What may encourage or deter health services utilization by people living with or at the risk of HIV/AIDS in special health centers? Qualitative evidence from a stigmatized community.

BACKGROUND: Behavioral Diseases Counseling Centers (BDCCs) and Vulnerable Women's Counseling Centers (VWCCs) in Iran are the main peripheral centers that offer educational, counseling, diagnostic, preventive, curative and protective services to individuals living with or at high risk of contracting HIV/AIDS and female sex workers respectively. Due to the social stigma surrounding HIV in Iran, this study aims to identify the factors that may hinder or encourage HIV/AIDS patients and women with risky sexual behaviors from visiting these centers. METHODS: Conducted in 2023, this qualitative study involved individuals visiting BDCCs and VWCCs in two western provinces of Iran, Ilam and Kermanshah. The study participants included 21 health staff members working in BDCCs and VWCCs and 20 HIV/AIDS patients and vulnerable women with unsafe sexual behaviors referring to these centers. Purposive, snowball and maximum variation sampling techniques were applied to interview the participants. Interviews were conducted between January 5th and May 21st, 2023, using a semi-structure guideline. Interviews were transcribed and content analysis approach was applied to analyze data using MAXQDA20 software. RESULTS: According to the findings, the barriers and facilitators of visiting specialized centers for HIV/AIDS patients and vulnerable women were categorized into three main categories, 10 subcategories and 35 sub-subcategories including: Medical and operational processes (4 subcategories and 12 sub-subcategories), mutual interactions between the personnel and visitors (people living with and at the risk of getting HIV/AIDS) (3 subcategory and 13 sub-subcategories), and physical characteristics of the centers (3 subcategories and 10 sub-subcategories). CONCLUSIONS: To improve the performance of BDCCs and VWCCs and encourage people living with and at the risk of contracting HIV/AIDS to visit these centers regularly, health policy makers should consider modifying clinical processes, physical features, personnel behaviors and visitors' concerns raised by the interviewees and the issues identified in this study.

Trends in epidemiology of Hepatitis B and C Infections in Ilam Province: National Notifiable Diseases Surveillance System data.

BACKGROUND: Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are the main causes of severe liver failure worldwide. This study was conducted to evaluate the incidence rate and trend of these infections over six successive years from 2008 to 2013 in Ilam Province, western Iran. METHODS: We studied the registered data of HBV and HCV based on the National Notifiable Diseases Surveillance System in Ilam Province from 2008 to 2013. Incidence rate per 100,000 populations was estimated for HBV and HCV infections through location, years and age groups of patients. RESULTS: The overall incidence rate per 100,000 populations from 2008 to 2013 for HBV infection was 9.57, 5.83, 16.26, 12.44, 21.89 and 13.93, respectively. The corresponding values for HCV infection were 0.55, 0.72, 1.44, 2.69, 1.24 and 1.93, respectively and these trends for both the HBV and HCV infections were increasing. The major distribution of HBV and HCV infections was 25-44 years of age. Both HBV and HCV infections were more common in males, urban areas and married patients. Forty-one percent of cases were carriers and history of surgery was the common risk factor. CONCLUSIONS: Our results showed that HBV and HCV are prevalent in the middle-age group. Despite effective vaccination against hepatitis B, optimized blood donor screening and better sterilization procedures for blood products, trend of HBV and HCV in Ilam are increasing. Further studies should address the role other risk factors in the trend of HBV and HCV.