Fatemeh Tavakoli1, Mehrdad Khezri1, Michelle Tam2, Azam Bazrafshan1, Hamid Sharifi1, Mostafa Shokoohi3. 1. HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran. 2. Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada. 3. HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada. Electronic address: mostafa.shokoohi@utoronto.ca.
Abstract
BACKGROUND: Illicit drug use is a prevalent risk behavior among female sex workers (FSWs) as it increases the vulnerability of this marginalized population to negative health outcomes, including HIV infection. This systematic review and meta-analysis aimed to estimate the prevalence of injection and non-injection drug use among FSWs in Iran. METHODS: Systematic searches of PubMed, Embase, Web of Science, Scopus, and PsycINFO (for English records), along with Iranian databases including IranMedex, Iran Psych Magiran, Scientific Information Database, and Irandoc (for Farsi records) were conducted for studies published from inception through to July 2020. We included quantitative studies on injection and non-injection drug use among FSWs. The pooled prevalence and 95% confidence intervals (CI) of recent and lifetime drug injection and non-injection were estimated using random-effects meta-analysis. RESULTS: Of 458 screened records, 19 met the inclusion criteria. The pooled prevalence of recent non-injection drug use and injection drug use was 56.94% (95% CI: 44.68, 68.78) and 5.67% (95% CI: 2.09, 10.73), respectively. Opium (33.00%, 95% CI: 24.53, 42.05) and crystal methamphetamine (20.68%, 95% CI: 13.59, 28.79) were the most prevalent recent non-injection drugs used. Additionally, the pooled prevalence of lifetime non-injection drug use was 76.08% (95% CI: 66.81, 84.27) and injection drug use was 10.72% (95% CI: 7.02, 15.07). CONCLUSIONS: This systematic review shows that drug use, both injection and non-injection, is prevalent among FSWs in Iran. These findings highlight the importance of evidence-based harm reduction and treatment programs to reduce the burdens of drug use and its associated potential consequences among these underserved women.
BACKGROUND: Illicit drug use is a prevalent risk behavior among female sex workers (FSWs) as it increases the vulnerability of this marginalized population to negative health outcomes, including HIV infection. This systematic review and meta-analysis aimed to estimate the prevalence of injection and non-injection drug use among FSWs in Iran. METHODS: Systematic searches of PubMed, Embase, Web of Science, Scopus, and PsycINFO (for English records), along with Iranian databases including IranMedex, Iran Psych Magiran, Scientific Information Database, and Irandoc (for Farsi records) were conducted for studies published from inception through to July 2020. We included quantitative studies on injection and non-injection drug use among FSWs. The pooled prevalence and 95% confidence intervals (CI) of recent and lifetime drug injection and non-injection were estimated using random-effects meta-analysis. RESULTS: Of 458 screened records, 19 met the inclusion criteria. The pooled prevalence of recent non-injection drug use and injection drug use was 56.94% (95% CI: 44.68, 68.78) and 5.67% (95% CI: 2.09, 10.73), respectively. Opium (33.00%, 95% CI: 24.53, 42.05) and crystal methamphetamine (20.68%, 95% CI: 13.59, 28.79) were the most prevalent recent non-injection drugs used. Additionally, the pooled prevalence of lifetime non-injection drug use was 76.08% (95% CI: 66.81, 84.27) and injection drug use was 10.72% (95% CI: 7.02, 15.07). CONCLUSIONS: This systematic review shows that drug use, both injection and non-injection, is prevalent among FSWs in Iran. These findings highlight the importance of evidence-based harm reduction and treatment programs to reduce the burdens of drug use and its associated potential consequences among these underserved women.
Authors: Mohammad Karamouzian; Hamid Sharifi; Mehrdad Khezri; Mostafa Shokoohi; Ali Mirzazadeh; Fatemeh Tavakoli; Nima Ghalekhani; Ghazal Mousavian; Soheil Mehmandoost; Parvin Afsar Kazerooni; Ali Akbar Haghdoost Journal: AIDS Behav Date: 2022-02-23