title: Potential for sexual transmission of HIV infection from male injecting-drug users who have sex with men in Tehran, Iran.
abstract: BACKGROUND
  Iran faced an HIV epidemic among injecting-drug users (IDUs) and has responded to this threat. Meanwhile, there is growing concern over the possibility of bridging HIV infection from IDUs to other populations, including men who have sex with men (MSM).
  
  
  METHODS
  Cross-sectional biobehavioral surveys were conducted among 370 injecting-drug users recruited from drug treatment centers, a drop-in center, as well as streets in drug-populated areas in Tehran, Iran, between 2003 and 2004.
  
  
  RESULTS
  Data from these surveys showed that about 12% of male, sexually experienced IDUs have had same-gender sex, and HIV prevalence is high (19%), but condom use during the last sexual encounter was low (20%). A multivariate analysis showed that IDUs who had sex with men (MSM IDUs), compared to other sexually experienced IDUs, are younger (AOR, 0.89; 95% CI, 0.81-0.98), more likely to have used a shared needle/syringe for drug injection (AOR, 4.29; 95% CI, 1.82-10.12), and have had more than 5 sexual partners in their lifetime (AOR, 2.71; 95% CI, 1.14-6.44).
  
  
  CONCLUSIONS
  These results show that MSM IDUs exhibit more drug-related and sexual risk behaviors that may serve as a bridge for sexual transmission of HIV to other populations, including the broader MSM community, in Tehran. This report intends to encourage health authorities in Iran to take serious action to prevent sexual transmission of HIV from MSM IDUs to their sexual networks.
authors.affiliation: Department of Global Health and Socio-epidemiology, Kyoto University School of Public Health, Kyoto, Japan. saman.zamani@gmail.com
authors.forename: Saman
authors.initials: S
authors.lastname: Zamani
authors.forename: Masako
authors.initials: M
authors.lastname: Ono-Kihara
authors.forename: Seiichi
authors.initials: S
authors.lastname: Ichikawa
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kihara
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D015658:HIV Infections / Q000453:epidemiology / Q000635:transmission* / Q000821:virology; D018451:Homosexuality, Male; D006801:Humans; D007492:Iran / Q000453:epidemiology; D008297:Male; D015995:Prevalence; D012309:Risk-Taking; D012725:Sexual Behavior; D012747:Sexual Partners; D015229:Sexually Transmitted Diseases, Viral / Q000635:transmission / Q000821:virology; D015819:Substance Abuse, Intravenous / Q000150:complications*; D055815:Young Adult