HIV Knowledge, Attitudes, and Practices of Young People in Iran: Findings of a National Population-Based Survey in 2013

Assessment of Knowledge and Attitudes Related to HIV/AIDS Among the Population With Increasing Incidence Rate

Introduction Lack of awareness and negative attitudes toward people living with HIV/AIDS (PLWHA) are key barriers to minimizing the transmission of HIV. Therefore, the present survey-based study aimed to assess the knowledge regarding HIV/AIDS and attitudes toward PLWHA. Methods In the present study, we collected data from 612 Kyrgyz national participants using a self-administered questionnaire. Results Among the participants, 59% (361) were females, and 41% (251) were males. The mean age of the participants was 26.23 (SD = 7.7) years. All participants were aware of HIV/AIDS, and 59.1% (362) agreed to have sufficient information about HIV/AIDS. Overall, the participants displayed a high level of knowledge about HIV/AIDS transmission, and 89.2% (546) of them were aware of sexual transmission of HIV/AIDS. Among the participants, 54% (330) believed that using condoms during sexual intercourse could prevent the transmission of HIV/AIDS. Concerning social attitudes, 17% (104) of the participants agreed that HIV-infected individuals should be isolated from society. Moreover, 39% (238) of them disagreed to work with PLWHA. The results of the study suggest that female participants were more aware of the modes of HIV/AIDS transmission than males. However, misconceptions regarding transmission routes were present in both genders. Conclusion The present study revealed that study participants had correct knowledge about HIV/AIDS transmission modes such as unsafe blood transfusion and injectable drug abuse. However, knowledge about unsafe tattooing and mother-to-baby mode of HIV/AIDS transmission was observed to be lower. Female participants were found to be more aware of HIV/AIDS transmission. There is a need to address the knowledge and awareness gap in the general population of Kyrgyzstan, especially among the male population.

Knowledge and utilization of sexual and reproductive health services among young males in a slum area in Nigeria: A cross-sectional study

Background

Globally, young people are faced with sexual and reproductive health challenges such as unintended pregnancies, sexually transmitted infections and unsafe abortions which result from limited knowledge of sexual and reproductive health and poor utilization of the available services. The purpose of this study was to assess the sexual and reproductive health knowledge, pattern of service utilization, and the associated factors among young males in slum communities of Mushin Local Government Area (L.G.A), Lagos State, Nigeria.

Methods

The study was conducted among young males, 15-24 years in Mushin Local Government Area, Lagos State, Nigeria. Data was collected using a pre-tested structured questionnaire that consisted of three domains with 57 questions, and was interviewer-administered. Multi-stage sampling technique was used to select 422 participants. Descriptive statistics, bivariate analysis, and binary logistic regression were carried out using SPSS version 20.

Results

The mean age of the respondents was 21.01 years ± 2.00, and 73.06% of the respondents had good knowledge of sexual and reproductive health. 52.85% of the respondents had poor knowledge regarding the likely occurrence of pregnancy at mid-menstrual cycle. Nearly two-third (64%) of the respondents have ever visited a health facility for sexual and reproductive health service. Ethnicity(AOR = 2.73), access to the internet(AOR = 1.77) and having ever had sex(AOR = 1.96) were significantly associated with the utilization of the services.

Conclusion

Good knowledge of sexual and reproductive health was observed among the respondents, although misconceptions still exist. Service utilization, however, remains low due to some individual and socio-cultural factors. It is therefore important to increase awareness of Sexual and Reproductive Health, and make the services available and affordable to young people for increased uptake.

Knowledge and practice of high school students regarding HIV/AIDS prevention and transmission: Results from a cross-sectional study in an Iranian less-developed, high-risk region

BACKGROUND

Some residents of the Persian Gulf Coastline (PGC) areas are circular migrants due to geo-commercial issues. They have a higher risk of HIV infection and non-disclosure of their HIV/AIDS status. These people who live with HIV (PLHIV) are considered as the bridge population for HIV transmission to general population, especially adolescents. This study sought to investigate the knowledge and behavior of adolescents regarding HIV/AIDS prevention and transmission in a less-developed, high-risk area located along the PGC.

MATERIALS AND METHODS

In this cross-sectional study, using multistage cluster random sampling, 1450 students were invited to complete a standardized questionnaire previously used in a 2013 Iranian national high-risk behaviors survey. The prevalence of adequate knowledge, condom use, and stigmatization of HIV/AIDS and their 95% confidence intervals (CIs) were estimated. Adjusted odds ratios (ORs) were estimated using ordinal logistic regression.

RESULTS

Totally, 17.09% (CI: 15.0-19.3) of the students had adequate knowledge. Social networks and the internet were the most important sources of information (20.9%, CI: 18.6-23.3). Socioeconomic status (OR: 2.0, 95% CI: 1.7-2.3), gender (0.6, CI: 0.5-0.8), residential area (0.08, CI: 0.05-0.1), and using social networks and the internet as the main sources of information (1.5, CI: 1.1-1.9) were correlated to the level of knowledge. Furthermore, 29.8% (CI: 27.2-32.5) of the students respected the social rights of PLHIV, and 12.6% (CI: 10.7-14.6) reported condom use.

CONCLUSION

HIV/AIDS-related education is needed in the PGC. Such education should be focused on males, students from marginalized areas, and people with lower socioeconomic status. Social networks and the internet may be the most effective way to improve people's knowledge about HIV/AIDS.

Predicting the HIV/AIDS Knowledge among the Adolescent and Young Adult Population in Peru: Application of Quasi-Binomial Logistic Regression and Machine Learning Algorithms

Inadequate knowledge is one of the principal obstacles for preventing HIV/AIDS spread. Worldwide, it is reported that adolescents and young people have a higher vulnerability of being infected. Thus, the need to understand youths' knowledge towards HIV/AIDS becomes crucial. This study aimed to identify the determinants and develop a predictive model to estimate HIV/AIDS knowledge among this target population in Peru. Data from the 2019 DHS Survey were used. The software RStudio and RapidMiner were used for quasi-binomial logistic regression and computational model building, respectively. Five classification algorithms were considered for model development and their performance was assessed using accuracy, sensitivity, specificity, FPR, FNR, Cohen's kappa, F1 score and AUC. The results revealed an association between 14 socio-demographic, economic and health factors and HIV/AIDS knowledge. The accuracy levels were estimated between 59.47 and 64.30%, with the random forest model showing the best performance (64.30%). Additionally, the best classifier showed that the gender of the respondent, area of residence, wealth index, region of residence, interviewee's age, highest educational level, ethnic self-perception, having heard about HIV/AIDS in the past, the performance of an HIV/AIDS screening test and mass media access have a major influence on HIV/AIDS knowledge prediction. The results suggest the usefulness of the associations found and the random forest model as a predictor of knowledge of HIV/AIDS and may aid policy makers to guide and reinforce the planning and implementation of healthcare strategies.

Knowledge, Attitude, and Behavior of Clinical Dental Students in the Oral Care of HIV/AIDS Patients

Introduction In the future, clinical dental students, as health service providers, will play a key role in the oral care of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients. Clinical dental students need to increase their knowledge of HIV because it is vital for the diagnosis and management of HIV/AIDS patients that they have a positive attitude regarding oral care behavior toward HIV/AIDS patients. This study aims to explain the relationship between the knowledge, attitudes, and behavior of clinical dental students in the oral care of HIV/AIDS patients at Airlangga University Dental Hospital.

Materials and Methods This study used a cross-sectional approach with a sample of 132 respondents. The sample was taken by purposive sampling technique. The independent variable in this study was the attitudes and behavior of clinical dental students toward the care of HIV/AIDS patients. The dependent variable in this study was the knowledge and attitudes of clinical dental students toward the oral care of HIV/AIDS patients. The research data obtained were analyzed using Spearman's rho at ≤0.05.

Result There was significant correlation between knowledge and attitudes (p = 0.001, r = 0.596); knowledge and behavior (p = 0.001, r = 0.637); attitudes and behavior (p = 0.001, r = 0.699) of dentistry students in the care of HIV/AIDS patients oral cavity.

Conclusion Clinical dental students' knowledge of HIV/AIDS will influence their attitudes toward HIV/AIDS patients and their behavior in the oral care of HIV/AIDS. It is hoped that future research can be conducted by adding other independent variables to determine a wider range of factors that affect oral care in HIV/AIDS patients.

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.

Social Support Associated with Condom Use Behavior Among Female Sex Workers in Iran

BACKGROUND

Despite the widespread knowledge about social support and health, there is little information about the association between social support and HIV risk behaviors such as condom use among female sex workers (FSWs) in Iran. This study aimed to determine the association between social support and frequency of condom use among FSWs in Tehran, Iran.

METHODS

Using mixed sampling methods, we recruited 170 FSWs in Tehran in 2017. We measured self-reported social support by face-to-face interviews using a standardized questionnaire. Linear regression was used to assess the association between socio-demographic characteristics (age, education level, marital status, and place of living), transactional sex characteristics (age at first transactional sex and frequency of transactional sex in the last month), HIV knowledge, social support network characteristics (social network size, duration of tie, intimacy, social support), and condom use behavior.

RESULTS

Of the total of 1193 persons in FSW's social networks, 615 (51%) were sexual partners, 529 (44%) were peer sex workers, and 36 (5%) were family members. The participants perceived moderate social support from sexual partners, low from peer sex workers, and very low from family members. Adjusted for individual and other network characteristics, peer sex worker social support (b = 0.28, 95%CI 0.06, 0.50), and family support (b = 1.12, 95%CI 0.028, 2.23) were significantly associated with condom use.

CONCLUSION

Family and peer sex worker social support are associated with condom use, but less strongly than HIV knowledge or place of living. However, very few FSWs are socially connected with families. Interventions to promote condom use among this vulnerable population should also consider social and familial support.

Determinants of safe sexual behavior of female sex workers in Tehran: the woman, her network, and the sexual partner

BACKGROUND

Despite the steady growth of sexual transmission of HIV, there is little evidence about safe sexual behavior of FSWs, and social network effects on this behavior, in Iran. Our aim in this study was to determine the effect of social network characteristics on condom use among FSWs, considering individual characteristics of the FSWs and of their sexual partners, characteristics of their relationship, and the FSW's personal network.

METHODS

A cross-sectional ego-centric network survey of 170 FSWs was carried out in Tehran between January and June 2017. A multilevel ordered logistic regression analysis was conducted to examine the effects of individual and relational characteristics simultaneously.

RESULTS

Condom use in sexual relationships of the FSWs on average was rather low. Important determinants of safe sexual behavior were found both at the level of the individual FSW and at the level of the sexual partner. The main determinants at the level of the individual FSW were FSWs' age and HIV knowledge. At the level of the sexual partner, age and education of sexual partners, as well as intimacy, duration of tie, frequency of contacts with a given partner, frequency of contact, perceived social support, and perceived safe sex norms were significantly associated with condom use.

CONCLUSIONS

The findings highlighted that considering only the individual characteristics of female sex workers is not sufficient for effectively promoting condom use. Factors at the network and dyadic level should also be considered, especially the role of sexual partners. Network-based interventions may be useful which modify social relationships to create a social environment that can facilitate changes in sexual behavior.

Prevalence of Sexual Transmitted Infections (STIs) and Un-Protected Sex in Temporary Marriage in Iran: A Systematic Review and Meta-Analysis

Background:

Temporary marriage (TM) is legitimate sexual relations without social, moral approval, which can be a threat to individuals’ health, it is a risk factor for spread of Sexual Transmitted Infections (STIs). Therefore, it is necessary to identify and control STIs in TM-individuals and subsequent save of “society health”. In this meat-analysis, we examined the prevalence of STIs in TM in Iran. We further examined un-protected sex among TM-individuals.

Method:

Up to Feb 2020, we searched international and national electronic databases identify to published studies on the prevalence of STIs in TM. We estimated the prevalence of STIs in TM using a random-effect pooled estimate analysis approach.

Results:

Totally, we retrieved 1616 studies from the previously mentioned databases, of which, 18 met the eligibility criteria, published from 1995 to 2020 in different provinces. The total sample size of the included studied contained 2056 TM-individuals, of which 368 were found with STIs and 955 with unprotected sex. The pooled prevalence of STIs and unprotected sex among TM women was 39% (95%CI: 24% to 54%), 55% (95%CI: 40% to 70%)

Conclusion:

STI and unprotected sex are high among TM-individuals which call an urgent need for community and health care providers to provide especially designed medical and psycho-social supportive care services in a safe and unprejudiced environment for TM-individuals. Furthermore, untrained health care providers for TM-individuals, under reporting, social stigma should be taken in to account. Denying the presence of such realities, does not eradicate the facts but results in catastrophic public health problems.

Spatial pattern and associated factors of HIV testing and counselling among youths (15-24 years) in Ethiopia

BACKGROUND

HIV testing and counseling (HTC) services are key for HIV prevention, treatment, care, and support. Although the prevalence of HIV infection is high among adolescents and young adults, evidence suggests the utilization of HTC service among youth is very low in Ethiopia. Identifying factors and the geographic variation of HTC uptake is important to prioritize and design targeted prevention programs to increase its utilization and reduce HIV infection in hot spot areas.

METHODS

Data from the 2016 Ethiopian Demographic and Health Survey were used to analyze 10,781 youth aged 15-24 years. The spatial analysis was performed in ArcGIS 10.1. The Bernoulli model was used by applying Kulldorff methods using the SaTScan software to analyze the purely spatial clusters of HTC uptake. A multilevel logistic regression analysis was used to identify the associated individual and community-level factors of HTC uptake and estimate between community variance. All models were fitted in Stata version 14.0 and finally, the adjusted odds ratio (AOR) with a corresponding 95% confidence interval (CI) were reported.

RESULTS

In this study, the spatial patterns of HTC uptake were found to be non-random (Global Moran's I = 0.074, p value< 0.001). Forty-seven primary clusters were identified that were located in the entire Somali region with a relative likelihood of 1.50 and the Log-Likelihood Ratio of 135.57. Youth who were ever married (AOR = 4.65; 95% CI; 4.05, 5.34), those attended higher education (AOR = 3.97; 95% CI; 3.10,5.08), those from richest household (AOR = 1.86; 95% CI; 1.44, 2.39), aged 20-24 years (AOR = 2.25; 95% CI; 2.02,2.51), having compressive HIV related knowledge (AOR = 2.05; 95% CI; 1.75,2.41), and exposed to media (AOR = 1.38; 95% CI; 1.22,1.57) were positive association with HTC uptake. However, being male (AOR = 0.81; 95% CI; 0.73,0.91) and having high HIV related stigma (AOR = 0.53; 95% CI; 0.42,0.67) were negatively associated with HTC uptake. At the community-level, youth from communities with a high percentage of educated (AOR = 1.45; 95% CI; 1.17,1.80) were more likely to utilize HTC compared with those from communities with low percentages of educated.

CONCLUSION

The current study indicated differences in HTC uptake in the country. Both individual and community-level factors affected HTC uptake in Ethiopia. Multifaceted intervention approaches that consider individual and community factors are required to improve HTC uptake.

Knowledge, attitudes and practices towards people living with HIV/AIDS in Lebanon

Background

Up till today, studies carried in Lebanon have focused more on the prevalence of HIV and behaviors and quality of life of infected individuals, however, none of these studies discussed the degree of stigma towards these populations. Therefore, the aim of this study is to measure the rate of stigma in terms of knowledge, attitude and practice towards patients living with Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS) (PLWHA) and examine the factors associated with this stigma.

Methods

A cross-sectional survey, enrolling 862 participants, was carried across the five governorates in Lebanon: Beirut, Mount Lebanon, North, South and Bekaa. The survey was a self-administered questionnaire which covered information about participants’ general demographics, their knowledge, attitudes, practices and awareness towards HIV/AIDS in Lebanon., attitudes towards PLWHA, practices related to HIV/AIDS and awareness regarding HIV/AIDS situation in Lebanon.

Results

The response rate to the survey was 78.36% (862 participants). Being Muslim (Beta = -2.56) or Druze (Beta = -2.64) compared to Christians were significantly associated with lower knowledge towards HIV/AIDS, whereas having a secondary (Beta = 2.71) and a university (Beta = 3.04) levels of education compared to illiteracy and higher age (Beta = 0.05) were significantly associated with higher knowledge. Higher knowledge (Beta = 0.66) was significantly associated with better attitude, whereas higher age (Beta = -0.14) and being Muslim compared to Christian (Beta = -3.44) were significantly associated with worse attitude. Better attitude (Beta = 0.02) was significantly associated with better practice, whereas females compared to males (Beta = -0.39), having a secondary level of education compared to illiteracy (Beta = -0.88) and being Muslim compared to Christian (Beta = -0.32) were significantly associated with worse practice.

Conclusion

Our results stress the need for educational programs, advocacy campaigns and policies to help reduce HIV stigma. This will then help start developing interventions and strategies for a possible reduction in the stigmatization level.

Predictors of HIV/AIDS comprehensive knowledge and acceptance attitude towards people living with HIV/AIDS among unmarried young females in Uganda: a cross-sectional study

BACKGROUND

Youth in general and young females, in particular, remain at the center of HIV/AIDS epidemic. To avoid and prevent HIV infection, comprehensive knowledge as well as correct understanding of transmission and prevention strategies are crucial. Thus, the aim of this study is to explore the predictors of comprehensive knowledge on HIV/AIDS and accepting attitude towards PLWHIV.

METHODS

A cross-sectional study was conducted using data from the 2016 Uganda Demographic Health Survey. A two-stage probability sampling method was applied and data were collected using a standard questionnaire. Of the total 8674 women aged 15-49 years, 1971 eligible women aged 15-24 years were included in this analysis. Data analysis was done using SPSS version 23. A Chi-square test followed by logistic regression analysis was used to explore the relationship between specific explanatory variables and outcome variables. The results were reported using odds ratios with 95% confidence interval. P value less than 0.05 was considered as statistically significant.

RESULTS

Overall, 99.3% of the unmarried women aged 15-24 years were aware of HIV/AIDS, but only 51.9% had comprehensive knowledge on HIV/AIDS. Around 70% of the respondents were aware that "using condoms every time when having sex" and "having only one faithful uninfected partner" can prevent HIV transmission. About 68% of the unmarried women rejected at least two common local misconceptions about HIV/AIDS. An alarmingly small (20.6%) proportion of the respondents had a positive acceptance attitude towards PLWHIV. All variables were significantly associated with having comprehensive knowledge on HIV/AIDS in the unadjusted logistic regression analysis. After adjustment, older age (20-24 years), being educated, wealthier, and ever been tested for HIV/AIDS became predictors of adequate comprehensive HIV/AIDS knowledge. Moreover, respondents with adequate comprehensive knowledge of HIV/AIDS were more likely (OR 1.64, 95% CI 1.30-2.08) to have a positive acceptance attitude towards PLWHIV than their counterparts.

CONCLUSION

Our study demonstrated a remarkably high level of awareness about HIV/AIDS among study participants, but the knowledge and positive acceptance attitude towards PLWHIV were not encouraging. Thus, endeavors to expand and strengthen educational campaigns on HIV/AIDS in communities, health facilities, and schools are highly recommended. Attention should particularly focus on young-aged and disadvantaged women with low educational level, poor socioeconomic status and those who have never been tested for HIV/AIDS.

Sexual and Reproductive Health Challenges in Temporary Marriage: A Systematic Review

Background: Temporary marriage is a legal form of marriage in Shia Islam allowing a man and a woman to become married in a fixed period of time. This review was conducted to identify the potential effects of temporary marriage on the sexual and reproductive health of women.

Study design: A systematic review

Methods: Electronic databases, including Web of Knowledge, Embase, PubMed, Scopus, ScienceDirect, PsycINFO, ProQuest, IranMedex, Scientific Information Database (SID), and Magiran, were searched up to October 2020 to identify the studies carried out on sexual and reproductive health challenges in temporary marriage. All the selected articles were assessed for eligibility according to their titles and abstracts.

Results: During the search on articles published within 1995 to October 2020, 1,802 relevant records were identified, and after evaluation 30 full-text papers were included in the present systematic review. Out of the 34,085 study participants in the selected studies, 3,547 subjects had temporary marriage who were studied under six different categories, namely (1) sexually transmitted infections (STIs)/human immunodeficiency viruses, (2) early child marriage, (3) unplanned pregnancy and induced abortion, (4) violence, (5) psychosocial disorders, and (6) other issues. Individuals with temporary marriage are vulnerable and need to have easy access to health education and sexual and reproductive health services in a safe and unprejudiced environment. Ignoring the aforementioned facts will cause serious public health problems, especially for women from a lower socioeconomic background.

Conclusions: In the current situation with under-reporting of temporary marriage-related events due to social stigma and absence of quality services in sexual and reproductive health, women with temporary marriage are under the additional risk of STIs, unwanted pregnancy, abortion, and violence.

Knowledge, Attitudes, and Practices Among the General Population During COVID-19 Outbreak in Iran: A National Cross-Sectional Online Survey

Background: Emerged in December 2019, coronavirus disease 2019 (COVID-19) is one of the largest pandemics ever. During the early phase, little was known about public knowledge, attitudes, and practices (KAP) relating to coronavirus disease. This study was designed to determine KAP of Iranians toward COVID-19. Methods: A cross-sectional online survey was carried out in Iran from February 25 to April 25 using a self-administered questionnaire on 1,480 people. COVID-19-related KAP questions were adapted from other internationally validated questionnaires specific for infectious diseases. Results: All participants were aware of COVID-19. When asked unprompted, 80% of respondents could correctly cite fever, difficulty in breathing, and cough as signs/symptoms of COVID-19. Most of our sample population knew that staying at home and isolated (95.3%) as well as constant handwashing and using disinfectants (92.5%) could prevent COVID-19. However, there were also widespread misconceptions such as the belief that COVID-19 can be transmitted by wild animals (58%) and by air (48.3%). Unprompted, self-reported actions taken to avoid COVID-19 infection included handwashing with soap and water (95.4%), avoiding crowded places (93%), cleansing hands with other disinfectants (80.), and covering mouth and nose when coughing or sneezing (76.1%). The Internet and social media (94.5%) were the main coronavirus information sources. However, the most trusted information sources on coronavirus were health and medical professionals (79.3%). The majority of participants (77.0%) wanted more information about coronavirus to be available. Conclusion: Our findings suggest that people's knowledge and attitude toward COVID-19 at the time of its outbreak was at a high level.

Social determinants of male partner attendance in women's prevention-of mother-to-child transmission program in Malawi

BACKGROUND

Male partners are rarely present during PMTCT (Prevention-Mother-To-Child-Transmission) services in Sub-Saharan Africa (SSA). Male involvement is increasingly recognised as an important element of women's access to care. This study aims to identify the socio-demographic characteristics, HIV-Knowledge, Attitude and Practice (KAP) among women accompanied and not accompanied by their male partners.

METHODS

We included pregnant women enrolled in PMTCT programme between August 2018 and November 2019 in the Southern Region of Malawi. Eligible women were aged 18 years or older, living with a male partner, enrolled for the first time in one of the four selected facilities. We provided a KAP survey to women and their partners attending the facilities. Our primary objective was to assess and analyse the proportion of women who were accompanied by their partner at least once. We applied descriptive statistics and logistic regressions to study the association between being accompanied and explanatory variables.

RESULTS

We enrolled 128 HIV-positive women: 82 (64.1%) were accompanied by their male partners and 46 (35.9%) were alone. In the multivariable model, women's unemployment and owning a means of transport are negatively associated with male attendance (respectively adjusted OR 0.32 [95% CI, 0.11-0.82] and 0.23 [95% CI, 0.07-0.77]), whereas, in the univariable model, high women's level of knowledge of HIV is positively associated with male attendance (OR 2.17 [95% CI, 1.03-4.58]). Level of attitude and practice toward HIV were not significantly associated to our study variable.

CONCLUSIONS

Our study shows a high male attendance in Malawi compared to other studies performed in SSA. This study highlights that women's level of knowledge on HIV and their economic condition (employment and owning a means of transport) affects male attendance. Moreover, the study points out that gender power relationships and stringent gender norms play a crucial role thus they should be considered to enhance male involvement.

A qualitative examination of men's participation in contraceptive use and its barriers in Tehran

From 1989 to 2014, Iran was known as a country with a successful family planning programme, and has experienced a sharp decline in fertility over recent decades. This led to the introduction of pronatalist policies in 2014 and the restriction of family planning services. The aim of this study was to explore men's views on their access to contraceptive information and services and the socio-cultural barriers to such access in Tehran. The qualitative study was conducted in 2014 using in-depth interviews with 60 married men of varying ages and socioeconomic status from across Tehran. The data were analysed with a basic interpretive approach using MAXQDA10. Although the majority of the men acknowledged the importance of family planning and contraceptive use, they reported that their access to contraceptive information and services was limited. Discussion of sexual matters and contraception among men was identified as being somewhat embarrassing. Three main issues were identified: (1) men's poor awareness of contraceptive use; (2) men's poor access to high-quality health care services; and (3) cultural taboos and gender norms as barriers to contraception use by men. Socio-cultural and gender norms were found to significantly affect the men's contraceptive use. The study results support the growing call for gender-transformative approaches to family planning and reproductive health service delivery in Iran, to involve men and facilitate their greater participation.

HIV knowledge and associated factors among young Ethiopians: application of multilevel order logistic regression using the 2016 EDHS

Background

Human Immunodeficiency virus continues to be a major global health problem infecting 75 million and killing 32 million people since the beginning of the epidemic. It badly hit Sub Saharan Africa than any country in the world and youths are sharing the greatest burden. The study aims to assess the level of HIV-knowledge and its determinants among Ethiopian youths using the 2016 Ethiopia Demographic and Health Survey data.

Methods

A nationally representative 2016 Ethiopian Demographic and Health Survey data were used. A total of 10,903 youths comprising 6401 females and 4502 males were included in the study. Descriptive statistics and multilevel order logistic regression were used and confidence interval was used to declare statistical significance in the final model.

Results

The mean age and SD of youths included in this study was 19.10 (±2.82). Among Ethiopian youths, 20.92% (95% CI: 18.91, 23.09%) had low knowledge of HIV whereas, 48.76% (95% CI: 47.12, 50.41%) and 30.31% (95% CI: 28.51, 32.18%) of them had moderate and comprehensive HIV knowledge respectively. Being male, access to TV and radio, ever tested for HIV/AIDS, owning a mobile telephone, and attending primary school and above compared to non-attendants were associated with having higher HIV knowledge. But, dwelling in rural Ethiopia, being in the Protestant and Muslim religious groups as compared to those of Orthodox followers and being in married groups were associated with having lower HIV knowledge. Approximately, 12% of the variation in knowledge of HIV was due to regions.

Conclusion

Only one-third of Ethiopian youths have deep insight into the disease, whereas, nearly one-fifth of them have lower HIV-knowledge. There is a significant disparity in HIV-related knowledge among Ethiopian youths living in different regions. Rural residents, less educated, female, and married youths have less knowledge of HIV as compared to their counterparts. Youths who do not have a mobile phone, who lack health insurance coverage, and who have limited access to media have less knowledge about HIV. Therefore, the due focus should be given to the aforementioned factors to minimize the disparities between regions and to enhance Ethiopian youths’ HIV-knowledge.

Epidemiology of HIV in Iran

:

Iran has been one of the active countries fighting against HIV/AIDS in the Middle East during the last decades. Moreover, there is a strong push to strengthen the national health management system concerning HIV prevention and control. In Iran, HIV disease has its unique features, from changes in modes of transmission to improvement in treatment and care programs, which can make it a good case for closer scrutiny. The present review describes the HIV epidemic in Iran from the first case diagnosed until prevention among different groups at risk and co-infections. Not only we addressed the key populations and community-based attempts to overcome HIV-related issues in clinics, but we also elaborated on the efforts and trends in society and the actual behaviors related to HIV/AIDS. Being located in the Middle East and North Africa (MENA) region, given the countryspecific characteristics, and despite all the national efforts along with other countries in this region, Iran still needs to take extra measures to reduce HIV transmission, especially in health education. Although Iran is one of the pioneers in implementing applicable and appropriate policies in the MENA region, including harm reduction services to reduce HIV incidence, people with substance use disorder continue to be the majority of those living with HIV in the country. Similar to other countries in this region, the HIV prevention and control programs aim at 90-90-90 targets to eliminate HIV infection and reduce the transmission, especially the mother-to-child transmission and among other key populations.

Adolescents and Young People's Sexual and Reproductive Health in Iran: A Conceptual Review

This paper reviews the evidence on the sexual and reproductive health (SRH) of young people in Iran from 2001 to 2019 and maps needs, challenges, and opportunities in this area. From among 125 papers, 43 articles were examined for this review. Findings indicated that although the majority of youth abstain from sex before marriage, significant minorities are sexually active before marriage, with a huge heterogeneity based on gender and geographical region. A gender disparity is apparent in high-risk sexual behaviors. Multiple partners, inconsistent condom use, and younger age at sexual debut were more prevalent among men than women. There is a need to narrow gender disparities that expose young women to greater risks, expand health awareness and relevant skills, and enable access to SRH services. While the government has reaffirmed many commitments for young people's wellbeing, policy development falls far short of realizing these commitments. Future success requires increased evidence on the SRH of youth as well as political will and strategic commitment to SRH for young people. The challenge is to develop comprehensive and culturally appropriate SRH education and confidential and nonjudgmental youth services. Due to the importance of families and parents, such programs need to engage families.

HIV-Related Knowledge and Stigma Among the General Population in the Southeast of Iran

Background: HIV-related stigma is a barrier to effective HIV responses among people living with HIV (PLHIV). Objectives: The current study aimed at measuring HIV-related stigma, and its associated factors among the general population in the Southeast of Iran. Methods: The current cross-sectional study was conducted on a convenience sample of 900 individuals in Kerman, Southeast of Iran, from July to September 2016. Data was collected using a self-administered questionnaire, including (I) demographic and background characteristics; (II) HIV-related stigma; and (III) HIV-related knowledge. Data were analyzed with SPSS version 20 using descriptive statistics, as well as bivariable and multivariable linear regressions. Results: Low, moderate, and high levels of stigmatizing attitudes toward PLHIV were reported by 39.1%, 57.8%, and 3.1% of the participants, respectively. Female sex(beta = 0.33, P value = 0.01) and those not having a history of HIV testing (beta = 0.45, P value < 0.001) had, on average, higher levels of stigmatizing attitudes, while those with a higher level of education (beta = -0.97, P value < 0.001) had, on average, lower levels of stigmatizing attitudes. Conclusions: Gender-sensitive educational interventions need to be developed to reduce the negative attitude towards PLHIV in Iran.

Relationships between Media Exposure and Knowledge, Attitude, and Practice on HIV/AIDS: A Cross Sectional Survey of Adolescent Islamiyya Girls in Nigeria

Exposure to HIV/AIDS media among adolescents in sub-Saharan Africa was reported as low in the early 2000s, but now given developments in technology and program appeal, there emerges a need for reassessment. Given that communication, particularly through the media plays a major role in stemming the spread of the epidemic, this study examines the HIV/AIDS media exposure, knowledge, attitude, and practice (KAP) of adolescent Islamiyya girls in northern Nigeria as a predominantly Muslim society. The objectives of the study were to (1) identify the girls' major sources of information on HIV/AIDS; (2) assess their exposure to HIV/AIDS media and their HIV/AIDS knowledge, attitude and practice; and (3) verify relationships between media exposure and HIV/AIDS KAP. Based on the Advertising Research Foundation's Hierarchy of Effects model, hypotheses were posed to test the relationships. A questionnaire survey was administered on a randomly selected sample of 500 Islamiyya girls in Bauchi, Nigeria, from an estimated population of 35,000. Results were analyzed using descriptive statistics and partial least squares structural equation modeling. The results showed media exposure is not a significant predictor of HIV/AIDS practice, but it is a significant predictor of HIV/AIDS knowledge. And HIV/AIDS knowledge significantly predicted both HIV/AIDS attitude and practice. HIV/AIDS attitude also significantly predicted HIV/AIDS practice. It is thus concluded that among Nigerian adolescent girls, exposure to HIV/AIDS media is a necessary but not a sufficient predictor of HIV/AIDS KAP.

Association between HIV knowledge and stigmatizing attitudes towards people living with HIV in Afghanistan: findings from the 2015 Afghanistan Demographic and Health Survey

BACKGROUND

Afghanistan has witnessed a dramatic increase in HIV infections. Public health officials have responded with campaigns to educate the public about HIV prevention and transmission. We examine the association between HIV prevention and transmission knowledge and stigma towards people living with HIV (PLHIV) in Afghanistan.

METHODS

We conducted a secondary analysis of cross-sectional data (n=11 930) from the 2015 Afghanistan Demographic and Health Survey. Hierarchical linear regression analysis was used to examine the effects of accurate HIV knowledge related to safer sex and local misconceptions about the virus's transmission (e.g. mosquitos and witchcraft) on two stigma outcomes, namely, stigma towards public others with HIV (teachers and food vendors) and stigma towards close family members with HIV.

RESULTS

Stigmatizing attitudes were highly prevalent and HIV knowledge varied widely. Multivariate analyses show that correct knowledge related to local misconceptions about HIV prevention and transmission is significantly associated with lower stigma towards public others (ΔR2adjusted=0.07); however, knowledge had little and contradictory influence in the model predicting stigma towards close family members with HIV (ΔR2adjusted=0.005).

CONCLUSIONS

These findings suggest that it would be worthwhile designing interventions that dispel local misconceptions about HIV. This may be helpful in reducing stigma towards PLHIV in public positions but not towards family members, which calls for alternative strategies for reducing HIV-related stigma.

Relevance of students' demographic characteristics, sources of information and personal attitudes towards HIV testing for HIV knowledge: evidence from a post-conflict setting

Although studies on HIV knowledge have previously been conducted in central Serbia and southern Kosovo, none has included the Serbian population residing in the northern part of the Kosovo province. The aim of this study was to assess HIV-related knowledge and to estimate factors contributing to a higher HIV-related knowledge level among Serbian university students in the Kosovo province. A cross-sectional study including 1017 first- and fourth-year students enrolled at the University of Pristina temporarily seated in Kosovska Mitrovica was carried out during the academic year 2013-2014. The students completed a 31-item questionnaire comprising demographic data, HIV transmission knowledge and attitude towards HIV testing. Data were statistically analysed. Students demonstrated good knowledge of HIV (average 32.8 ± 3.3 out of a maximum 42). Only 5% of the students reported having been tested for HIV. Factors associated with being more knowledgeable about HIV were studying health-related disciplines (β = -0.09; 95% confidence interval [CI] -0.13, 0.00), using the internet as a source of information about HIV (β = -1.09; 95% CI -1.65, -0.52), having a positive attitude towards HIV testing (β = -0.43; 95% CI -0.59, -0.26), having a low self-perceived risk for HIV infection (β = 0.41; 95% CI 0.23, 0.56) and the position that one would keep the same level of contact with an HIV-positive person after learning their HIV status (β = 0.38; 95% CI 0.21, 0.55). Setting up specialized classes on this topic at high schools and universities could help to increase the awareness of HIV infection and promote HIV testing and a positive attitude towards HIV-positive persons.

The effects of an educational program based on the health belief model on information-motivation-skill-behavioral skills among women living with human immunodeficiency virus

BACKGROUND

Human immunodeficiency virus (HIV) is a kind of behavioral disease in that adopting behavioral changes is the only way to control and stop the epidemic. The aim of this study is to investigate the effect of education base on the health belief model (HBM) on health-seeking behavior among HIV-positive women.

MATERIALS AND METHODS

This study is a paralleled, randomized controlled clinical trial done with control group among HIV-positive women who were registered at the voluntary and counseling testing center of Imam Khomeini hospital in Tehran. Data were gathered by using information obtained from the Motivation-Skill-Behavior questionnaire and demographic data. The women were divided by permuted block and were randomized into two groups. Interventional group participated in six HBM educational classes and used routine counseling guidelines, but the control group used only routine counseling protocol. Data were collected before, immediately after, and 3 weeks after interference among all participants. Data were analyzed by using SPSS software version 16.

RESULTS

According to the results and statistical test, before intervention, the mean score of knowledge was not significantly different in the two groups, but after intervention in the interventional group, test result and follow-up increased statistically significantly (P = 0.000). Both groups had increased mean score of knowledge, and there is significant trend in level of knowledge (interventional group 20.79 ± 1.88, control group: 17.36 ±2.44) and there was a significant increase in mean attitude follow-up score (P < 0.001).

CONCLUSION

According to the result of the present study, counseling base on HBM by trained educator can increase information-motivation-skill-behavior among women living with HIV.

Age of Onset of Methamphetamine Consumption among the Iranian Youth Aged 19-29: A Cross-sectional Study

Background

Around the world, one of the main concerns and risky behaviors among youths is methamphetamine consumption. Since the age of onset of methamphetamine use is decreasing, therefore, it is important to identify the effective factors on the age of onset of methamphetamine consumption. In the present study, factors affecting the age of onset of methamphetamine consumption was studied in Iranian youths aged 19-29 years.

Methods

In this cross-sectional nationwide study, individuals aged 19-29 years were selected through multistage cluster sampling and convenience sampling method from 13 provinces in Iran. People completed the questionnaire pertaining to knowledge, attitude, and history of methamphetamine consumption. In order to investigate the factors effective on the age of onset of methamphetamine consumption, we used the Weibull parametric model for data with doubly censored characteristic.

Findings

3246 people participated in this study, half of whom were men and mostly single (60.3%), university student or graduate (50.2%), and unemployed (58.1%). Nearly 6% of participants have ever used methamphetamine. Mean and standard deviation (SD) of age of onset of methamphetamine use was 20.3 ± 3.3 years. Data analysis indicated that the variables of gender, marital status, education, knowing a methamphetamine consumer, knowing an ecstasy consumer, ecstasy consumption, illegitimate sex, attitude towards methamphetamine, and age group were the factors affecting the age of onset of methamphetamine consumption.

Conclusion

The results can contribute to the policy-makers to take the necessary interventions on the factors affecting the age of onset of methamphetamine consumption to reduce the methamphetamine consumption, especially in the critical young ages.

Engage In or Refrain From? A Qualitative Exploration of Premarital Sexual Relations Among Female College Students in Tehran

This study explored the factors that educated young Iranian women consider when they decide whether to have premarital sex. Using a purposive sampling method, 30 in-depth interviews were conducted with female college students in both government and private universities in Tehran in 2005-2006. The respondents included unmarried women who had experienced sexual relations, unmarried women who had abstained, and married women. Young women's considerations for premarital sex included (1) marriage meaning and motivations; (2) compliance with family values and expectations; (3) perceived gender and social norms of premarital sex; (4) importance of religiosity; and (5) sexual knowledge and self-efficacy. Marriage meaning and motivation seem to be the central pillar in the complex decision to engage in or refrain from premarital sex among female college students. These considerations have theoretical implications for understanding premarital relationships and sex in a conservative setting. Finally, some shifts are occurring in the meaning of marriage and sexual mores among educated young women in Iran; these changes are discussed.

Characterising HIV/AIDS knowledge and attitudes in the Middle East and North Africa: Systematic review and data synthesis

This article reviews HIV/AIDS knowledge and attitudes in various population groups in the Middle East and North Africa (MENA), and highlights their relevance to HIV epidemiology and the design and implementation of preventions and treatment efforts. PubMed and the MENA HIV/AIDS Epidemiology Synthesis Project database of grey/unpublished literature were searched. Levels of knowledge were categorised based on presence of basic knowledge, comprehensive knowledge, and misconceptions and misinformation. Attitudes towards people living with HIV/AIDS (PLHIV) were classified into positive or negative. Basic knowledge was overall high among key populations at higher risk of infection (KPAR), and bridging and general population groups, but still a few population pockets had low basic knowledge. Level of comprehensive knowledge was overall low, and misinformation and misconceptions were prevalent. Some KPAR, including people who inject drugs, men who have sex with men, and female sex workers, were unaware of some modes of HIV transmission. Perception of risk of infection was low even among KPAR. We found differentials in knowledge putting women, rural populations, refugees, and other marginalised minorities at a disadvantage. Attitudes towards PLHIV tended to be negative. These findings are of concern, particularly for KPAR currently experiencing emerging HIV epidemics.

HIV risk perception and sexual behaviors among female sex workers in Tehran, Iran

Background: An adequate perception of the degree to which one is at risk of having or contracting HIV is necessary for behavioural change and the adoption of safe behaviours. There are limited data regarding HIV risk perceptions among female sex workers in Iran. This study aimed to determine the HIV risk perception status and its association with sexual behaviours among female sex workers in Tehran. Methods: A cross sectional study was conducted among 170 female sex workers in Tehran. Participants were recruited using a combination of snowball, purposeful, and convenience sampling methods. Multiple logistic regression was used to identify adjusted associations between background factors, sexual behaviours, and HIV risk perception. The analysis was conducted by the "logistf" package in the R statistical system. P-value less than .05 was considered as statistically significant. Results: Among the participants, 122 (77%) reported high HIV risk perception. Most female sex workers with high HIV risk perception reported that they did not consistently use condoms (n=120, 98%. Female sex workers with a higher frequency of sex work (AOR=1.18, 95% CI: 1.08, 1.31), inconsistent condom use (AOR=0.15, 95% CI: 0.02, 0.66), a history of HIV testing (AOR=5.1, 95% CI: 1.2, 26.0), and low HIV knowledge (AOR=0.97, 95% CI=0.95, 0.996) were more likely to report high HIV risk perception. Conclusion: Most female sex workers with risky sexual behaviours had a high HIV risk perception. Effective educational programs are suggested to enable female sex workers to correctly assess their own HIV risk and change risk behaviors based on self-assessment of actual risk.

Epidemiologic and clinical findings of children with acquired immunodeficiency syndrome in four provinces of Iran

INTRODUCTION

The human immunodeficiency virus (HIV) is still a remarkable challenge throughout the world, especially in developing countries. Despite the fact that HIV in children is becoming one of the most challenging diseases, it seems that pediatric AIDS in Iran is an unknown disease and there is a lack of studies about it. The aim of this study was to describe the characteristics of HIV-positive children who referred to the hospitals of Tehran, Kermanshah, Kurdistan, and Qom provinces of Iran.

MATERIALS AND METHODS

This study was a retrospective investigation of medical records among 61 children with a diagnosis of HIV who were admitted to the children's hospitals in the four provinces of Iran during a 3-year period (2013-2016).

RESULTS

The frequency of HIV in the center of Iran (Tehran and Qom provinces) was higher (N = 37, 61%). Most of the infected patients were between 5 and 15 years old, 52% were male, and 93% had a history of HIV in their family. Median age at diagnosis of HIV was 2 years. Most of the hospitalized patients were discharged and only two patients (3%) died due to HIV infection. The vast majority of patients (93%) were infected through maternal transmission and a low percentage (29%) were diagnosed before 1 year of age. All of them were in the third stage of the disease. All patients had a positive HIV PCR test. HIV EIA was positive in the majority of cases (98%). A history of addiction in the family was demonstrated in 22 cases (36%). Weight loss (N = 51, 84%), prolonged fever (N = 50, 81%), and respiratory infection (N = 26, 47%) were the most common symptoms.

CONCLUSION

This study demonstrated a high frequency of pediatric HIV among children aged 5-15 years in four provinces of Iran. Novel strategies to prevent and eliminate mother-to-child transmission of HIV, diagnostic facilities, and treatment of infected mothers during pregnancy in our country are highly recommended.

Comprehensive analysis of the HIV/AIDS policy-making process in Iran

Background

A huge number of people living with HIV/AIDS lives in developing countries. Thus, strengthening health systems in these countries is a prerequisite for improving disease prevention and care. After three decades of HIV/AIDS policy-making in Iran, conducting a comprehensive analysis on the policy process seems to be essential. In the present study, we aimed to analyse the HIV/AIDS policy-making process in Iran from 1986 to 2016.

Methods

This was a theory-based, multi-method and retrospective study. Interviewing of key informants and review of policy documents were concurrently conducted to identify and include further key informants (39 participants) and documents in the study. Framework analysis was used to analyse data.

Results

The mean age of participants working in HIV/AIDS policy-making was of 48 years and participants had a mean of 14 years of working experience. Findings were categorized as contextual factors, content of HIV/AIDS policies, actors involved in the policy process, and evidence use in the policy process. Contextual effective factors on the HIV/AIDS policy-making process were categorized into five major themes, namely situational factors, structural-managerial factors, socioeconomic factors, political and legal factors, and international factors. The HIV/AIDS phenomenon in Iran was identified to be deeply rooted in the culture and traditions of society. The HIV/AIDS policy content has, recently, been crystallized in the national strategic plans and harm reduction policies of the country. The policy process has been conducted with a solely governmental top-down approach and is now suffering from poor evidence and lack of sufficient consideration of contextual factors.

Conclusions

There is a great need for change in the approach of government towards the issue and to increase the participation of non-governmental sectors and civil society in the policy process.

HIV- and AIDS-related knowledge and attitude of residents in border regions of Vietnam

BACKGROUND

Residents in border areas are vulnerable to HIV/AIDS due to high rates of risk behaviors such as unprotected sexual practices or illicit drug use. Improving knowledge and attitude toward HIV/AIDS prevention and treatment are vital to diminish the burden of the HIV epidemic in this setting. However, evidence about this issue in Vietnam has been limited. This study aims to explore the knowledge and attitude toward HIV/AIDS among people in Vietnam border zones.

METHODS

We conducted a cross-sectional study in three border communes in Thanh Hoa province with 600 HIV(-) residents. Data about socio-demographic characteristics, general HIV knowledge, knowledge about prevention of mother-to-child transmission, treatment and care, HIV testing services, and attitude toward HIV/AIDS were collected. Multivariate Tobit regression was used to determine related factors with the knowledge and attitude.

RESULTS

The highest percentage of people having correct statements was for "HIV could be transmitted from mother to child" (98.2%), while the lowest percentage was for item "Know health facilities where HIV-positive people could register for care and check-up" (28.2%). People had the highest score in "Knowledge about HIV transmission routes" and the lowest score in "Knowledge about HIV/AIDS prevention measures". Most of the people were not afraid of being exposed to HIV-positive individuals (66.0%), willing to buy goods from HIV-positive sellers (78.9%), and willing to take care of people living with HIV in their family (90.1%). Education, ethnic, marital status, occupations, and HIV/AIDS information sources were found to be associated with knowledge and attitude toward HIV/AIDS.

CONCLUSIONS

The general knowledge and attitude on HIV/AIDS of residents were relatively good. Educational campaigns to improve knowledge and attitude toward PLWH, involving peer educators and local associations, are potential strategies for sustaining HIV intervention in this remote setting.

HIV knowledge and risk behaviors among drug users in three Vietnamese mountainous provinces

BACKGROUND

Globally, people who inject drugs are highly vulnerable to HIV transmission. Methadone maintenance treatment (MMT) programs are one of the most cost-effective mechanisms to substitute opioid use and improve the quality of life of patients. Since the coverage of MMT is still limited and even for those patients who are treated, improving their knowledge on HIV and maintaining healthy behaviors are key to maximizing the outcomes of HIV harm reduction programs. This study examined the knowledge on HIV, perceived risk and HIV testing among drug users accessing methadone maintenance services in three Vietnamese mountainous areas.

METHODS

A cross-sectional study of 300 people enrolling for MMT services in three provinces in Vietnam was conducted. The factors associated with the knowledge, attitudes, and practices of respondents about HIV/AIDS were exploited using multivariable logistic model.

RESULTS

Of the 300-people surveyed, 99% knew of HIV and 60.6% were identified as having good knowledge. While 75.2% identified that injecting drugs was a risk factor for HIV, 52.2% thought they were not at risk of HIV mainly as they did not share needles. 92.6% had undergone HIV testing with 17.4% being positive, a number which was significantly lower than Vietnam's national average for people who inject drugs. Age, ethnicity and education were associated with knowledge of HIV while ART treatment was linked to self-assessed HIV status.

CONCLUSIONS

This study sheds new light on the knowledge attitudes and practices of people who inject drugs, particularly males in mountainous areas of Vietnam regarding HIV prevention. Overall, knowledge was good with most conducting safe practices towards transmission. Enhanced education and targeting of minority groups could help in increasing the numbers receiving MMT and HIV services.

Condom Use and its Associated Factors Among Iranian Youth: Results From a Population-Based Study

Background: Given the young structure of Iran’s population and the fact that extramarital sexual relationships are both prohibited by legislation and shunned by society and religion, examining condom use practices among Iranian youth is highly important. The aim of this study was to explore condom use and its correlates among Iranian young adults.

Methods: In a sample of 3,045 individuals aged 19-29 who were recruited from a nation-wide study, we analyzed data from 633 participants who reported a history of extramarital sex. Subjects were asked about their condom use practices during their last penetrative sex. Data were collected through a self-administered questionnaire where the respondents completed the survey on their own and passed it to trained gender-matched interviewers. Multivariable regression models were constructed to report adjusted odds ratios (AOR) along with 95% CI.

Results: Of the 633 participants, 222 (35.1%) reported condom use at last sex. Men reported significantly higher condom use than women (38.5% vs. 25.7%). Having a stable job (AOR = 1.86, 95% CI: 1.01, 3.43), higher knowledge of condom use (AOR = 1.57, 95% CI: 1.03, 2.37) and sexual transmission of HIV (AOR = 1.83, 95% CI: 1.18, 2.85) were positively associated with condom use at last sex. Conversely, experience of sex under the influence of substances (AOR = 0.66, 95% CI: 0.45, 0.94) was significantly associated with reduced odds of condom use at last sex.

Conclusion: This study shows that only one out of every three young adults reported using condoms at last sex. While educational programs are helpful, multi-sectoral approaches (eg, individual-, community-, and structural-level interventions) are required to change sexual behaviours towards safe sex practices and reinforce negotiating condom use among youth.

Effectiveness of a Structured Teaching Program on Knowledge and Attitudes Toward HIV among Young Women in India

India has the third highest number of persons living with HIV in the world. We evaluated the effectiveness of a structured teaching program on HIV-related knowledge and attitudes among 600 young women, aged 20-40 years, in India. This study employed a quasi-experimental pre-post design. Significant differences were found in the level of the participants' knowledge of (t = 78.89, p < .05) and attitudes toward (t = 64.14, p < .05) HIV after the intervention. Our findings suggest that the structured teaching program could be utilized in increasing young women's knowledge of, and improving their attitudes about, HIV.

Barriers to Health Service Utilization Among Iranian Female Sex Workers: A Qualitative Study

Objectives

In most countries around the world, sex work is an illegal activity. Female sex workers (FSWs) in Iran hide their identities, and they are known to be a hard-to-reach population. Despite free access to HIV testing, fewer than half of FSWs receive HIV testing. The purpose of this study was to characterize the reasons for which FSWs do not seek testing at drop-in centers (DICs) and voluntary counseling and testing (VCT) centers in Iran.

Methods

A qualitative study was conducted in 2016. The participants were 24 FSWs who received services at VCT centers and DICs for vulnerable females in the north of Iran and 9 males who were the clients of FSWs. In this study, we made use of purposive sampling and carried out a thematic analysis.

Results

We found 4 major and 6 minor themes. The major themes were: fear of being infected (with HIV), stigma, indifference, and knowledge.

Conclusions

Despite the significant efforts made by the government of Iran to establish and expand DICs for vulnerable females, the number of FSWs receiving services at these centers has not been very considerable. Consequently, by introducing and implementing training programs for peer groups, it may be possible to take steps toward establishing strategic programs for the control and prevention of HIV/AIDS.

Knowledge of and attitudes toward HIV/AIDS among Iranian women

OBJECTIVES

This study investigated the knowledge of Iranian women about HIV/AIDS and whether they had accepting attitudes towards people living with human immunodeficiency virus (HIV), and sought to identify factors correlated with their knowledge and attitudes.

METHODS

The data analyzed in the present study were taken from Iran's Multiple Indicator Demographic and Health Survey, a national survey conducted in 2015. In total, 42,630 women aged 15-49 years were identified through multi-stage stratified cluster random sampling and interviewed. Associations of the socio-demographic characteristics of participants with their knowledge and attitudes were examined using multiple logistic regression analysis.

RESULTS

The majority (79.0%) of Iranian women had heard about HIV/AIDS, but only 19.1% had a comprehensive knowledge. In addition, only 15.4% of women had accepting attitudes toward people with HIV. Being older, married, more highly educated, and wealthier were factors associated with having more comprehensive knowledge of HIV/AIDS, and living in urban areas was associated with having more positive attitudes toward people with HIV.

CONCLUSIONS

The relatively poor knowledge of Iranian women and the low prevalence of accepting attitudes toward people living with HIV highlight the need to develop policies and interventions to overcome this issue, which would be a basis for further prevention of HIV/AIDS in Iran.

Knowledge, Attitude, and Practices Regarding HIV and TB Among Homeless People in Tehran, Iran

BACKGROUND

Homeless people are at high risk of HIV and tuberculosis (TB) infection due to living in poor sanitary conditions and practicing high-risk behavior. The aim of this study is to assess the knowledge, attitude, and practice (KAP) of homeless people in Tehran regarding TB and HIV.

METHODS

Using a convenience sampling, we performed a cross-sectional study on homeless people in Tehran from June to August 2012. Participants aged 18-60 years having at least 10 days of homelessness in the preceding month to the study period were included. All required data were collected through face-to-face interviews conducted using a researcherdesigned questionnaire. Each score in KAP of TB and HIV was separately divided by the maximum score and multiplied by 100 to attain percentage scores. The mean scores were compared using analysis of variance (ANOVA) and student's t test. A Tukey test was used for post hoc analysis and two-by-two comparisons.

RESULTS

In this study, 593 participants consisting of 513 men and 80 women were included. The mean age of the participants was 41.74 ± 0.45 years. Moreover, the total mean score of KAP toward HIV was 79.24 (95% CI: 77.36, 81.12), 57.13 (95% CI: 55.12, 59.14), and 21.14 (95% CI: 18.35, 23.93), respectively. The total mean score of knowledge and practice regarding TB was 62.04 (95% CI: 59.94, 64.14) and 42.57 (95% CI: 40.36, 44.78), respectively.

CONCLUSION

Although a relatively acceptable knowledge was detected in this high-risk population, practices regarding TB and HIV showed some weaknesses. Developing special programs to improve the healthy behavior of this population is highly recommended.

Reasons for Inconsistent Condom Use Found as Answers to a Multiple Response Question: A National Survey of Iranian Adults, 2013

Background: The use of condoms is important for preventing Sexually Transmitted Infections (STIs). However, the prevalence of condom use is not satisfactory. The aim of this study was to assess the reasons for inconsistent condom use in Iranian adults.

Study design: Cross-sectional study.

Methods: Data were gathered through multi-stage sampling. Participants were enrolled from 13 provinces in Iran aged between 19 and 29 years. They had ever-extramarital sex and did not use condoms regularly in their sexual contacts, asked the reasons for inconsistent condom use.

Results: We had 3,246 adults, from which 635 (19.5%) had ever-extramarital sex. Among them, 495 (77.96%) did not use condoms with regularity. The reason frequently chosen for inconsistent condom use was ‘that it is not accessible’ (49.3%). The differences between the categories of some variables, according to the choice of reasons for inconsistent condom use, were significant (P<0.05): age, gender, knowledge of HIV, attitude towards HIV, knowing infected HIV person and alcohol or stimulant(s) used before sexual contact. According to multivariate multilevel logistic, the effect of gender was significant on most of reasons for inconsistent condom use (P<0.05).

Conclusions: Most of the reasons that were selected for inconsistent condom use were inaccessibility and not knowing that its use is essential. Hence, it is important to improve the knowledge of adults regarding STI/HIV and extend the locations of condom distribution. We should try to promote the culture of condom use as a routine.

Knowledge about the human immunodeficiency syndrome among elders in a unit for the care of the elderly

Objective

To analyze the knowledge of elders regarding HIV/AIDS.

Methods

Descriptive, cross-sectional, quantitative study, with 457 elders from the Unit for the Care of Elders in Uberaba - Minas Gerais, lasting 3 months. The instruments used were the Mental State Mini-exam and a questionnaire on the human immunodeficiency virus for elders, together with frequency measures for their analysis.

Results

Most participants were female (74%), between 60 and 69 y/o (51%). The question with the most correct answers was about syringe/needle transmission (96.2%) and the ones with the least (45.3% and 49.6%, respectively) were regarding AIDS transmission through mosquito bites and whether a person with the human immunodeficiency virus always presents symptoms (49.6%). 88.2% of participants never use condoms.

Conclusion

The general level of knowledge can be considered good, responding to our goal. However, gaps in knowledge were identified due to the lack of campaigns aimed exclusively at such public, as well as to the lack of awareness of professionals.