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1.
J Phys Act Health ; : 1-8, 2020 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-32109881

RESUMO

BACKGROUND: Because of high prevalence of coronary artery diseases (CADs) in Iran and their relationship with low physical activity (LPA), this study aimed to measure the epidemic size of LPA, its incidence rate, and its relationship with other CAD risk factors in Kerman, Iran. METHODS: About 10,000 adults were randomly recruited through single-stage cluster sampling. Demographic characteristics, biochemical variables, smoking, opium use, mental status, and physical activities were assessed. The relationship between LPA and 7 other CAD risk factors was measured. Five-year incidence rate of LPA was calculated according to the data from the physically active participants in the first phase of the study (n = 3416) who attended the second phase after 5 years. RESULTS: The prevalence of low, moderate, and intense physical activity was 47.2%, 34.8%, and 18.0%, respectively. LPA rose from 45.1% to 62.2% after the age of 25 years. Women had higher LPA than men. Participants with LPA had significantly higher chance of cigarette smoking, diabetes, overweight/obesity, hypertension, and opium addiction. Five-year incidence rate of LPA was 5.1 persons/100 person-years among physically active population. CONCLUSION: Almost half of the studied population suffering from LPA was at risk of CAD. Such risky lifestyle pattern while worsened in the last 5 years makes the emerging of CAD epidemic unavoidable, if appropriate timely interventions not being in place accordingly.

2.
Sex Transm Infect ; 96(1): 68-75, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31836679

RESUMO

OBJECTIVE: The HIV trend among female sex workers (FSWs) is understudied. We assessed the prevalence and trend of HIV and five other STIs among FSWs in Iran. METHODS: We recruited FSWs (1337 in 2015, 1005 in 2010) from 21 sites in 13 cities in two cross-sectional biobehavioural surveys. Eligible FSWs were women aged ≥18 years who reported selling sex to more than one male client in the past 12 months. Consenting FSWs were interviewed using a behavioural questionnaire and tested for HIV and five other STIs. We considered study sites as clusters in the analysis and two-sided Fisher's exact test to compare the HIV prevalence between the two survey rounds. RESULTS: HIV prevalence was 2.1% in 2015 (vs 4.0% in 2010, p=0.007). Lifetime drug injection was reported by 6.1% of participants in 2015 (vs 14.6% in 2010, p=0.003). In 2015, among FSWs with history of lifetime drug injection, HIV prevalence was 8.6% (vs 9.8% in 2010, p=0.425). The prevalence of other STIs in 2015 was 0.4% (95% CI 0.2 to 1.0) for syphilis, 1.3% (95% CI 0.8 to 2.1) for gonorrhoea, 6.0% (95% CI 4.8 to 7.4) for chlamydia, 11.9% (95% CI 8.5 to 16.5) for trichomoniasis and 41.8% (95% CI 39.2 to 44.5) for human papillomavirus. CONCLUSIONS: HIV prevalence among FSWs in Iran decreased, but remains considerably high. The decrease in HIV prevalence compared with 2010 might be explained by a decrease in drug injection. Other STIs are also high in this population. Harm reduction programmes need to be continued and scaled up among this underserved population in Iran.

3.
Arch Sex Behav ; 2019 Nov 07.
Artigo em Inglês | MEDLINE | ID: mdl-31701288

RESUMO

Given the high burden of HIV and other sexually transmitted infections (STIs) among female sex workers (FSW) and their potential role in bridging HIV/STIs into the general population, estimating the prevalence of HIV/STIs among FSW is essential for future research and policy developments. This systematic review and meta-analysis synthesize the available HIV/STIs data among FSW in Iran. We searched MEDLINE, PsycINFO, CINAHL, Embase, Web of Science, Google Scholar, and Iranian databases from inception through to January 2018. Inclusion criteria were original quantitative studies that measured HIV/STIs prevalence among FSW. Pooled prevalence estimates were calculated using random-effects meta-analyses. Out of a total of 299 screened studies, 12 were included with total study participants of 4328 FSW. Heterogeneity was present but meta-regression analyses revealed no significant association between HIV prevalence and year of publication, city, and age. Pooled HIV prevalence was 2.23% (95% confidence interval [CI] 0.82, 3.64). We estimated the prevalence of other STIs as 0.77% (95% CI 0.01, 1.53) for hepatitis B, 6.18% (95% CI 1.32, 11.04) for hepatitis C, 0.33% (95% CI 0.00, 0.66) for syphilis, 1.47% (95% CI 0.22, 2.71) for gonorrhea, 9.80% (95% CI 4.70, 14.91) for chlamydia, and 6.18% (95% CI 4.92, 7.43) for trichomonas vaginalis. Based on the existing evidence, HIV and STIs prevalence among FSW are relatively low in Iran. Strategies for timely diagnosis and treatment of HIV and other STIs among FSW and their sexual and injecting partners are needed to reduce the burden of HIV/STIs among these vulnerable populations in Iran.

5.
Ann Epidemiol ; 35: 29-34, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31171443

RESUMO

PURPOSE: Given the adverse impacts of enforcement-based approaches toward sex work on female sex workers' (FSWs') health, safety, and well-being, we explored the prevalence and correlates of recent incarceration among FSWs in Iran. METHODS: From January to August 2015, we recruited FSWs from 21 harm reduction facilities and 152 FSWs from street venues in 13 major cities across Iran. Correlates of recent (i.e., last year) incarceration were assessed through an exploratory multivariable logistic regression model. RESULTS: A total of 90 of 1326 (6.8%) FSWs reported a recent incarceration; primary reasons for incarceration were drug-related (n = 48/90; 52.9%). Having a recent incarceration was significantly and positively associated with history of illicit drug use/injection (adjusted odds ratio [aOR] = 3.22, 95% confidence interval [CI]: 1.67, 6.19), rape in last year (aOR = 2.67, 95% CI: 1.65, 4.31), unstable housing (aOR = 2.28, 95% CI: 1.16, 4.91), and working in brothels (aOR = 2.22, 95% CI: 1.18, 4.16). CONCLUSIONS: In sum, recent incarceration was significantly associated with history of drug use and sociostructural vulnerabilities. Taken together, these data suggest the potential health impacts of the integration of programs to mitigate substance use, sexual violence, and living conditions into comprehensive services for FSWs in Iran.


Assuntos
Prisioneiros/estatística & dados numéricos , Delitos Sexuais/estatística & dados numéricos , Profissionais do Sexo/estatística & dados numéricos , Abuso de Substâncias por Via Intravenosa/epidemiologia , Adulto , Feminino , Redução do Dano , Humanos , Irã (Geográfico)/epidemiologia , Prevalência , Prisões , Fatores de Risco , Profissionais do Sexo/psicologia , Inquéritos e Questionários
6.
Int J Epidemiol ; 48(6): 1744-1749, 2019 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-31106350

RESUMO

Estimating the number of people in hidden populations is needed for public health research, yet available methods produce highly variable and uncertain results. The Anchored Multiplier calculator uses a Bayesian framework to synthesize multiple population size estimates to generate a consensus estimate. Users submit point estimates and lower/upper bounds which are converted to beta probability distributions and combined to form a single posterior probability distribution. The Anchored Multiplier calculator is available as a web browser-based application. The software allows for unlimited empirical population size estimates to be submitted and combined according to Bayes Theorem to form a single estimate. The software returns output as a forest plot (to visually compare data inputs and the final Anchored Multiplier estimate) and a table that displays results as population percentages and counts. The web application 'Anchored Multiplier Calculator' is free software and is available at [http://globalhealthsciences.ucsf.edu/resources/tools] or directly at [http://anchoredmultiplier.ucsf.edu/].

7.
J Urban Health ; 96(4): 549-557, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30963510

RESUMO

We used four methods (direct count, indirect count, wisdom of the crowd, and unique object multiplier) to map and estimate the population size of street children in six major cities in Iran in 2017. In aggregate for the six cities, the number of street children was estimated at 5296 (interquartile range [IQR] 4122-7071) using the median of the four methods. This corresponds to a rate of 16.3 (IQR 12.5-24.5) per 10,000 children age 5-18 years old, or 3.2 (IQR 2.4-5.3) per 10,000 total population. The total number for street children in the country is estimated at 26,000 (IQR 20,239-34,719) children. Results can help policy-makers advocate for resources, plan programs, and evaluate the reach of programs for street children. The maps created through the course of the population size estimation exercise can also guide outreach efforts to provide street children with health and social welfare services.

8.
PLoS One ; 14(4): e0214785, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30964906

RESUMO

INTRODUCTION: In order to determine the impact of HIV prevention and care programs, it is essential to look at both HIV incidence and prevalence estimates and trends over time. We estimated the HIV incidence and prevalence and assessed the trend using data from three cross-sectional surveys of men who have sex with men (MSM) in two cities in Georgia. METHODS: Using respondent-driven sampling strategy, a total of 796 eligible MSM (18 years or older men with self-reported oral or anal sex with another man in past 12 months) were recruited in Tbilisi in 2010, 2012 and 2015 and 115 in Batumi 2015 into behavioral surveys and HIV testing. To estimate the HIV incidence, we divided the number MSM tested positive for HIV to the time at risk. We calculated the time at risk as years since age at first anal intercourse to the age at last HIV-negative test or the age at first HIV-positive test, accounted for the interval censorship. We calculated the respondent-driven sampling adjusted estimates for HIV prevalence and assessed the trend in Tbilisi by Chi2 test for trend. For HIV incidence rate, we used Kaplan Meier method to estimate the rates and assessed the subgroup differences by log-rank test. RESULTS: The HIV prevalence was 14.9% in Batumi in 2015; it significantly increased in Tbilisi from 6.2% in 2010 to 14.1% in 2012, and to 19.6% in 2015 (p-value for trend < 0.001). Likewise, the HIV incidence rate in Tbilisi significantly increased form 0.45 per 100 person-years (PY) in 2010 to 0.98 per 100 PY in 2012 (p-value 0.01), and to 1.63 per 100 PY in 2015 (p-value < 0.001). HIV incidence rate was 1.37 per 100 PY in Batumi in 2015. In 2015, young MSM (Tbilisi: 3.71, Batumi: 3.92 per 100 PY, p-value< 0.008), single MSM (Tbilisi: 1.99, per 100 PY, p-value 0.03) and less educated MSM (Batumi: 1.86 per 100 PY, p-value 0.03) had higher HIV incidence than other MSM. CONCLUSION: Our findings suggest the continuous transmission of HIV among MSM in Tbilisi and a high prevalence of HIV among MSM in Batumi and the critical need for scaling up the coverage and accessibility of combination prevention packages including rapid HIV diagnosis and treatment.


Assuntos
Infecções por HIV/epidemiologia , Infecções por HIV/transmissão , Adulto , Estudos Transversais , República da Geórgia/epidemiologia , HIV/patogenicidade , Homossexualidade Masculina , Humanos , Incidência , Masculino , Prevalência , Assunção de Riscos , Comportamento Sexual
9.
JMIR Public Health Surveill ; 5(1): e11737, 2019 Mar 14.
Artigo em Inglês | MEDLINE | ID: mdl-30869646

RESUMO

BACKGROUND: Key populations, including female sex workers (FSWs), are at a disproportionately high risk for HIV infection. Estimates of the size of these populations serve as denominator data to inform HIV prevention and treatment programming and are necessary for the equitable allocation of limited public health resources. OBJECTIVE: This study aimed to present the respondent-driven sampling (RDS) adjusted reverse tracking method (RTM; RadR), a novel population size estimation approach that combines venue mapping data with RDS data to estimate the population size, adjusted for double counting and nonattendance biases. METHODS: We used data from a 2014 RDS survey of FSWs in Windhoek and Katima Mulilo, Namibia, to demonstrate the RadR method. Information from venue mapping and enumeration from the survey formative assessment phase were combined with survey-based venue-inquiry questions to estimate population size, adjusting for double counting, and FSWs who do not attend venues. RadR estimates were compared with the official population size estimates, published by the Namibian Ministry of Health and Social Services (MoHSS), and with the unadjusted RTM. RESULTS: Using the RadR method, we estimated 1552 (95% simulation interval, SI, 1101-2387) FSWs in Windhoek and 453 (95% SI: 336-656) FSWs in Katima Mulilo. These estimates were slightly more conservative than the MoHSS estimates-Windhoek: 3000 (1800-3400); Katima Mulilo: 800 (380-2000)-though not statistically different. We also found 75 additional venues in Windhoek and 59 additional venues in Katima Mulilo identified by RDS participants' responses that were not detected during the initial mapping exercise. CONCLUSIONS: The RadR estimates were comparable with official estimates from the MoHSS. The RadR method is easily integrated into RDS studies, producing plausible population size estimates, and can also validate and update key population maps for outreach and venue-based sampling.

10.
Drug Alcohol Depend ; 198: 133-135, 2019 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-30921649

RESUMO

OBJECTIVE: To understand the number of young adult people who inject drugs (PWID) with hepatitis C virus (HCV) infection accessing direct-acting antiviral (DAA) treatment and their barriers and facilitators to treatment uptake. METHODS: Using prospective cohort data from young adult PWID in San Francisco with newly identified HCV infection, we calculated the number who: (i) accepted referral to DAA therapy, (ii) initiated DAA therapy, (iii) completed DAA therapy, and (iv) achieved sustained virologic response (SVR) or cure. Behavioral survey data identified possible barriers and facilitators to DAA therapy. RESULTS: Of 60 young adult PWID with new HCV infection identified between February 2015 and January 2018, thirty accepted a referral to HCV care; five initiated and completed HCV treatment and achieved cure. Barriers to DAA uptake included fear of medical establishments, competing basic needs, and delaying care because they were feeling well. CONCLUSION: While few HCV-positive young adult PWID engaged in DAA therapy, all those who did achieved cure. Youth-tailored services that overcome the stigma and marginalization related to injection drug use are needed to improve treatment uptake.


Assuntos
Antivirais/uso terapêutico , Usuários de Drogas/estatística & dados numéricos , Hepacivirus , Hepatite C/tratamento farmacológico , Abuso de Substâncias por Via Intravenosa/virologia , Usuários de Drogas/psicologia , Feminino , Hepatite C/psicologia , Hepatite C/virologia , Humanos , Masculino , Estudos Prospectivos , São Francisco , Abuso de Substâncias por Via Intravenosa/psicologia , Inquéritos e Questionários , Resposta Viral Sustentada , Adulto Jovem
11.
AIDS Behav ; 23(6): 1594-1603, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30460664

RESUMO

We used two national surveys (2010: N = 1597; 2013: N = 1057) of people who inject drugs (PWID) in past-month to assess the prevalence and population size of PWID with either safe or unsafe injection and sex behaviors, overall and by HIV status. In 2013, only 27.0% (vs. 32.3% in 2010) had safe injection and sex, 24.6% (vs. 23.3% in 2010) had unsafe injection and sex, 26.4% (vs. 26.5% in 2010) had only unsafe injection, and 22.0% (vs. 18.0% in 2010) had unsafe sex only. Among HIV-positive PWID in 2013, only 22.1% (~ 2200 persons) had safe injection and sex, 14.2% (~ 1400 persons) had unsafe injection and sex, 53.1% (~ 5200 persons) had unsafe injection, and 10.6% had unsafe sex (~ 1100 persons). Among HIV-negative PWID in 2013, only 27.5% (~ 22,200 persons) had safe injection and sex, 25.9% (~ 20,900 PWID) had unsafe injection and sex, 23.2% (~ 18,700 persons) had unsafe injection, and 23.3% (~ 18,800 persons) had unsafe sex. HIV-positive and -negative PWID in Iran continue to be at risk of HIV acquisition or transmission which calls for targeted preventions services.


Assuntos
Infecções por HIV/transmissão , Abuso de Substâncias por Via Intravenosa/epidemiologia , Sexo sem Proteção/estatística & dados numéricos , Adulto , Feminino , Inquéritos Epidemiológicos , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Vigilância da População , Prevalência , Adulto Jovem
12.
Addict Behav ; 90: 40-47, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30355536

RESUMO

OBJECTIVE: This study examines the prevalence of drug and poly-drug use and their associated factors among female sex workers (FSW) in Iran. METHODS: We analyzed data from a bio-behavioral surveillance survey of 1347 FSW across 13 major cities in Iran in 2015. Two outcome measures were defined: i) past-month "any drug use", a binary variable defined as none or any; and ii) a three-category past-month "poly-drug use" variable defined as none, only one drug, and more than one drug. Correlates of these two study outcomes were assessed using multivariable logistic regression and multinomial logistic regression, respectively. Adjusted odds ratios (AOR) and 95% confidence intervals (CI) were reported. RESULTS: We found that 24.9% (95% CI: 16.1, 36.4) and 13.5% (95% CI: 8.1, 21.5) of FSW reported past-month any drug use and poly-drug use, respectively. Longer sex work career (AOR 2.44 [95% CI: 1.28, 4.63]), unstable housing (AOR 2.56 [1.17, 5.64]), past-year experience of sexual violence (AOR 1.61 [1.15, 2.27]), and incarceration (AOR 2.02 [1.23, 3.32]) were positively associated with any drug use. Similarly, FSW who were unstably housed (AOR 3.4 [1.06, 10.95]), reported past-year experience of sexual violence (AOR 2.06 [95% CI: 1.24, 3.41]) and incarceration (AOR 2.82 [1.60, 4.97]) were positively associated with past-month poly-drug use. CONCLUSION: Drug use is frequent among Iranian FSW, particularly among those who experienced sexual violence, unstable housing or incarceration. Programs to reduce harms associated with drug and poly-drug use should target FSW as a priority population.

13.
PLoS One ; 13(11): e0207681, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30496204

RESUMO

In Iran, People Who Inject Drugs (PWID), Female Sex Workers (FSW), and prisoners are the main key populations at risk of HIV infection. This study aimed to evaluate the trend of HIV incidence among PWID, FSW and prisoners as an impact measure of HIV harm reduction and prevention efforts in Iran. Data were obtained from the two rounds of national bio-behavioral surveillance surveys among FSW (2010 (n = 872), 2015 (n = 1339)), PWID (2010 (n = 2417), 2014 (n = 2307)), and prisoners (2009 (n = 4536), 2013 (n = 5390)) through facility-based (FSW and PWID surveys) and cluster sampling (prisoner surveys). Time-at-risk was calculated assuming the age at first sex or drug injection as the beginning of the at-risk period and the age at the time of the interview or date when they received a positive HIV test result as the end of this period, adjusted for interval censoring. HIV incidence among PWID in 2014 was 5.39 (95% CI 4.71, 6.16) per 1,000 person-years (PY), significantly lower than in 2009 (17.07, 95% CI 15.34, 19.34). Similarly, HIV incidence was 1.12 (95% CI 0.77, 1.64) per 1,000 PY among FSW in 2015, a significant drop from 2010 (2.38, 95% CI 1.66, 3.40). Also, HIV incidence decreased among prisoners from 1.34 (95% CI: 1.08, 1.67) in 2009 to 0.49 (95% CI: 0.39, 0.61) per 1,000 PY in 2013. Our findings suggest that after an increase in the 2000s, the HIV incidence may have been decreased and stabilized among key populations in Iran.


Assuntos
Usuários de Drogas , Infecções por HIV/epidemiologia , Prisioneiros , Profissionais do Sexo , Estudos Transversais , Usuários de Drogas/estatística & dados numéricos , Feminino , Humanos , Incidência , Irã (Geográfico)/epidemiologia , Masculino , Prisioneiros/estatística & dados numéricos , Medição de Risco/tendências , Profissionais do Sexo/estatística & dados numéricos , Inquéritos e Questionários
14.
Epidemiol Health ; 40: e2018041, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30121969

RESUMO

Network scale-up is an indirect size estimation method, in which participants are questioned on sensitive behaviors of their social network members. Therefore, the visibility of the behavior affects the replies and estimates. Many attempts to estimate visibility have been made. The aims of this study were to review the main methods used to address visibility and to provide a summary of reported visibility factors (VFs) across populations. We systematically searched relevant databases and Google. In total, 15 studies and reports that calculated VFs were found. VF calculation studies have been applied in 9 countries, mostly in East Asia and Eastern Europe. The methods applied were expert opinion, comparison of NSU with another method, the game of contacts, social respect, and the coming-out rate. The VF has been calculated for heavy drug users, people who inject drugs (PWID), female sex workers (FSWs) and their clients, male who have sex with male (MSM), alcohol and methamphetamine users, and those who have experienced extra-/pre-marital sex and abortion. The VF varied from 1.4% in Japan to 52.0% in China for MSM; from 34.0% in Ukraine to 111.0% in China for FSWs; and from 12.0% among Iranian students to 57.0% in Ukraine for PWID. Our review revealed that VF estimates were heterogeneous, and were not available for most settings, in particular the Middle East and North Africa region, except Iran. More concrete methodologies to estimate the VF are required.


Assuntos
Viés , Projetos de Pesquisa , Rede Social , Humanos
15.
Prison J ; 98(2): 213-228, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30078913

RESUMO

We explored the potentials of using three indirect methods including crosswise, proxy respondent method, and network scale-up (NSU) in comparison to direct questioning in collecting sensitive and socially stigmatized HIV-related risk behaviors information from prisoners (N=265). Participants reported more sexual contact in prison for their friends than they did for themselves (10.6% vs. 3.8% in men, 13.7% vs. 0% in women). In men, NSU provided lower estimates than direct questioning, while in women NSU estimates were higher. Different data collection methods provide different estimates, and collectively offer a more comprehensive picture of HIV-related risk behaviors in prisons.

17.
Int J Epidemiol ; 47(5): 1636-1644, 2018 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-29931067

RESUMO

Background: The multiplier method is one of the most frequently used population size estimation (PSE) methods for key populations, yet estimates from this method are often inconsistent with each other, other PSE methods and local knowledge. We developed a novel Bayesian approach, the 'Anchored Multiplier', which synthesizes estimates from multipliers coupled to an a priori estimate to arrive at a single consensus estimate and credible range. Methods: Data for size estimation were collected from three cross-sectional bio-behavioural surveillance studies of people who inject drugs (PWID) in San Francisco, CA, USA (2005, 2009 and 2012). We demonstrate the application of the Anchored Multiplier and a Variance Adjusted-Anchored Multiplier using PSE produced by multipliers in the three surveys and the literature for the USA. Size estimates were compared with estimates from other available PSE methods. Results: Using the Anchored Multiplier, we estimated the PWID population made up 2.41% [95% credible interval (CI): 1.9-2.85] of the adult population in 2005, 2.1% (95% CI: 1.8-2.48) in 2009 and 2.3% (95% CI: 2.03-2.61) in 2012. The Variance Adjusted-Anchored Multiplier calculated similar point estimates, with wider 95% credible intervals. Credible intervals from both approaches were substantially narrower than from other standard PSE methods and, unlike other methods, indicated that the prevalence of PWID was stable over time. Conclusions: The Anchored Multiplier is a promising new approach to size estimation, which generates a single estimate to inform programmatic strategies to counter the HIV epidemic, and provides a robust denominator to quantify the burden of disease for key populations.


Assuntos
Teorema de Bayes , Infecções por HIV/epidemiologia , Modelos Estatísticos , Densidade Demográfica , Abuso de Substâncias por Via Intravenosa/epidemiologia , Adulto , Estudos Transversais , Técnica Delfos , Feminino , Humanos , Masculino , Vigilância da População , Prevalência , São Francisco/epidemiologia
18.
AIDS Behav ; 22(Suppl 1): 19-25, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29744768

RESUMO

Among 1337 Iranian adult female sex workers in 2015, we assessed the diagnostic value of 4 self-reported sexually transmitted infection (STIs) symptoms for detecting laboratory-confirmed gonorrhea, chlamydia, trichomoniasis, human papillomavirus (HPV), and syphilis. While 37.7% reported vaginal discharge (VD), 25.9% reported pain or burning (P/B), 3.0% reported genital ulcers (GU), and 1.4% reported genital warts (GW), the prevalence of laboratory-confirmed syphilis, gonorrhea, chlamydia, trichomoniasis, and HPV was 0.4, 1.3, 6.0, 11.9, and 41.9%, respectively. The sensitivity of VD was 40.3% for detecting tricomoniasis, 37.5% for chlamydia, and 37.5% for gonorrhea. The sensitivity of P/B ranged from 12.5% for gonorrhea to 25.2% for trichomoniasis. The sensitivity of GU and GW was very low for 5 STIs. The sensitivity of all symptoms combined was also lower than 50%. Among asymptomatic participants, 41.2% tested positive for HPV, 11.8% for trichomoniasis, and less than 6.6% for other STIs. Symptom-based case management and surveillance of STIs can lead to misclassification of a large proportion of cases.


Assuntos
Trabalho Sexual , Profissionais do Sexo/estatística & dados numéricos , Doenças Sexualmente Transmissíveis/diagnóstico , Doenças Sexualmente Transmissíveis/epidemiologia , Adolescente , Adulto , Infecções por Chlamydia/diagnóstico , Infecções por Chlamydia/epidemiologia , Condiloma Acuminado/diagnóstico , Condiloma Acuminado/epidemiologia , Feminino , Gonorreia/diagnóstico , Gonorreia/epidemiologia , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Papillomaviridae , Infecções por Papillomavirus/diagnóstico , Infecções por Papillomavirus/epidemiologia , Valor Preditivo dos Testes , Prevalência , Sífilis/diagnóstico , Sífilis/epidemiologia , Tricomoníase/diagnóstico , Tricomoníase/epidemiologia
19.
J Res Health Sci ; 18(2): e00413, 2018 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-29784894

RESUMO

BACKGROUND: This study aimed to estimate the prevalence of substance use among university students measured by direct and indirect methods, and to calculate the visibility factor (VF) defined as ratio of indirect to direct estimates of substance use prevalence. STUDY DESIGN: A cross-sectional study. METHODS: Using a multistage non-random sampling approach, we recruited 2157 students from three universities in Kerman, Iran, in 2016. We collected data on substance use by individual face-to-face interview using direct (i.e. self-report of their own behaviors) and indirect (NSU: Network scale up) methods. All estimates from direct and indirect methods were weighted based on inverse probability weight of sampling university. RESULTS: The response rate was 83.6%. The last year prevalence of water pipe, alcohol, and cigarettes indirect method was 44.6%, 18.1%, and 13.2% respectively. Corresponding figures in NSU analysis were 36.4%, 18.2%, and 16.5% respectively. In the female population, VF for all types of substance was less than male. CONCLUSIONS: Considerable numbers of university students used substances like a water pipe, alcohol, and cigarettes. NSU seems a promising method, especially among male students. Among female students, direct method provided more reliable results mainly due to transmission and prestige biases.


Assuntos
Autorrelato , Estudantes/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adolescente , Adulto , Consumo de Bebidas Alcoólicas/epidemiologia , Estudos Transversais , Feminino , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Prevalência , Fatores de Risco , Fumar/epidemiologia , Universidades/estatística & dados numéricos , Adulto Jovem
20.
AIDS Behav ; 22(Suppl 1): 10-18, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29766329

RESUMO

We examined the association of dyadic-level factors with syringe sharing among people who inject drugs (PWID) in Kerman, Iran. In a cross-sectional study, we collected data on 329 drug-injecting dyads by individual face-to-face interviews. An injecting dyad was defined as 2 PWID who knew each other and injected drugs together during the last 6 months. If they reported at least 1 occasion of syringe sharing, the dyad was considered high-risk. Dyadic-level factors associated with syringe sharing were assessed using cross-classified multilevel logistic regression. The rate of syringe sharing was significantly higher for dyads who were more intimate (adjusted odds ratio [AOR] 4.5, CI 95%, 2.3-8.6), who had instrumental support (AOR 2.1, 95% CI 1.1-4.5), and who pooled money for drugs (AOR 4.1, 95% CI 2.0-8.3). The rate was lower in same-sex dyads (AOR 0.4, 95% CI 0.2-0.9) and in dyads who shared health information (AOR 0.5, 95% CI 0.2-0.9). Findings highlight close-peer influences on syringe-sharing behavior.


Assuntos
Uso Comum de Agulhas e Seringas/estatística & dados numéricos , Comportamento Sexual , Parceiros Sexuais , Rede Social , Abuso de Substâncias por Via Intravenosa/epidemiologia , Adulto , Cidades , Estudos Transversais , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Humanos , Relações Interpessoais , Irã (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Análise Multinível , Grupo Associado , Fatores de Risco , Sexo sem Proteção/estatística & dados numéricos
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