Prevalence of HIV, HCV, and High-Risk Behaviors for Substance Users in Drop in Centers in Southern Iran.
OBJECTIVE
Drop In Centers (DICs) are organizations in which health and social services are delivered to drug users on the basis of harm-reduction strategies. The aim of this epidemiological study was to estimate the prevalence of human immunodeficiency virus (HIV) and hepatitis C virus (HCV) infection at these centers over a 6-year period.


METHODS
All of the DICs (7 in total) visited were located in Shiraz, the capital city of Fars province, southern Iran. Every patient record in these centers was studied between April 2006 and April 2011. Complementary information on the frequency of HIV was collected from the Voluntary Counseling and Testing services. A logistic regression model was applied to data analysis. The study explored risk factors associated with HIV and HCV infections, which were primarily high-risk sexual behavior.


RESULTS
This study examined 1,327 people, 79.5% of whom were males. The mean age of first substance use and the first injection among intravenous drug users (IDUs) were 20.24 ± 6.11 and 26.5 ± 7.3 years, respectively. In total, 13.5% and 20.2% of the subjects who registered at the DICs were infected with HCV and HIV, respectively. Shared injection, history of imprisonment, maleness, unsafe sex, inadequate housing, and low education were risk factors for HIV infection. Shared injection, unsafe sex, history of imprisonment, and maleness were predisposing factors for HCV infection. A history of imprisonment and substance use upon registration at the DIC were significant risk factors for female sex workers.


CONCLUSIONS
Our study emphasized the implementation of preventive measures like education and needle exchange program as harm-reduction strategies. Drop in Centers are important for the management of health problems, including HIV infection and social problems such as crime. Periodic epidemiological studies on DICs are necessary to monitor and modulate the services delivered by these centers.
From the Health Policy Research Center (AS, MM, KBL), Shiraz University of Medical Sciences, Shiraz, Iran; and Tehran University of Medical Sciences (MN), Tehran Iran.
Alireza
A
Salehi
Mojtaba
M
Naghshvarian
Maryam
M
Marzban
Kamran
K
Bagheri Lankarani
D000328:Adult; D060085:Coinfection / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000209:etiology; D006526:Hepatitis C / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D007492:Iran / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D016320:Substance Abuse Treatment Centers / Q000706:statistics & numerical data; D015819:Substance Abuse, Intravenous / Q000150:complications; D019966:Substance-Related Disorders / Q000150:complications*; D047568:Unsafe Sex / Q000706:statistics & numerical data; D055815:Young Adult