title: High HIV prevalence in a respondent-driven sampling survey of injection drug users in Tehran, Iran.
abstract: Iran is facing unprecedented dual drug use and HIV epidemics. We conducted a cross-sectional survey to obtain HIV prevalence and risk behavior data from injection drug users (IDU) in Tehran. We used respondent-driven sampling (RDS) to recruit IDU through successive waves starting with 24 "seeds," conducted anonymous face-to-face interviews and HIV testing and counseling, and used RDSAT to adjust data. During 44 weeks, 1,726 study referral coupons resulted in 645 (37 %) IDU referrals, of whom 548 (85 %) were enrolled. From those enrolled, 84 % were incarcerated, 47 % employed, 55 % single, 27 % under 30 years of age, and 26 % homeless. The adjusted HIV prevalence was 26.6 % (95 % confidence interval 21.3-32.1), and was higher among certain IDU subgroups (e.g., those who sharing injection paraphernalia). Our estimates of HIV prevalence were higher than some other estimates; however, repeated surveys using similar methodology are needed to monitor the trend of HIV epidemic over time.
authors.affiliation: Institute for Health Policy Studies, University of California, 3333 California Street, Suite 265, San Francisco, CA, 94118, USA, MMalekinejad@ucsf.edu.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Malekinejad
authors.forename: Minoo
authors.initials: M
authors.lastname: Mohraz
authors.forename: Nooshin
authors.initials: N
authors.lastname: Razani
authors.forename: Gholamreza
authors.initials: G
authors.lastname: Akbari
authors.forename: Willi
authors.initials: W
authors.lastname: McFarland
authors.forename: Parastoo
authors.initials: P
authors.lastname: Khairandish
authors.forename: Housien
authors.initials: H
authors.lastname: Malekafzali
authors.forename: Mohammad M
authors.initials: MM
authors.lastname: Gouya
authors.forename: Asieh
authors.initials: A
authors.lastname: Zarghami
authors.forename: George W
authors.initials: GW
authors.lastname: Rutherford
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D037001:Directive Counseling; D005260:Female; D015658:HIV Infections / Q000517:prevention & control / Q000635:transmission*; D040261:Harm Reduction; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D007492:Iran / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D018671:Needle-Exchange Programs / Q000458:organization & administration / Q000706:statistics & numerical data*; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data*; D015995:Prevalence; D015397:Program Evaluation; D012309:Risk-Taking; D015819:Substance Abuse, Intravenous / Q000150:complications / Q000453:epidemiology* / Q000523:psychology; D019037:Urban Health Services / Q000706:statistics & numerical data*