title: HIV prevalence and related risk behaviours among prisoners in Iran: results of the national biobehavioural survey, 2009.
abstract: OBJECTIVE
  To estimate the prevalence of HIV and related risk behaviours among prisoners in Iran in 2009.
  
  
  METHODS
  Using multistage random sampling, we recruited 5,530 prisoners from 27 prisons in Iran. Behavioural data were collected using a face-to-face questionnaire-based interview, and HIV status was determined by ELISA of dried blood spots. Weighted estimates were calculated based on the sampling probability and response rate.
  
  
  RESULTS
  HIV prevalence was 2.1% (95% CI 1.2 to 3.6). One in eight prisoners (12.3%, 95% CI 8.0% to 16.6%) had been tested for HIV in the last year and received results, 20.5% (95% CI 15.1 to 27.4%) had comprehensive knowledge about HIV and 24.7% (95% CI 17.9% to 32.9%) reported condom use at last vaginal/anal sex in prison. Although 16.5% (95% CI 12.5% to 21.5%) acknowledged a lifetime history of drug injection, only 22 prisoners reported drug injection inside the prison in the month preceding the interview. Of note, 12.9% (95% CI 10.6% to 15.6%) had been tattooed in prison. There were significant associations between HIV prevalence and a history of drug injection (adjusted odds ratio (AOR): 7.8, 95% CI 4.7 to 13.2), tattooing (AOR: 2.1, 95% CI 1.1 to 4.2) and age over 30 years (AOR: 1.4, 95% CI 1.1 to 1.9).
  
  
  CONCLUSIONS
  Considerable HIV prevalence among prisoners is found in Iran. Expanding harm reduction programmes inside prisons with inclusion of sexual risk reduction programmes and post-release programmes will help directly prevent acquisition and transmission of infection inside prisons and indirectly slow onward transmission in the outside communities.
authors.affiliation: Regional Knowledge Hub, and WHO Collaborating Centre for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, , Kerman, Iran.
authors.forename: Soodabeh
authors.initials: S
authors.lastname: Navadeh
authors.forename: Ali
authors.initials: A
authors.lastname: Mirzazadeh
authors.forename: Mohammad Mehdi
authors.initials: MM
authors.lastname: Gouya
authors.forename: Marziyeh
authors.initials: M
authors.lastname: Farnia
authors.forename: Ramin
authors.initials: R
authors.lastname: Alasvand
authors.forename: Ali-Akbar
authors.initials: AA
authors.lastname: Haghdoost
mesh_terms: D000328:Adult; D017677:Age Distribution; D000701:Analgesics, Opioid / Q000627:therapeutic use; D017280:Condoms / Q000706:statistics & numerical data*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000517:prevention & control / Q000523:psychology; D040261:Harm Reduction; D006306:Health Surveys; D006801:Humans; D007492:Iran / Q000453:epidemiology; D008297:Male; D008691:Methadone / Q000627:therapeutic use; D008875:Middle Aged; D016017:Odds Ratio; D058850:Opiate Substitution Treatment / Q000379:methods*; D015995:Prevalence; D011329:Prisoners / Q000523:psychology / Q000706:statistics & numerical data*; D011330:Prisons; D018570:Risk Assessment; D012309:Risk-Taking; D018571:Sentinel Surveillance; D012725:Sexual Behavior / Q000523:psychology / Q000706:statistics & numerical data*; D015819:Substance Abuse, Intravenous / Q000150:complications / Q000453:epidemiology* / Q000517:prevention & control; D011795:Surveys and Questionnaires; D013653:Tattooing / Q000009:adverse effects* / Q000706:statistics & numerical data
chemical_list: D000701:Analgesics, Opioid; D008691:Methadone
keywords: AIDS; Drug Misuse; HIV