Payam Roshanfekr1, Mehrdad Khezri2, Salah Eddin Karimi3, Meroe Vameghi1, Delaram Ali4, Sina Ahmadi1, Elahe Ahounbar5, Kambiz Mahzari6, Mohsen Roshanpajouh7, Mehdi Noroozi4, Mostafa Shokoohi2,8, Ali Mirzazadeh2,9. 1. Social Welfare Management Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. 2. 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. 3. Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. 4. Social Determinants of Health Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. 5. Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. 6. Advisor to the Committee on Aids Prevention and Control Affiliated to the Health Ministry, Expert, Prevention and Addiction Affairs Bureau State Welfare Organization (SWO), Tehran, Iran. 7. Addiction Department, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences (IUMS), Tehran, Iran. roshanpajouh@gmail.com. 8. Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada. 9. Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA.
Abstract
BACKGROUND: Street-based female sex workers (FSWs) are highly at risk of HIV and other harms associated with sex work. We assessed the prevalence of non-injection and injection drug use and their associated factors among street-based FSWs in Iran. METHODS: We recruited 898 FSWs from 414 venues across 19 major cities in Iran between October 2016 and March 2017. Correlates of lifetime and past-month non-injection and injection drug use were assessed through multivariable logistic regression models. Adjusted odds ratios (AOR) and 95% confidence intervals (CI) were reported. RESULTS: Lifetime and past-month non-injection drug use were reported by 60.3% (95% CI 51, 84) and 47.2% (95% CI 38, 67) of FSWs, respectively. The prevalence of lifetime and past-month injection drug use were 8.6% (95% CI 6.9, 10.7) and 3.7% (95% CI 2.6, 5.2), respectively. Recent non-injection drug use was associated with divorced marital status (AOR 2.00, 95% CI 1.07, 3.74), temporary marriage (AOR 4.31 [1.79, 10.40]), had > 30 clients per month (AOR 2.76 [1.29, 5.90]), ever alcohol use (AOR 3.03 [1.92, 6.79]), and history of incarceration (AOR 7.65 [3.89, 15.30]). Similarly, lifetime injection drug use was associated with ever alcohol use (AOR 2.74 [1.20-6.20]), ever incarceration (AOR 5.06 [2.48-10.28]), and ever group sex (AOR 2.44 [1.21-4.92]). CONCLUSIONS: Non-injection and injection drug use are prevalent among street-based FSWs in Iran. Further prevention programs are needed to address and reduce harms associated with drug use among this vulnerable population in Iran.
BACKGROUND: Street-based female sex workers (FSWs) are highly at risk of HIV and other harms associated with sex work. We assessed the prevalence of non-injection and injection drug use and their associated factors among street-based FSWs in Iran. METHODS: We recruited 898 FSWs from 414 venues across 19 major cities in Iran between October 2016 and March 2017. Correlates of lifetime and past-month non-injection and injection drug use were assessed through multivariable logistic regression models. Adjusted odds ratios (AOR) and 95% confidence intervals (CI) were reported. RESULTS: Lifetime and past-month non-injection drug use were reported by 60.3% (95% CI 51, 84) and 47.2% (95% CI 38, 67) of FSWs, respectively. The prevalence of lifetime and past-month injection drug use were 8.6% (95% CI 6.9, 10.7) and 3.7% (95% CI 2.6, 5.2), respectively. Recent non-injection drug use was associated with divorced marital status (AOR 2.00, 95% CI 1.07, 3.74), temporary marriage (AOR 4.31 [1.79, 10.40]), had > 30 clients per month (AOR 2.76 [1.29, 5.90]), ever alcohol use (AOR 3.03 [1.92, 6.79]), and history of incarceration (AOR 7.65 [3.89, 15.30]). Similarly, lifetime injection drug use was associated with ever alcohol use (AOR 2.74 [1.20-6.20]), ever incarceration (AOR 5.06 [2.48-10.28]), and ever group sex (AOR 2.44 [1.21-4.92]). CONCLUSIONS: Non-injection and injection drug use are prevalent among street-based FSWs in Iran. Further prevention programs are needed to address and reduce harms associated with drug use among this vulnerable population in Iran.
Entities:
Keywords:
Drug use; Female sex workers; Harm reduction; Injection drug use; Iran
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