Effect of Social Support Interventions on Adherence to Antiretroviral Therapy Among People Living with HIV: A Systematic Review and Meta-Analysis.

This systematic review and meta-analysis examined the effects of social support interventions (SSIs) on adherence to antiretroviral therapy (ART) among people living with HIV. We systematically searched Web of Science, PubMed/MEDLINE, Scopus, and Cochrane Library in September 9, 2020. English-language publications of randomized controlled trials (RCTs) in peer-reviewed journals were considered eligible. To estimate the effects of SSIs on adherence to ART, odds ratios (ORs) with 95% confidence intervals (CIs) were pooled using random effects models. Subgroup analysis was used to investigate the sources of heterogeneity. Of 243 records identified, 17 controlled trials were included. The meta-analysis found significant and moderate effect size in the improvement of adherence to ART from SSIs. Subgroup analysis showed that the study design, follow up duration, source of social support, and year of publication significantly moderated the effect sizes in the meta-analysis. Our findings support the hypothesis that social support interventions can improve adherence to ART. Using various types and sources of social support, further research is needed to assess the effect of SSIs on adherence to ART across different settings.

Social network and HIV risk behaviors in female sex workers: a systematic review.

BACKGROUND: Social network characteristics have an important role in understanding HIV transmission among female sex workers. The purpose of this systematic review was to summarize and critically appraise the existing studies on the social network characteristics and HIV risk behaviors among female sex workers. METHOD: A systematic review was performed using predefined eligibility criteria through searching electronic databases. Two independent reviewers assessed the methodological quality of studies. RESULTS: Nineteen papers met the eligible review criteria. The synthesized evidence suggests that characteristics of social networks, especially functional characteristics such as social support and social capital, are important constructs for understanding the HIV risk behaviors. CONCLUSIONS: The findings of the present review enhance our understanding of the role of social network characteristics in HIV risk behaviors among female sex workers. However, the findings also highlighted a dearth of knowledge about the association of structural characteristics of social networks with HIV risk behaviors among female sex workers.

HIV Risk Perception and Risky Behavior Among People Who Inject Drugs in Kermanshah, Western Iran.

PURPOSE: Understanding and increasing awareness on individual risk for HIV infection as well as HIV risk perception's effects on different behavioral outcomes for people who inject drugs (PWID) is important for policymaking and planning purposes. The objectives of the present study were to determine whether HIV risk perception was associated with greater injection and sexual risk-taking behaviors among PWIDs. METHOD: We surveyed 460 PWID in Kermanshah regarding their demographic characteristics, sexual risk behaviors, HIV risk perception, and drug-related risk behaviors in the month prior to the study. Three classes of HIV risk perception were identified using ordinal regression to determine factors associated with HIV risk perception. RESULTS: Study participants were categorized as follows: "low" (n = 100, 22%), "moderate" (n = 150, 32%), and "high" (n = 210, 46%) risk perception for becoming infected with HIV. The odds of categorizing as "high" risk for HIV was significantly greater in PWID that reported unprotected sex (adjusted odds ratio (AOR) 2.4, p value 0.02), receptive syringe sharing (AOR 1.8, p value 0.01), and multiple sex partners (AOR 1.4, p value 0.03). PWID who reported unprotected sex had 2.7 times the odds of "high" risk perception when compared to PWID with "low" risk perception. CONCLUSION: Findings show that PWID could rate their HIV risk with acceptable accuracy. Additionally, perceived HIV risk was associated with many risk factors for transmission of HIV, emphasizing the importance of developing targeted prevention and harm reduction programs for all domains of risk behaviors, both sexual and drug-related use.

Socioeconomic Status and Domostic Violence Interact in Perdict of Quality of Life in Married Women: A Population-Based Study in Westeren Iran.

Objective: Women's quality of life is essential both for women's and their family's health. The aim of this study was to examine the quality of life status and interaction of subjective socioeconomic status and violence, on quality of life of married women in west of Iran. Materials and methods: This was a cross-sectional study that recruited 1533 married women using multi-stages sampling method. Multiple linear regression was employed for estimating adjusted association and 95% confidence intervals. Results: The mean (SD) age of the participants was 33.67(11). The majority of participants (92%) experienced some degree of domestic violence. Less than half of women (46.70%) perceived medium socioeconomic status. Mean (SD) score of quality of life was 3.57 (0.94). There was a significant statistical interaction between socioeconomic status and domestic violence on quality of life. Conclusion: These findings suggest that considering the interaction of subjective socioeconomic status with domestic violence in prevention program, especially in poor categories of family, appears to be one of the important ways in improving married-females' quality of life.

The role of risk perception, risk communication, and demographic factors in COVID-19 preventive behaviors: an online survey in Iran.

OBJECTIVES: This study investigated preventive behaviors toward coronavirus disease 2019 (COVID-19) and related factors in a Kurdish Iranian sample. METHODS: This online survey was conducted among the population aged 18 and above in Kermanshah Province, in western Iran, in April 2020. Samples were invited and recruited through social media. Data were collected using a questionnaire consisting of 4 sections (questions on demographic variables, risk perception, risk communication, and COVID-19 preventive behaviors) and analyzed using Stata ver. 8. RESULTS: The Pearson correlation test showed that risk communication was significantly correlated with COVID-19 preventive behaviors (r=0.320, p<0.01). In the final model, where the explanatory power increased with the entry of the risk communication variable, the variables explained a total of 14% of variance in COVID-19 preventive behaviors. Sex (ß=-0.482), risk perception (ß=0.047), and risk communication (ß=0.662) were significant determinants. CONCLUSION: Risk communication and risk perception related to COVID-19, as well as being a woman, were determinants of COVID-19 preventive behaviors.

Social determinants of adherence to COVID-19 preventive guidelines: a comprehensive review.

Adherence to coronavirus disease 2019 (COVID-19) preventive guidelines (ACPG) is an important strategy to control the COVID-19 pandemic effectively. The present study aimed to identify and summarize the social determinants of ACPG among the general population. A comprehensive review was performed from December 2019 to February 2021 through searching electronic databases. Two independent reviewers assessed and selected relevant studies. Next, the characteristics and main findings of the included studies were summarized. Finally, the World Health Organization's conceptual framework of social determinants of health was used to synthesize the identified social determinants of ACPG. Forty-one of 453 retrieved articles met the inclusion criteria. The study results showed different patterns of ACPG among various communities. Furthermore, 84 social determinants were identified and categorized into structural and intermediary determinants. ACPG is a set of complex behaviors associated with different individual sociodemographic and behavioral characteristics; living and working conditions; COVID-19 knowledge, attitudes, and risk perceptions; exposure to sources and information level; leisure activities; social support; trust; social norms; psychosocial well-being; socio-economic position; and the socio-economic and political context. Interventions to promote ACPG among the general population should consider the identified social determinants of ACPG.

Factors associated with time between using a drug and injection initiation among people who inject drugs in Kermanshah, Iran.

Background The transition from non-injection to injection drug use dramatically increases the risk of transmitting HIV and other blood borne infections including hepatitis B virus (HBV) and hepatitis C virus (HCV). The aim of this study was to explore factors associated with the transition from first illicit drug use to first injection among drug users. Methods Using snowball sampling and convenience sampling through needle and syringe programmes (NSPs), we recruited 500 people who inject drugs (PWID) in Kermanshah, between September and December 2014. Trained interviewers collected data on socio-demographic characteristics, HIV testing and drug-related risk behaviors over the last month prior to interview using a structured questionnaire. Our main outcome variable was first illicit drug use to first injection (TIJ). TIJ was calculated by subtracting age at first drug injection from age of first illicit drug use. Results Overall, the average age at first drug use and injection were 21.4 [standard deviation (SD 5.6)] and 22.8 (SD 8.9), respectively. The average duration of injection was 6.0 (SD 4.6) years. Overall, the mean of TIJ for participants was 1.4 (IQR = 2, 4) years. Age of first injecting drug use negatively correlated with TIJ (R2 = 0.219, p = 0.001). Education level and socioeconomic status (SES), and negatively correlated with TIJ. Conclusion Some demographic factors and drug use characteristics including educational level, SES, knowledge of HIV status, age of initiating drug use, being a poly drug user and using methamphetamine were predictors of the time to transition.

Migraine and quality of life in high school students: a population-based study in Boukan, Iran.

The aim of the study was to estimate quality of life and determine the adjusted association of migraine with the quality of life in a sample of students. This population-based study was performed among 857 high school students in Boukan City (with a Kurdish language-speaking population, about 600 km west of the city of Tehran, Iran). The World Health Organization Quality of Life questionnaire was used along with International Headache Society criteria. Multiple linear regression models were applied. The mean scores of quality of life domains of physical health, psychological, environmental, and social relationships were 69.1 (standard deviation = 16.5), 61.5 (standard deviation = 18. 1), 66.3 (standard deviation = 20. 8), and 65.2 (standard deviation = 17. 8) out of 100, respectively. Migraine after adjusting for the other factors was associated significantly with the scores in the physical (P = .002), social (P = .002), and environmental (P = .033) domains. Migraine is associated with reducing the physical, environmental, and social aspects of the students' quality of life.

Psychological, Social, and Familial Problems of People Living with HIV/AIDS in Iran: A Qualitative Study.

BACKGROUND: HIV/AIDS is one of the diseases which not only makes threats to physical health, but also, due to the negative attitudes of people and the social stigma, affects the emotional and social health of patients. The aim of this study was to identify the psychological, social, and family problems of people living with HIV/AIDS (PLWHA) in Iran. METHODS: In this qualitative study, we used purposive sampling to enroll PLWHA, their families, and physicians and consultants in two cities of Kermanshah and Tehran. Each group of PLWHA, their families, physicians, and consultants participated in two focus group discussions (FGDs), and a total of eight FGDs were conducted. Six interviews were held with all key people, individually. RESULTS: Based on the views and opinions of various groups involved in the study, the main problems of PLWHA were: Ostracism, depression, anxiety, a tendency to get revenge and lack of fear to infect others, frustration, social isolation, relationship problems, and fear due to the social stigma. Their psychological problems included: Marriage problems, family conflict, lack of family support, economic hardships inhibiting marriage, and social rejection of patient's families. Their family problems were: Unemployment, the need for housing, basic needs, homelessness, and lack of social support associations. CONCLUSIONS: It seems that the identification and focusing on psychological, social, and family problems of affected people not only is an important factor for disease prevention and control, but also enables patients to have a better response to complications caused by HIV/AIDS.