Inconsistent Condom Use among Iranian Male Drug Injectors.
OBJECTIVE
The aim of this study was to determine the prevalence and associated factors of inconsistent condom use among Iranian male injecting drug users (IDUs).


METHODS
Data came from the national Iranian behavioral survey of drug dependence, which sampled 7743 individuals with drug dependence, from medical centers, prisons, and streets in 29 provinces in Iran, in 2007. This study included all individuals who were male, IDUs, and were sexually active (n = 1131). The main outcome was inconsistent condom use which was assessed using a single item. A logistic regression was used to determine the association between socio-economic data, drug use data, and high risk injection behaviors with inconsistent condom use.


RESULTS
83.3% of sexually active IDUs (n = 965) reported inconsistent condom use. Based on the logistic regression, likelihood of inconsistent condom use was higher among those with a history of syringe sharing [Odds Ratio (OR); 1.63, 95% Confidence Interval (CI); 1.13-2.34], but lower among those with higher education levels (OR; 0.34, 95% CI; 0.14-0.82), those who mostly inject at home (OR; 0.09, 95% CI; 0.02-0.47), and those with a history of treatment (OR; 0.54, 95% CI; 0.31-0.94).


CONCLUSIONS
Because of the link between unsafe sex and risky injecting behaviors among Iranian IDUs, combined programs targeting both sexual and injection behavior may be more appropriate than programs that target sexual or injection behavior. The efficacy of combined programs should be, however, compared with traditional programs that only target sexual or injection behavior of IDUs.
Department of Health Behavior and Health Education, University of Michigan School of Public Health , Ann Arbor, MI , USA ; Center for Research on Ethnicity, Culture, and Health, University of Michigan School of Public Health , Ann Arbor, MI , USA.
Shervin
S
Assari
Department of Psychology, Bu-Ali Sina University , Hamedan , Iran.
Mosaieb
M
Yarmohmmadi Vasel
Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences , Tehran , Iran.
Mahmood
M
Tavakoli
Universal Network for Health Information Dissemination and Exchange , Tehran , Iran ; Medicine and Health Promotion Institute , Tehran , Iran.
Mahmoud
M
Sehat
Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences , Tehran , Iran.
Firoozeh
F
Jafari
Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences , Tehran , Iran ; Center for Behavioral and Social Research, Darius Institute , Tehran , Iran.
Hooman
H
Narenjiha
Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences , Tehran , Iran ; Center for Behavioral and Social Research, Darius Institute , Tehran , Iran.
Hassan
H
Rafiey
Behavioral Sciences Research Center, Baqiyatallah Medical Sciences University , Tehran , Iran.
Khodabakhsh
K
Ahmadi
HIV risk behaviors; Iran; drug injectors; inconsistent condom use; men; protective health behaviors