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Int J Drug Policy. 2017 Jun;44:86-91. doi: 10.1016/j.drugpo.2017.03.011. Epub 2017 May 4.

Injection drug use among female sex workers in Iran: Findings from a nationwide bio-behavioural survey.

Author information

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; School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.
2
Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA; 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
School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.
4
Epidemiology & Biostatistics, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, ON, Canada; 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.
5
Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
6
Center for Disease Control (CDC), Ministry of Health and Medical Education, Tehran, Iran.
7
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.
8
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. Electronic address: hsharifi@kmu.ac.ir.

Abstract

BACKGROUND:

Globally, one in three women who inject drugs is involved in sex work which increases their vulnerability to sexually transmitted infections including HIV. This study was conducted to improve our understanding of injection drug use practices among Iranian female sex workers (FSWs) and shed light on the high-risk profile of FSWs who inject drugs (FSW-IDUs).

METHODS:

This survey was conducted in 2010, by recruiting 872 FSWs through facility-based sampling from 21 sites in 13 cities in Iran. Data were collected through face-to-face interviews and lifetime injection drug use was assessed through the responses to the question "Have you ever injected any illicit drugs?". Independent variables included a range of socio-demographic and risk characteristics. Logistic regression models were applied to investigate the correlates of lifetime history of injection drug use.

RESULTS:

Median (Q1, Q3) age of the participants was 30 (25, 37) and a total of 127 (14.6%, 95% confidence interval (CI): 12.3-17.1) had ever injected drugs. In the multivariable logistic regression model, older age (adjusted odds ratio (AOR)=AOR25-34 vs. <18=3.37, 95% CI: 1.64, 7.70; AOR≥35 vs. <18=2.80, 95% CI: 1.11, 7.10), longer duration (>5 years) of involvement in sex work (AOR=1.06, 95% CI: 1.02, 1.10), and history of drinking alcohol (AOR=4.42, 95% CI: 2.67, 7.32) were positively associated with lifetime history of drug injection and younger age at sex work debut (AOR=0.52, 95% CI: 0.28, 0.96) was negatively associated with lifetime history of illicit drug injection among FSWs.

CONCLUSION:

The prevalence of injection drug use among FSWs in Iran is concerning. Given the potential of this sub-population in bridging HIV into the general population, gender-sensitive and peer-led harm reduction programs should be further scaled up to meet the special needs of this vulnerable population.

KEYWORDS:

Female sex workers; HIV; Injection drug use; Iran; Women who inject drugs

PMID:
28478309
DOI:
10.1016/j.drugpo.2017.03.011
[Indexed for MEDLINE]

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