sedghijalal
- Ph.D., Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
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Designing a national plan for improving sexual health in Iran: An experience of an Islamic country. Med J Islam Repub Iran 2016; 30:407. [PMID: 27683648 PMCID: PMC5038988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2015] [Accepted: 07/31/2016] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Prevalence of sexual dysfunction varies from 20% to 40% in men and women in different studies in Iran. Despite its high prevalence, it seems that this issue has been neglected, particularly in Islamic countries. The aim of this study was to assess sexual health in Iran. This was a mixed method study. METHODS Data were collected through evaluating country's sexual health programs and literature review. Sexual health status was drafted and formed following a sound analysis by stakeholders. After conducting interviews and focus group discussions, the main points of the meetings, influencing factors of the present status and oncoming strategies were obtained upon experts' opinions. RESULTS Review of general policies and the literature showed that although there is adequate support for improving sexual health status in the country, sexual health status has been decreased in the last decade. Based on Iranian sexual health indicators and experts' opinions, the focus points could be divided into the following groups: Structural and functional -political, legal-behavior, and cultural. CONCLUSION Breaking the taboo of sexual health issues would require attention from the policy makers especially in Islamic nations to facilitate the steps on the road to sexual health. In this regard, clarified vision, strategic goals and interventional policies are proposed. An inter-sectional cooperation is needed to implement interventions to promote sexual health status.
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Shahbazi M, Moazen B, Rezaei F, Shokoohi M, Farnia M, Moradi G, Dolan K. Views of Iranian prison staff towards needle-exchange program in prison. DRUGS-EDUCATION PREVENTION AND POLICY 2016. [DOI: 10.3109/09687637.2016.1149147] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
| | - Babak Moazen
- Institute of Public Health, University of Heidelberg, Heidelberg, Germany,
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran,
| | - Farimah Rezaei
- Shahid Beheshti Hospital, Isfahan University of Medical Sciences, Isfahan, Iran,
| | - Mostafa Shokoohi
- Regional Knowledge Hub, and WHO Collaborating Centre for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran,
- Department of Epidemiology & Biostatistics, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario, Canada,
| | - Marzieh Farnia
- Iran Prisons Organization, Health and Treatment Department, Tehran, Iran,
| | - Ghobad Moradi
- Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran, and
| | - Kate Dolan
- Program of International Research and Training, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
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Alam-mehrjerdi Z, Daneshmand R, Samiei M, Samadi R, Abdollahi M, Dolan K. Women-only drug treatment services and needs in Iran: the first review of current literature. ACTA ACUST UNITED AC 2016; 24:3. [PMID: 26893096 PMCID: PMC4758153 DOI: 10.1186/s40199-016-0141-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Accepted: 02/05/2016] [Indexed: 11/15/2022]
Abstract
Background Iran (Persia) has a women-only drug treatment system. However, literature is not documented. The current study aimed to review the development of women-only drug treatment and harm reduction services (WODTHRS) and the factors associated with treatment entry and outcomes in Iran. The review was based on a comprehensive search for all literature focusing on WODTHRS in Iran. Methods Data were collected by conducting systematic searching of scientific English and Persian databases and grey literature. This was done in line with Cochrane Guideline for conducting systematic reviews. Overall, 19,929 studies were found. But, only 19 original studies were included after excluding non-relevant studies. Results The review findings indicate how WODTHRS have been developed in the past 15 years. The review findings underscore the roles of numerous factors in treatment entry such as the side effects of illicit drug use. In addition, cognitive-behavioral interventions, methadone treatment and some factors outside drug treatment such as family support increase positive treatment outcomes among women. In contrast, financial problems as well as other factors such as insufficient medical, psychiatric and social work services hamper treatment entry and positive treatment outcomes. Conclusions The review results highlight that eliminating barriers to treatment entry and positive treatment outcomes should be addressed. Conducting randomized controlled trials is needed to evaluate the effectiveness of WODTHRS. This issue should address the factors influencing service utilization to incorporate the best practice for women. The evaluation of the long-term efficacy of WODTHRS is a critical research gap which should be addressed in future studies.
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Affiliation(s)
- Zahra Alam-mehrjerdi
- Program of International Research and Training, National Drug and Alcohol Research Centre, Faculty of Public Health and Community Medicine,, University of New South Wales, Sydney, Australia
| | - Reza Daneshmand
- Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
| | - Mercedeh Samiei
- Department of Psychiatry, School of Behavior Sciences, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Roya Samadi
- Psychiatry and Behavioral Sciences Research Center, Department of Psychiatry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Abdollahi
- Department of Toxicology and Pharmacology, Faculty of Pharmacy and Pharmaceutical Sciences Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Kate Dolan
- Program of International Research and Training, National Drug and Alcohol Research Centre, Faculty of Public Health and Community Medicine,, University of New South Wales, Sydney, Australia
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The Effect of Drug Abstinence Program on Memory Functioning of Heroin Addicts. INTERNATIONAL JOURNAL OF TRAVEL MEDICINE AND GLOBAL HEALTH 2015. [DOI: 10.20286/ijtmgh-0303117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Taghizadeh H, Taghizadeh F, Fathi M, Reihani P, Shirdel N, Rezaee SM. Drug Use and High-Risk Sexual Behaviors of Women at a Drop-In Center in Mazandaran Province, Iran, 2014. IRANIAN JOURNAL OF PSYCHIATRY AND BEHAVIORAL SCIENCES 2015; 9:e1047. [PMID: 26288640 PMCID: PMC4539583 DOI: 10.17795/ijpbs1047] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/29/2014] [Revised: 07/15/2014] [Accepted: 11/24/2014] [Indexed: 11/25/2022]
Abstract
BACKGROUND Female drug users are more likely to transmit human immunodeficiency virus (HIV) to their sexual partners. Little is known about HIV, sexually transmitted diseases (STDs), cervicitis, and drug abuse among female sex workers in Iran. OBJECTIVES Therefore, this study was conducted at a drop-in center (DIC) in Iran to investigate the prevalence of HIV associated risk factors, the prevalence of drug use, high-risk sexual behaviors, and the relationship between the associated factors in women. PATIENTS AND METHODS This quantitative cross-sectional study was conducted on 190 female sex workers (SW) in a DIC in Sari, Mazandaran, Northern Iran, in January and February 2014. The study sample was selected through census sampling. In the end, 190 female SWs referring to the DIC participated in our study. There was no limitation in sampling. The self-administered questionnaire was completed via an interview. RESULTS The results showed that 39% of the female SWs were less than 30 years old and 64% had elementary school education. In addition, 59% of the participants took some type of illegal drugs and 1.1% of them were reportedly injecting drug users. Moreover, 43% of them had substance dependent husbands, and 39% were reportedly regular condom users. They had 1 - 10 sexual partners on average per week. The overall prevalence of HIV infection was 4%. A significant relationship was found between the type of drugs used and factors such as having a substance dependent husband, use of condom during the last sexual contact, regular condom use, and the number of sexual acts per week. A significant correlation exists between using psychiatric drugs and factors like regular condom use, education, cervicitis, and the number of sexual conducts per week. CONCLUSIONS Female sex workers often engage in sex for financial reasons and are at high risk of drug abuse, HIV, and cervicitis. In addition, the rate of cervicitis among females with high-risk sexual behavior is considerable in Mazandaran, Iran. Therefore, the state authorities should provide sex workers with health care services and help them acquire a good job to support their life.
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Affiliation(s)
- Hassan Taghizadeh
- Department of Anesthesiology, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | - Fatemeh Taghizadeh
- Psychiatry and Behavioral Science Research Center, Addiction Institute AND Department of Mental Health, Public Health Center, Mazandaran University of Medical Sciences, Sari, IR Iran
| | - Mohammad Fathi
- Department of Anesthesiology, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | - Parisa Reihani
- Department of Psychology, Educational Organization of Mazandaran, Sari, IR Iran
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Drug Use and High-Risk Sexual Behaviors of Women at a Drop-In Center in Mazandaran Province, Iran, 2014. IRANIAN JOURNAL OF PSYCHIATRY AND BEHAVIORAL SCIENCES 2015. [DOI: 10.5812/ijpbs.9(2)2015.1047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Sardashti S, Samaei M, Firouzeh MM, Mirshahvalad SA, Pahlaviani FG, SeyedAlinaghi S. Early initiation of antiretroviral treatment: Challenges in the Middle East and North Africa. World J Virol 2015; 4:134-141. [PMID: 25964878 PMCID: PMC4419117 DOI: 10.5501/wjv.v4.i2.134] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Revised: 01/11/2015] [Accepted: 02/11/2015] [Indexed: 02/05/2023] Open
Abstract
New World Health Organization guidelines recommend the initiation of antiretroviral treatment (ART) for asymptomatic patients with CD4+ T-cell counts of ≤ 500 cells/mm3. Substantial reduction of human immunodeficiency virus (HIV) transmission is addressed as a major public health outcome of this new approach. Middle East and North Africa (MENA), known as the area of controversies in terms of availability of comprehensive data, has shown concentrated epidemics among most of it’s at risk population groups. Serious challenges impede the applicability of new guidelines in the MENA Region. Insufficient resources restrict ART coverage to less than 14%, while only one fourth of the countries had reportable data on patients’ CD4 counts at the time of diagnosis. Clinical guidelines need to be significantly modified to reach practical utility, and surveillance systems have not yet been developed in many countries of MENA. Based on available evidence in several countries people who inject drugs and men who have sex with men are increasingly vulnerable to HIV and viral hepatitis, while their sexual partners - either female sex workers or women in monogamous relationships with high-risk men - are potential bridging populations that are not appropriately addressed by regional programs. Research to monitor the response to ART among the mentioned groups are seriously lacking, while drug resistant HIV strains and limited information on adherence patterns to treatment regimens require urgent recognition by health policymakers. Commitment to defined goals in the fight against HIV, development of innovative methods to improve registration and reporting systems, monitoring and evaluation of current programs followed by cost-effective modifications are proposed as effective steps to be acknowledged by National AIDS Programs of the countries of MENA Region.
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Noori R, Jafari F, Moazen B, Khoddami Vishteh HR, Farhoudian A, Narenjiha H, Rafiey H. Evaluation of anxiety and depression among female spouses of Iranian male drug dependents. INTERNATIONAL JOURNAL OF HIGH RISK BEHAVIORS & ADDICTION 2015; 4:e21624. [PMID: 25861583 PMCID: PMC4386056 DOI: 10.5812/ijhrba.21624] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Revised: 08/24/2014] [Accepted: 10/01/2014] [Indexed: 11/16/2022]
Abstract
BACKGROUND Existing evidences suggest the more vulnerability of spouses of drug dependents, in exposure to mental disorders. OBJECTIVES This study aimed to evaluate the associated parameters of anxiety and depression among female spouses of male drug dependents. PATIENTS AND METHODS With a cross-sectional design in 2010, a total of 237 Iranian women were selected and divided into three groups: 1. non-drug-dependent wives who had non-drug-dependent husbands (Group I), 2. non-drug-dependent wives who had drug-dependent husbands (Group II), and 3. drug-dependent wives who had drug-dependent husbands (Group III). Socio-demographic characteristics were collected by a checklist, and the levels of anxiety and depression were measured through the Hospital Anxiety and Depression Scale (HADS). Linear regression was applied for determination of anxiety and depression predictors. RESULTS Mean age of the participants was about 35 years, and mean duration of marriage was 14 years. Drug dependence of the husband (P = 0.010) and lower monthly income of the family (P = 0.007) predicted the higher level of anxiety among the participants, while older age (P = 0.031), shorter marital duration (P = 0.016), and lower educational level (P = 0.045) in addition to spousal drug dependence (P = 0.023), and lower family income (P = 0.014) were significantly associated with higher levels of depression. CONCLUSIONS Findings of the present study demonstrate that spousal drug dependence and lower monthly income were common predictors of anxiety and depression among spouses of drug dependents in Iran, while older age, shorter marital duration and lower educational level were predictors of depression. However, more research is needed to find casual relationships between spousal drug dependence and mental health in Iran.
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Affiliation(s)
- Roya Noori
- Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, IR Iran
| | - Firoozeh Jafari
- Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, IR Iran
- Corresponding author: Firoozeh Jafari, Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, IR Iran. Tel/Fax: +98-2122180095, E-mail:
| | - Babak Moazen
- Non Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Hamid Reza Khoddami Vishteh
- Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, IR Iran
| | - Ali Farhoudian
- Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, IR Iran
| | - Hooman Narenjiha
- Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, IR Iran
| | - Hassan Rafiey
- Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, IR Iran
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Nedjat S, Moazen B, Rezaei F, Hajizadeh S, Majdzadeh R, Setayesh HR, Mohraz M, Gooya MM. Sexual and reproductive health needs of HIV-positive people in Tehran, Iran: a mixed-method descriptive study. Int J Health Policy Manag 2015; 4:591-8. [PMID: 26340488 DOI: 10.15171/ijhpm.2015.68] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Accepted: 03/14/2015] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND People Living with HIV (PLHIV) are highly stigmatized and consequently hard-to-access by researchers and importantly, public health outreach in Iran, possibly due to the existing socio-cultural situation in this country. The present study aimed to evaluate the sexual and reproductive health needs of PLHIV in Tehran, the capital of Iran. METHODS As a mixed-method descriptive study, this project was conducted in 2012 in Tehran, Iran. In this study, we evaluated and discussed socio-demographic characteristics, family and social support, sexual behaviors, fertility desires and needs, PMTCT services, contraceptive methods, unintended pregnancy and safe abortion, and Pap smear tests among 400 participants referring to the behavioral disorders consulting centers. RESULTS Of the sample 240 (60%) were male and 160 (40%) were female. About 50% of women and 40% of men were 25-34 years old. More than 60% of men and 96% of women were married, while more than 50% of the participants had HIV-positive spouses at the time of study. According to the results, fertility desire was observed among more than 30% of female and 40% of male participants. Results of the in-depth interviews indicate that the participants are not satisfied with most of the existing services offered to address their sexual and reproductive health needs. CONCLUSION Despite the availability of services, most of sexual and reproductive health needs of the PLHIV are overlooked by the health system in Iran. Paying attention to sexual and reproductive health needs of PLHIV in Iran not only protects their right to live long and healthy lives, but also may prevent the transmission of HIV from the patients to others within the community.
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Affiliation(s)
- Saharnaz Nedjat
- School of Public Health and Institute of Public Health Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Babak Moazen
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farimah Rezaei
- Obstetrics and Gynecologist, Shahid Beheshti Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shayesteh Hajizadeh
- Department of Midwifery and Reproductive Health, Nursing and Midwifery School, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Maternal and Child Health, Nursing and Midwifery School, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Majdzadeh
- School of Public Health and Institute of Public Health Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Reza Setayesh
- Regional Support Team for the Middle East and North Africa (RST-MENA), Cairo, Egypt
| | - Minoo Mohraz
- Iranian Research Center for HIV and AIDS, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Mehdi Gooya
- Centre for Infectious Disease Control, Ministry of Health and Medical Education, Tehran, Iran
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HIV infection among female sex workers in concentrated and high prevalence epidemics: why a structural determinants framework is needed. Curr Opin HIV AIDS 2014; 9:174-82. [PMID: 24464089 DOI: 10.1097/coh.0000000000000042] [Citation(s) in RCA: 124] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW This article reviews the current state of the epidemiological literature on female sex work and HIV from the past 18 months. We offer a conceptual framework for structural HIV determinants and sex work that unpacks intersecting structural, interpersonal, and individual biological and behavioural factors. RECENT FINDINGS Our review suggests that despite the heavy HIV burden among female sex workers (FSWs) globally, data on the structural determinants shaping HIV transmission dynamics have only begun to emerge. Emerging research suggests that factors operating at macrostructural (e.g., migration, stigma, criminalized laws), community organization (e.g., empowerment) and work environment levels (e.g., violence, policing, access to condoms HIV testing, HAART) act dynamically with interpersonal (e.g., dyad factors, sexual networks) and individual biological and behavioural factors to confer risks or protections for HIV transmission in female sex work. SUMMARY Future research should be guided by a Structural HIV Determinants Framework to better elucidate the complex and iterative effects of structural determinants with interpersonal and individual biological and behavioural factors on HIV transmission pathways among FSWs, and meet critical gaps in optimal access to HIV prevention, treatment, and care for FSWs globally.
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Assari S, Moghani Lankarani M, Dejman M, Farnia M, Alasvand R, Sehat M, Roshanpazooh M, Tavakoli M, Jafari F, Ahmadi K. Drug Use among Iranian Drivers Involved in Fatal Car Accidents. Front Psychiatry 2014; 5:69. [PMID: 25221521 PMCID: PMC4148638 DOI: 10.3389/fpsyt.2014.00069] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Accepted: 05/31/2014] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Although the problem of substance use among drivers is not limited to certain parts of the world, most epidemiological reports on this topic have been published from industrial world. AIM To investigate pattern of drug use among Iranian drivers who were involved in fatal road accidents. METHODS This study enrolled 51 Iranian adults who were involved in fatal vehicle accidents and were imprisoned thereafter. Data came from a national survey of drug abuse that was done among Iranian prisoners. The survey collected data at the entry to seven prisons in different regions of the country during a 4-month period in 2008. Self-reported lifetime, last year, and last month drug use was measured. Commercial substance screening tests were applied to detect recent substance use (opioids, cannabinoids, methamphetamines, and benzodiazepines). RESULTS The commercial substance screening test showed three distinct patterns of recent illicit drug use: opioids (37.3%), cannabinoids (2.0%), opioids and cannabinoids (13.7%). 29.4% were also positive for benzodiazepines. The substance use screening test detected 23.5% of participants who had used drugs but did not disclose any substance use. CONCLUSION Opioids are the most common illicit drugs being used by Iranian drivers who are involved in fatal car accidents. The high rate of substance use prior to fatal car accidents in Iran advocates for the need for drug use control policies and programs as major strategies for injury prevention in Iran. There is also a need for substance screening among all drivers involved in fatal car accidents in Iran, as more than 20% of users may not disclose substance use.
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Affiliation(s)
- Shervin Assari
- Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USA
- Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI, USA
- Social Determinants of Health Research Centre, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Maryam Moghani Lankarani
- Universal Network for Health Information Dissemination and Exchange (UNHIDE), Tehran, Iran
- Medicine and Health Promotion Institute, Tehran, Iran
| | - Masoumeh Dejman
- Social Determinants of Health Research Centre, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Marzieh Farnia
- Health and Treatment Bureau of Iran Prisons Organization, Tehran, Iran
| | - Ramin Alasvand
- Health and Treatment Bureau of Iran Prisons Organization, Tehran, Iran
| | - Mahmood Sehat
- Universal Network for Health Information Dissemination and Exchange (UNHIDE), Tehran, Iran
- Medicine and Health Promotion Institute, Tehran, Iran
| | - Mohsen Roshanpazooh
- Universal Network for Health Information Dissemination and Exchange (UNHIDE), Tehran, Iran
| | - Mahmood Tavakoli
- Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Firoozeh Jafari
- Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Khodabakhsh Ahmadi
- Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
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16
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Rezazade M, Lashani Z, Ahmadi K. Mental health status among the staff of harm reduction centers. INTERNATIONAL JOURNAL OF HIGH RISK BEHAVIORS & ADDICTION 2014; 3:e12244. [PMID: 24971296 PMCID: PMC4070187 DOI: 10.5812/ijhrba.12244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/19/2013] [Revised: 12/14/2013] [Accepted: 01/27/2014] [Indexed: 11/16/2022]
Abstract
BACKGROUND Creating a supportive environment encourages charity services to help risk groups and individuals which has magnificent impacts on reducing their harm. OBJECTIVES According to this plan, the purpose of this study was to investigate the mental health status in the staff of harm reduction centers. MATERIALS AND METHODS The clustered sample of this comparative study consisted of 49 staff of harm reduction centers. The study was supported by the United Nations Development Program in Tehran, Iran. The participants completed GHQ-28 and DASS-21 questionnaires along with sociologic forms and the results were evaluated by descriptive statistics indexes and independent sample t-test. RESULTS One-hundred percent of the participants in this study showed the symptoms of psychological disorders, and approximately 16 percent suffered from moderate to high degree of anxiety, depression and stress. The level of anxiety (P ˂ 0.04) and stress (P ˂ 0.01) in the younger staff (less than 40 years) was significantly higher than older staff (more than 40 years old). In addition, somatic symptoms (P ˂ 0.05) and social withdrawal (P ˂ 0.01) were significantly higher in women than men. CONCLUSIONS Accordingly, major mental disorders in the staff of harm reduction centers, especially women and younger people need to be considered more than before.
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Affiliation(s)
- Majid Rezazade
- AIDS Prevention and Control Committee, Welfare Organization State, Tehran, IR Iran
- Corresponding author: Majid Rezazade, AIDS Prevention and Control Committee, Welfare Organization State, P.O.Box: 19395‑5487, Tehran, IR Iran. Tel: +98-2155951581, Fax: +98-2151212404, E-mail:
| | - Zeynab Lashani
- Department of Human Sciences, Shahed University, Tehran, IR Iran
| | - Khodabakhsh Ahmadi
- Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
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17
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Assari S, Yarmohamadivasel M, Moghani Lankarani M, Sehat M, Narenjiha H, Rafiey H, Noori R, Shirinbayan P, Ahmadi K. Having Multiple Sexual Partners among Iranian Intra-Venous Drug Users. Front Psychiatry 2014; 5:125. [PMID: 25346698 PMCID: PMC4193211 DOI: 10.3389/fpsyt.2014.00125] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2013] [Accepted: 08/25/2014] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Transmission of HIV from intra-venous drug users (IDUs) to the community occurs predominantly through high-risk sexual behaviors. Limited information exists regarding the high-risk sexual behaviors of IDUs in Iran. AIM The aim of this study was to determine the prevalence and factors associated with having multiple sexual partners among Iranian IDUs. METHODS This is a national survey on drug-dependent adults. Participants were sampled from medical centers, prisons, and streets of capitals of 29 provinces in Iran between May 2007 and February 2008. We analyzed data of 1416 current IDUs. Socio-demographics and drug use characteristics were entered into a binary logistic regression model to determine predictors of having multiple sexual partners. RESULTS Having multiple sexual partners in the past or at the time of survey was reported by 56.4% of Iranian IDUs. Multivariate analysis showed that the likelihood of having multiple sexual partners in IDUs decreased by being married [odds ratio (OR), 0.38; P < 0.001] and increased by female gender (OR, 13.44; P = 0.02), having illegal income (OR, 1.72; P = 0.003), higher monthly family income (OR, 1.01; P = 0.003), pleasure, curiosity, and recreation as cause of first drug use (OR, 1.37; P = 0.04), ruins as usual place for injection (OR, 1.89; P = 0.001) and history of syringe sharing (OR, 1.50; P = 0.02). CONCLUSION Having multiple sexual partners was reported by majority of Iranian IDUs, and this was linked to socio-demographics, initiation data, and other risk behaviors. This information should be considered in prevention efforts to reduce sexual transmission of HIV infection in Iran.
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Affiliation(s)
- Shervin Assari
- Department of Health Behavior and Health Education, University of Michigan School of Public Health , Ann Arbor, MI , USA ; Center for Research on Ethnicity, Culture, and Health, University of Michigan School of Public Health , Ann Arbor, MI , USA ; Department of Psychiatry, University of Michigan School of Medicine , Ann Arbor, MI , USA ; Social Determinant of Health Research Center, University of Social Welfare and Rehabilitation Sciences , Tehran , Iran
| | | | - Maryam Moghani Lankarani
- Universal Network for Health Information Dissemination and Exchange , Tehran , Iran ; Medicine and Health Promotion Institute , Tehran , Iran
| | - Mahmood Sehat
- Universal Network for Health Information Dissemination and Exchange , Tehran , Iran ; Medicine and Health Promotion Institute , Tehran , Iran
| | - Hooman Narenjiha
- Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences , Tehran , Iran ; Center for Behavioral and Social Research, Darius Institute , Tehran , Iran
| | - Hassan Rafiey
- Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences , Tehran , Iran ; Center for Behavioral and Social Research, Darius Institute , Tehran , Iran
| | - Roya Noori
- Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences , Tehran , Iran
| | - Peymaneh Shirinbayan
- Pediatric NeuroRehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences , Tehran , Iran
| | - Khodabakhsh Ahmadi
- Behavioral Sciences Research Center, Baqiyatallah Medical Sciences University , Tehran , Iran
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18
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Assari S, Ahmadi K, Rezazade M. Socio-Economic Status Determines Risk of Receptive Syringe Sharing Behaviors among Iranian Drug Injectors; A National Study. Front Psychiatry 2014; 5:194. [PMID: 25852577 PMCID: PMC4369970 DOI: 10.3389/fpsyt.2014.00194] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Accepted: 12/16/2014] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Although needle and syringe sharing is one of the main routs of transmission of HIV in several countries in the middle east, very little is known about how socio-economic status of injecting drug users (IDUs) is linked to the receptive syringe sharing behaviors in these countries. AIM To study socio-economic correlates of receptive needle and syringe sharing among IDUs in Iran. METHODS The study used data from the Unhide Risk Study, a national survey of IDUs. This study sampled 636 IDUs (91% male) via snowball sampling from eight provinces in Iran in 2009. Socio-demographic and drug use characteristics were collected. We used a logistic regression to determine factors associated with receptive needle and syringe sharing during the past 6 months. RESULTS From 636 IDUs enrolled in this study, 68% (n = 434) reported receptive needle and syringe sharing behaviors in the past 6 months. Odds of receptive needle and syringe sharing in the past 6 months was lower among IDUs who were male [odds ratios (OR) = 0.29, 95% confidence interval (CI) = 0.12-0.70], had higher education (OR = 0.74, 95% CI = 0.64-0.86) but higher among those who were unemployed (OR = 4.05, 95% CI = 1.50-10.94), and were single (OR = 1.47, 95% CI = 1.02-2.11). CONCLUSION This study presented factors associated with risk of receptive needle and syringe sharing among Iranian IDUs. This information may be used for HIV prevention and harm reduction purposes. Socio-economic status of Iranian IDUs may be closely linked to high-risk injecting behaviors among them.
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Affiliation(s)
- Shervin Assari
- Department of Psychiatry, School of Medicine, University of Michigan , Ann Arbor, MI , USA ; Center for Research on Ethnicity, Culture, and Health (CRECH), School of Public Health, University of Michigan , Ann Arbor, MI , USA ; Social Determinants of Health Research Center, University of Social Welfare and Rehabilitation , Tehran , Iran
| | - Khodabakhsh Ahmadi
- Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences , Tehran , Iran
| | - Majid Rezazade
- AIDS Prevention and Control Committee of Welfare Organization State , Tehran , Iran
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19
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Ahmadi K, Saghafi A. Psychosocial Profile of Iranian Adolescents' Internet Addiction. CYBERPSYCHOLOGY BEHAVIOR AND SOCIAL NETWORKING 2013; 16:543-8. [DOI: 10.1089/cyber.2012.0237] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Khodabakhsh Ahmadi
- Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Abolfazl Saghafi
- School of Mathematics, Iran University of Science and Technology, Tehran, Iran
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20
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Assari S, Yarmohmmadi Vasel M, Tavakoli M, Sehat M, Jafari F, Narenjiha H, Rafiey H, Ahmadi K. Inconsistent Condom Use among Iranian Male Drug Injectors. Front Psychiatry 2013; 4:181. [PMID: 24772093 PMCID: PMC3983495 DOI: 10.3389/fpsyt.2013.00181] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2013] [Accepted: 12/13/2013] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES The aim of this study was to determine the prevalence and associated factors of inconsistent condom use among Iranian male injecting drug users (IDUs). MATERIALS AND METHODS Data came from the national Iranian behavioral survey of drug dependence, which sampled 7743 individuals with drug dependence, from medical centers, prisons, and streets in 29 provinces in Iran, in 2007. This study included all individuals who were male, IDUs, and were sexually active (n = 1131). The main outcome was inconsistent condom use which was assessed using a single item. A logistic regression was used to determine the association between socio-economic data, drug use data, and high risk injection behaviors with inconsistent condom use. RESULT 83.3% of sexually active IDUs (n = 965) reported inconsistent condom use. Based on the logistic regression, likelihood of inconsistent condom use was higher among those with a history of syringe sharing [Odds Ratio (OR); 1.63, 95% Confidence Interval (CI); 1.13-2.34], but lower among those with higher education levels (OR; 0.34, 95% CI; 0.14-0.82), those who mostly inject at home (OR; 0.09, 95% CI; 0.02-0.47), and those with a history of treatment (OR; 0.54, 95% CI; 0.31-0.94). CONCLUSION Because of the link between unsafe sex and risky injecting behaviors among Iranian IDUs, combined programs targeting both sexual and injection behavior may be more appropriate than programs that target sexual or injection behavior. The efficacy of combined programs should be, however, compared with traditional programs that only target sexual or injection behavior of IDUs.
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Affiliation(s)
- Shervin Assari
- Department of Health Behavior and Health Education, University of Michigan School of Public Health , Ann Arbor, MI , USA ; Center for Research on Ethnicity, Culture, and Health, University of Michigan School of Public Health , Ann Arbor, MI , USA
| | | | - Mahmood Tavakoli
- Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences , Tehran , Iran
| | - Mahmoud Sehat
- Universal Network for Health Information Dissemination and Exchange , Tehran , Iran ; Medicine and Health Promotion Institute , Tehran , Iran
| | - Firoozeh Jafari
- Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences , Tehran , Iran
| | - Hooman Narenjiha
- Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences , Tehran , Iran ; Center for Behavioral and Social Research, Darius Institute , Tehran , Iran
| | - Hassan Rafiey
- Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences , Tehran , Iran ; Center for Behavioral and Social Research, Darius Institute , Tehran , Iran
| | - Khodabakhsh Ahmadi
- Behavioral Sciences Research Center, Baqiyatallah Medical Sciences University , Tehran , Iran
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