High prevalence of HIV infection associated with incarceration among community-based injecting drug users in Tehran, Iran.
OBJECTIVE
To determine the prevalence and correlates of HIV-1 infection among community-based injecting drug users (IDUs) in Tehran, Iran.


METHODS
In October 2004, 213 IDUs were recruited from a drop-in center and its neighboring parks and streets in Tehran. Participants were interviewed using a structured questionnaire regarding their sociodemographics and HIV risk characteristics, and specimens of oral mucosal transudate were collected and tested for HIV-1 antibodies. Data were analyzed using chi and multiple logistic regression to estimate odds ratios (OR) and 95% confidence intervals (CI).


RESULTS
The prevalence of HIV-1 infection was 23.2% (48 of 207) among male injecting drug users. In the multivariable analysis, a history of shared drug injection inside prison (OR, 2.45; 95% CI, 1.01-5.97) and that of multiple incarcerations (OR, 3.13; 95% CI, 1.08-9.09) were associated with significantly higher prevalence of HIV-1 infection.


CONCLUSIONS
The prevalence of HIV-1 infection has reached an alarming level among IDUs in Tehran, with incarceration-related exposures revealed to be the main correlates of HIV-1 infection. Urgent and comprehensive harm reduction programs for drug users in prison and those in the community in Tehran are of prime importance to prevent further transmission of HIV infection.
Zamani
Saman
S
Department of Global Health and Socio-epidemiology, Kyoto University School of Public Health, Kyoto, Japan. szamani@pbh.med.kyoto-u.ac.jp
Kihara
Masahiro
M
Gouya
Mohammad M
MM
Vazirian
Mohsen
M
Nassirimanesh
Bijan
B
Ono-Kihara
Masako
M
Ravari
Shahrzad Mortazavi
SM
Safaie
Afshin
A
Ichikawa
Seiichi
S
D000293:Adolescent; D000328:Adult; D003710:Demography; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D007492:Iran / Q000453:epidemiology; D008297:Male; D015999:Multivariate Analysis; D015995:Prevalence; D011329:Prisoners; D012725:Sexual Behavior; D012959:Socioeconomic Factors; D015819:Substance Abuse, Intravenous