Injection drug use in Rural Iran: integrating HIV prevention into iran's rural primary health care system.
Major opium trafficking routes traverse rural Iran, but patterns of drug use and HIV infection in these areas are unknown. In 2004, Iran's Ministry of Health integrated substance use treatment and HIV prevention into the rural primary health care system. Active opium or heroin users (N = 478) were enrolled in a rural clinic. Participants received counseling for abstinence from substances, or daily needle exchange and condoms. On enrollment, 108 (23%) reported injecting; of these, 79 (73%) reported sharing needles. Of 65 participants tested for HIV, 46 (72%) tested positive. Participants who received daily needle exchange/condoms stayed in the program longer than those who did not (AOR 2.08, 95% CI 1.1-3.88). This project demonstrates that HIV risks exist in rural Iran and suggests the innovative use of Iran's rural health care system to extend prevention and treatment services to these populations.
Mojtahedzadeh
Vahid
V
Iranian National Center for Addiction Studies, Ministry of Health, Treatment and Medical Education, Tehran, Islamic Republic of Iran.
Razani
Nooshin
N
Malekinejad
Mohsen
M
Vazirian
Mohsen
M
Shoaee
Shervan
S
Saberi Zafarghandi
Mohammad Bagher
MB
Hernandez
Alexandra L
AL
Mandel
Jeffrey S
JS
D000328:Adult; D017280:Condoms / Q000706:statistics & numerical data; D003695:Delivery of Health Care; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control*; D040261:Harm Reduction; D006556:Heroin Dependence / Q000150:complications / Q000453:epidemiology / Q000517:prevention & control; D006801:Humans; D007492:Iran / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016485:Needle Sharing; D018671:Needle-Exchange Programs; D009293:Opioid-Related Disorders / Q000150:complications / Q000453:epidemiology / Q000517:prevention & control; D009892:Opium; D011320:Primary Health Care; D015397:Program Evaluation; D018570:Risk Assessment; D012424:Rural Population; D015819:Substance Abuse, Intravenous / Q000150:complications / Q000453:epidemiology* / Q000517:prevention & control*
D009892:Opium