title: High prevalence of HIV infection associated with incarceration among community-based injecting drug users in Tehran, Iran.
abstract: 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.
authors.affiliation: Department of Global Health and Socio-epidemiology, Kyoto University School of Public Health, Kyoto, Japan. szamani@pbh.med.kyoto-u.ac.jp
authors.forename: Saman
authors.initials: S
authors.lastname: Zamani
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kihara
authors.forename: Mohammad M
authors.initials: MM
authors.lastname: Gouya
authors.forename: Mohsen
authors.initials: M
authors.lastname: Vazirian
authors.forename: Bijan
authors.initials: B
authors.lastname: Nassirimanesh
authors.forename: Masako
authors.initials: M
authors.lastname: Ono-Kihara
authors.forename: Shahrzad Mortazavi
authors.initials: SM
authors.lastname: Ravari
authors.forename: Afshin
authors.initials: A
authors.lastname: Safaie
authors.forename: Seiichi
authors.initials: S
authors.lastname: Ichikawa
mesh_terms: 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