Social determinants associated with risky sexual behaviors among men who inject drugs in Kermanshah, Western Iran

ABSTRACT Background: Limited studies exist on risky sexual behaviors and sociodemographic variables among people who use drugs. Understanding the social determinants of risky sexual behaviors is important for designing appropriate HIV/AIDS interventions. Therefore, to illuminate this uncharted area, we aimed to investigate the social determinants of risky sexual behaviors among people who inject drugs (PWID) in Kermanshah, Iran.Methods: Cross-sectional data were analyzed from the HIV Behavioral Surveillance among PWID, conducted from 2013 to 2014 in Kermanshah, Iran. Additional data were collected by holding interviews to acquire information on sociodemographic characteristics (i.e., age, educational), history of substance use (i.e., age of initiation, use of specific drug types in the past 6 months), sexual behaviors including consistent condom use (yes/no), and type of sexual partners (main, casual, exchange). We analyzed variables individually through bivariate analysis and subsequently ran significant variables (P < 0.2) in a multivariate regression model. P < 0.05 was considered statistically significant. Descriptive statistics and logistic regression were conducted in Stata 11.Results: Participants were between the age of 14 and 78 years (median = 31 years; SD = 11.23 years). Compared to PWIDs who reported no sexual risk behavior, participants that were more likely to partake in sexual risk behaviors were those of low (adjusted odds ratio [AOR] = 3.2, P < 0.05) or moderate (AOR = 2.2, P < 0.05) socioeconomic status and methamphetamine use (AOR = 2.8, P < 0.05).Conclusion: A key finding of this study is that PWID who reported having multiple sex partners with inconsistent condom use were more likely to experience poly-drug use, methamphetamine use, being of low socioeconomic and education level, and refuse to attend harm reduction programs.

[1]  M. Noroozi,et al.  Decomposition of Economic Inequality in Needle and Syringe Programs Utilization to its Determinants among Men Who Inject Drugs in Tehran using Blinder–Oaxaca Decomposition Method , 2018, Substance use & misuse.

[2]  M. Noroozi,et al.  Factors associated with HIV risk perception among people who inject drugs: Findings from a cross-sectional behavioral survey in Kermanshah, Iran , 2018 .

[3]  M. Noroozi,et al.  Social determinants and hepatitis C among people who inject drugs in Kermanshah, Iran: Socioeconomic status, homelessness, and sufficient syringe coverage , 2017 .

[4]  M. Noroozi,et al.  Comparing profile of people who inject drugs (PWID) accessing different types of needle and syringe programs or secondary distribution in Kermanshah, Iran , 2017 .

[5]  Z. J. Shushtari,et al.  HIV Risk Perception and Risky Behavior Among People Who Inject Drugs in Kermanshah, Western Iran , 2017, International Journal of Behavioral Medicine.

[6]  M. Noroozi,et al.  Patterns of HIV Risks and Related Factors among People Who Inject Drugs in Kermanshah, Iran: A Latent Class Analysis , 2017, Journal of psychoactive drugs.

[7]  M. Noroozi,et al.  Impact of Needle and Syringe Program Coverage on HIV Incidence in People Who Inject Drugs , 2016 .

[8]  M. Noroozi,et al.  Impact of HIV Status Notification on Risk Behaviors among Men Who Inject Drugs in Kermanshah, West of Iran , 2016, Journal of research in health sciences.

[9]  R. Kelishadi,et al.  Association of socioeconomic status with psychiatric problems and violent behaviours in a nationally representative sample of Iranian children and adolescents: the CASPIAN-IV study , 2016, BMJ Open.

[10]  A. Farhoudian,et al.  A Qualitative Study on Methamphetamine-Related Sexual High-Risk Behaviors in an Iranian Context , 2016 .

[11]  S. Yi,et al.  Factors Associated with Inconsistent Condom Use among Men Who Have Sex with Men in Cambodia , 2015, PloS one.

[12]  G. Rutherford,et al.  High HIV Prevalence in a Respondent-Driven Sampling Survey of Injection Drug Users in Tehran, Iran , 2015, AIDS and Behavior.

[13]  A. Alipour,et al.  HIV prevalence and related risk behaviours among female partners of male injecting drugs users in Iran: results of a bio-behavioural survey, 2010 , 2013, Sexually Transmitted Infections.

[14]  A. Haghdoost,et al.  HIV prevalence and risk behaviours among people who inject drugs in Iran: the 2010 National Surveillance Survey , 2013, Sexually Transmitted Infections.

[15]  H. Hagan,et al.  Dual HIV Risk: Receptive Syringe Sharing and Unprotected Sex Among HIV-Negative Injection Drug Users in New York City , 2013, AIDS and Behavior.

[16]  Zahra Alam Mehrjerdi.  Norjizak injection: a critical risk for transmitting blood-borne infectious diseases. , 2013 .

[17]  A. Noroozi,et al.  An Emerging Trend of Methamphetamine Injection in Iran: A Critical Target for Research on Blood-Borne Infection Diseases , 2013, Hepatitis monthly.

[18]  A. Haghdoost,et al.  Modelling HIV modes of transmission in Iran , 2012, Retrovirology.

[19]  L. Coolen,et al.  Concurrent Exposure to Methamphetamine and Sexual Behavior Enhances Subsequent Drug Reward and Causes Compulsive Sexual Behavior in Male Rats , 2011, The Journal of Neuroscience.

[20]  J. Montaner,et al.  Individual, Social, and Environmental Factors Associated with Initiating Methamphetamine Injection: Implications for Drug Use and HIV Prevention Strategies , 2011, Prevention Science.

[21]  T. Patterson,et al.  Sexual risk behavior associated with co-administration of methamphetamine and other drugs in a sample of HIV-positive men who have sex with men. , 2009, The American journal on addictions.

[22]  M. Forouzanfar,et al.  Prevalence of HIV and Hepatitis C Virus Infections and Related Behavioral Determinants among Injecting Drug Users of Drop-in Centers in Iran , 2009 .

[23]  R. Gilman,et al.  Sexual behavior and drug consumption among young adults in a shantytown in Lima, Peru , 2009, BMC public health.

[24]  J. Montaner,et al.  Structural factors associated with an increased risk of HIV and sexually transmitted infection transmission among street-involved youth , 2009, BMC public health.

[25]  Linda Richter,et al.  Behavioural strategies to reduce HIV transmission: how to make them work better , 2008, The Lancet.

[26]  M. Tyndall,et al.  Mapping violence and policing as an environmental-structural barrier to health service and syringe availability among substance-using women in street-level sex work. , 2008, The International journal on drug policy.

[27]  S. Aral,et al.  Drivers of STD/HIV epidemiology and the timing and targets of STD/HIV prevention , 2007, Sexually Transmitted Infections.

[28]  David R. Holtgrave,et al.  Homelessness and HIV-Associated Risk Behavior Among African American Men Who Inject Drugs and Reside in the Urban South of the United States , 2007, AIDS and Behavior.

[29]  R. Platt,et al.  Social Network-Related Risk Factors for Bloodborne Virus Infections Among Injection Drug Users Receiving Syringes through Secondary Exchange , 2007, Journal of Urban Health.

[30]  Jean Shoveller,et al.  Risky groups, risky behaviour, and risky persons: Dominating discourses on youth sexual health , 2006 .

[31]  M. Gouya,et al.  Needle and syringe sharing practices of injecting drug users participating in an outreach HIV prevention program in Tehran, Iran: A cross-sectional study , 2005, Harm reduction journal.

[32]  F. Molitor,et al.  Methamphetamine use and sexual and injection risk behaviors among out-of-treatment injection drug users. , 1999, The American journal of drug and alcohol abuse.

[33]  D. Vlahov,et al.  Socially desirable response tendency as a correlate of accuracy of self-reported HIV serostatus for HIV seropositive injection drug users. , 1998, Addiction.

[34]  J. Watters,et al.  HIV risk-related sex behaviors among injection drug users, crack smokers, and injection drug users who smoke crack. , 1993, American journal of public health.