Pattern of contributing behaviors and their determinants among people living with HIV in Iran: A 30-year nationwide study

Zahra Gheibi; Mohammad Fararouei; Sima Afrashteh; Mojtaba Akbari; Parvin Afsar Kazerooni; Mostafa Shokoohi

doi:10.3389/fpubh.2023.1038489

Pattern of contributing behaviors and their determinants among people living with HIV in Iran: A 30-year nationwide study

Front Public Health. 2023 Feb 24:11:1038489. doi: 10.3389/fpubh.2023.1038489. eCollection 2023.

Authors

Zahra Gheibi¹, Mohammad Fararouei¹, Sima Afrashteh², Mojtaba Akbari³, Parvin Afsar Kazerooni⁴, Mostafa Shokoohi^{5

6}

Affiliations

¹ Department of Epidemiology, Shiraz University of Medical Sciences, Shiraz, Iran.
² Clinical Research Development Center, The Persian Gulf Martyrs Hospital, Bushehr University of Medical Sciences, Bushehr, Iran.
³ Department of Epidemiology and Statistics, Isfahan University of Medical Sciences, Isfahan, Iran.
⁴ HIV/AIDS Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
⁵ HIV and Sexually Transmitted Infections Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance Institute for Futures Studies in Health Kerman University of Medical Sciences, Kerman, Iran.
⁶ Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.

Abstract

Introduction: A major shift in the routes of HIV transmission seams to be taking place in Iran. Our study aimed to investigate the 30-year trend of major HIV related behaviors in Iran.

Methods: The national HIV/AIDS registry database (from September 1986 to July 2016 with data on 32,168 people newly diagnosed with HIV) was used to study the 30 years trend and demographic determinants of major HIV related behaviors.

Results: The highest rate of drug injection (DI) among people living with HIV (PLHIV) was reported during 1996 to 1999 (p-for trend < 0.001) while the highest rate of sexual activity by minorities or hard to reach groups was during 2004 to 2011 (p-for trend < 0.001). Among males, drug injection was directly associated with being single (OR_{single/married} = 1.34), being unemployed (OR_{unemployed/employed} = 1.94) and having lower level of education (OR_{<highschool/≥highschool} = 2.21). Regarding females, drug injection was associated with being housewife (OR_{housewife/employed} = 1.35) and lower level of education (OR_{<highschool/≥highschool} = 1.85). In females, condomless sexual contact was more common among those younger (OR_20-29/<20 = 6.15), and married (OR_{married/single} = 7.76). However, among males those being single (OR_{married/single} = 0.82), being more educated (OR_{≥highschool/<highschool} = 1.24), and being unemployed (OR_{unemployed/employed} = 1.53) reported more sexual activity by minoritised or hard to reach groups.

Discussion: The pattern of major HIV related behaviors among Iranian males and females have been rapidly changing and people living with HIV (PLHIV) are being diagnosed at a younger age. Health education to younger individuals is an essential HIV controlling strategy among Iranian population. Implementation of surveys in hidden and hard-to-reach populations is also recommended.

Keywords: HIV related behaviors; HIV/AIDS; Iran; injecting drug users; sexual contacts.

MeSH terms

Educational Status
Female
HIV Infections* / epidemiology
Humans
Iran
Male
Risk-Taking
Sexual Behavior