Search

Abstract Background Poor sleep quality is a significant issue among people who inject drugs (PWID). This study aimed to evaluate sleep quality and associated factors among PWID in Iran. Methods Using respondent-driven sampling, 2,652 PWID (2,563 male) were recruited in 11 major cities in Iran between 2019 and 2020. The Pittsburgh Sleep Quality Index was utilized to measure sleep quality, and logistic regression was used to assess associations in RDSAnalyst, a software designed for respondent-driven sampling. Results The overall prevalence of poor sleep quality was 68.4% (68.3% among males and 70.2% among females). Married PWID had higher odds of poor sleep quality (Adjusted Odds Ratio (AOR): 1.41; 95% CI: 1.05, 1.91). Lack of access to sufficient food in the past 12 months was also associated with poor sleep quality (AOR: 1.73; 95% CI: 1.17, 2.57 for sometimes having no access, and AOR: 2.95; 95% CI: 1.93, 4.52 for always having no access compared to always having access). Additionally, good self-rated health was significantly associated with lower odds of poor sleep quality (AOR: 0.19; 95% CI: 0.11, 0.31). Conclusion Poor sleep quality is prevalent among PWID in Iran. It is recommended to mitigate the adverse effects of this issue and enhance the overall quality of life for PWID. Supportive interventions aimed at preventing and treating poor sleep quality, as well as improving overall health outcomes, are essential.

Food insecurity (FI) and sleep problems are major modifiable health issues among people living with HIV/AIDS (PLWH), and there is limited knowledge about their prevalence among this underrepresented population. Our study aimed to assess the relationship between FI and sleep problems as important environmental factors affecting PLWH in Iran.The national survey was conducted on 1185 confirmed HIV-positive patients who attended consulting centers in 15 geographically diverse provinces in Iran, during 2021–2022. Standard questionnaires were used to measure FI and sleep problems (Insomnia, Obstructive Sleep apnea (OSA), Excessive Daytime Sleepiness (EDS), and Poor sleep quality), and a logistic regression model was used to assess the association between FI and the odds of experiencing sleep problems.About 764 (The prevalence of FI = 64.47 %) of the participants had insecure status, with a mean score of 11.73 (SE = 0.34). Those with FI had a higher prevalence of insomnia, EDS, and poor sleep quality (54.84 %, 31.79 %, and 55.17 %, respectively) compared to those without FI (30.69 %, 17.03 %, and 40.42 %, respectively). FI increased the odds of being at risk for Insomnia (OR = 2.39, 95 % CI: 1.81–3.15), EDS (OR = 1.44, 95 % CI: 1.04–2.01), and poor sleep quality (OR = 1.79, 95 % CI: 1.29–2.48) in the multiple regression model. The results highlight the strong association between FI and a broad range of sleep problems in PLWH. Considering the impact of FI and impaired sleep health on PLWH, more attention is needed for at-risk groups for screening and intervention purposes.

Abstract Background Psychological discomfort and sleep problems are considered separate disorders. Due to the high prevalence of both disorders among people living with HIV (PLWH), this study was designed to evaluate how those challenges are present among PLWH. Method A cross-sectional study was conducted using data from a national survey of 1185 confirmed PLWH from 15 provinces in Iran from April to August 2019. Psychological discomfort and sleep quality were assessed using standardized versions of related Persian questionnaires. Logistic regression was used to assess the association between psychological discomfort and sleep quality in PLWH. Results The overall prevalence of poor sleep quality, depression, anxiety, and stress was 47.71%, 50.95%, 44.26%, and 41.77%, respectively. The results of multivariate-adjusted logistic regression showed that each psychological discomfort covariate increased the odds of poor sleep quality. Depression by adjusting for anxiety and stress, anxiety by adjusting for depression and stress, and stress by adjusting for depression and anxiety all increased the odds of poor sleep quality. Conclusion A high prevalence of psychological discomfort was observed in PLWH. Depression, anxiety, and stress were strongly associated with sleep quality. PLWH needed more attention and social support in order to reduce sleep and psychological issues.

Abstract The present study evaluates the non-communicable disease (NCD) patterns and related risk factors among people living with HIV (PLWH) in Iran. This national cross-sectional survey study was conducted on 1173 confirmed PLWHs with a mean age of 35.35 (56.82 Over 50 years old, 33.90 Under 50 years old) admitted from 15 different provinces in the country. Logistic regression was used to analyze the association of factors with having at least one NCD comorbidity. From 1173 PLWH, 225(19.18%) participants experienced at least one NCD (15.20% and 38.69% among under- and over-50-year-old patients, respectively). The prevalence of heart disease, hypertension, diabetes, and sleep apnea among all patients was 1.59%, 2.05%, 1.55%, and 10.26%, respectively. The similar prevalence for each NCD among those over 50 years was 10.11%, 15.71%, 9.01%, 25.44%, and 1.01%, 1.12%, 1.04%, and 9.23% among those under 50 years, respectively. The odds of being at risk of at least one NCD stood higher in patients over 50 years (ORadj = 2.93, 95% CI 1.96–4.37), married (ORadj = 2.48, 95% CI 1.41–4.35), divorced or widowed (ORadj = 2.78, 95% CI 1.48–5.20), and obese (ORadj = 3.82, 95% CI 2.46–5.91). According to our findings regarding the prevalence of NCDs among patients under 50 years of age, we recommend that policymakers give greater consideration to this group in the screening and care programs for NCDs since adults and the elderly are both vulnerable to the risk factors for developing NCDs.

Abstract Introduction Drug use is highly prevalent among female sex workers (FSWs). Some forms of drug use, such as injecting drug users (IDU), put them at greater risks for HIV and blood born disease (BBD). In this study, the pattern of drug use and its related factors among Iranian FSWs were investigated. Materials and methods This cross-sectional study was performed based on the data of the integrated bio-behavioral surveillance-III (IBBS-III) on FSWs in 8 cities of Iran using the respondent-driven sampling (RDS) method conducting in 2019–2020. Of the 1515 FSWs participating in the IBBS-III study, 1,480 answered questions about drug use. To calculate the prevalence of drug use lifetime and in the past month, weighted analysis was used. Univariate and multivariate logistic regression was used to investigate the factors related to drug use. Results The prevalence of lifetime drug use and the prevalence of current drug use (single and poly drug use) among FSWs were estimated to be 29.3% and 18.86%, respectively. According to multivariate regression analysis, the odds ratio (odds) of lifetime drug use showed a statistically significant association with lower education (AOR = 1.18; 95% CI: 1.07–1.3), being a direct sex worker (AOR = 1.77; 95% CI: 1.21–2.61), working in team houses or hangouts (AOR = 1.51; 95% CI: 1.10–2.06), a history of intentional abortion (AOR = 1.41; 95% CI: 1.07–1.87), condom use in the last sex (AOR = 1.61; 95% CI: 1.19–2.17), a history of imprisonment (AOR = 3.05; 95% CI: 2.25–4.14), HIV positive tests (AOR = 8.24; 95% CI: 1.66–40.9), alcohol use (AOR = 1.69; 95% CI: 1.29–2.29), and finding sexual clients in places such as parties, shopping malls, streets, and hotels, or by friends (AOR = 1.46; 95% CI: 1.01–2.12). Conclusion Given that drug use among FSWs is about 14 times higher than that of the Iranian general population, it is imperative that drug reduction programs be integrated into service packages. Specifically, prevention programs should be prioritized for occasional drug users within this population as they are at a greater risk of developing drug use issues compared to the general population.

Abstract Background Cancer poses an escalating public health challenge, necessitating a comprehensive understanding of cancer incidence to formulate effective control strategies. Aims This study aims to present a comprehensive overview of cancer incidence in Iran, utilizing data from the Iranian National Population‐based Cancer Registry (INPCR) for the year 2016. Methods The study employed INPCR data to compute crude and age‐standardized incidence rates (ASR) per 100 000 for the most common cancers among men and women across Iran's 31 provinces. Data analysis utilized Excel (2019) and STATA 14. Results In 2016, 124 833 new cancer cases were registered, with 65 495 (52.90%) occurring in men and 58 312 (47.10%) in women. ASRs for all cancers in the total population were 177.48, with specific rates for men and women at 192.96 and 162.33, respectively. The five most common cancers in men were prostate (23.25), stomach (21.56), colon (19.30), bladder (16.20), and lung (13.15). Among women, the leading cancers were breast (40.60), colon (14.64), thyroid (10.84), stomach (10.25), and lung (5.63). West Azarbaijan had the highest incidence among men, while Yazd topped the list for women. Age‐specific incidence rates revealed peaks in the 67–74 age group for men and the 40–50 age group for women. Conclusion This study affirms that while Iran exhibits a lower cancer incidence compared to global averages, there has been a temporal increase. Disparities in ASR exist across sexes and provinces, with shifts in the ranking of common cancers by sex compared to previous reports.

Abstract Background Breast cancer (BC) is the most common cancer among women worldwide. Increased survival of primary BC (PBC) has increased contralateral breast cancer (CBC) and become a health problem. Aims This study aimed to determine the effect of disease‐free interval (DFI), risk factors and PBC characteristics on the progression of CBC within primary BC survivors. Methods and Results This retrospective study identified 5003 women diagnosed with breast cancer between 2000 and 2020 in the cancer research center. The study included 145 CBC and 4858 PBC survivors, with CBC diagnosed at least 6 months after the detection of primary BC. ER+, PR+, and HER2+ were reported in 72.13%, 66.67%, and 30% of CBC patients. Invasive ductal carcinoma (IDC) BC was reported in 69.57% of patients, and 81.90% and 83.64% of the patients were treated with adjuvant chemotherapy and external radiotherapy. The Kaplan–Meier method indicated that the median time interval between PBC and CBC was 3.92 years, and the 5‐year DFI was 97%. The Cox proportional hazard regression model indicated that although more than half of the participants had no family history of BC (69.57%), women 60 years and older were negatively associated with CBC. Conclusion This study provides the first investigation of CBC and DFI risk factors among PBC survivors in Iran. Age was found to be negatively associated with CBC development particularly after the age of 60, indicating the necessity of tracking CBC survivors carefully in this age group.

Abstract Objective Alcohol use is more common among female sex workers (FSWs). This study assessed the prevalence of lifetime and past‐month alcohol use and related factors among FSWs in Iran. Methods We conducted a cross‐sectional survey among 1464 women from 8 major cities in Iran. Behavioral data were collected by trained interviewers and conducted face‐to‐face in a private room. Weighted analysis was used to determine the lifetime and past‐month alcohol use prevalence. Univariate and multivariate logistic regression was used to investigate the association between alcohol use and independent variables. Results The most alcohol used in lifetime and past‐month (weekly, less than once a week, and daily) in FSWs was 52.7% (12.25%, 12.94%, and 1.83%), respectively. In the final model, factors that were independently associated with alcohol use included the 31–40 years (AOR = 2.41, 95% CI: 1.13–5.15), education level of diploma (AOR = 2.43, 95% CI: 1.31–4.51), history of lifetime drug use (AOR = 2.79, 95% CI: 2.01–3.89), history of lifetime group sex (AOR = 2.07, 95% CI: 1.41–3.03), history of intentional abortion (AOR = 1.42, 95% CI: 1.06–1.92), six or more sexual clients in the last month (AOR = 3.25, 95% CI: 1.80–5.87), history of lifetime anal sex (AOR = 2.47, 95% CI: 1.82‐3.35), and FSWs the married, temporarily married, and living with partner were positively associated with lifetime alcohol use. Conclusion Alcohol use is prevalent among FSWs in Iran. Further prevention programs are needed to address and reduce harms associated with alcohol use among this vulnerable population in Iran. Designing intervention programs, it is suggested to consider other variables affecting alcohol use in FSWs.

IntroductionThe IraPEN program is an adapted version of the WHO-PEN program designed to prevent four major non-communicable diseases in Iran. This study aimed to determine the rate of compliance and related factors among individuals participating in the IraPEN program for the prevention of cardiovascular disease.MethodIn this study, compliance was defined as timely referral to the health center as scheduled, and the researchers approached four pilot sites of IraPEN from March 2016 to March 2018. Sex-stratified logistic regressions were applied to investigate factors related to compliance. However, it is important to note that in this study, compliance was defined as compliance to revisit, not compliance to taking prescribed medications or behavioral lifestyle changes.ResultsThe total compliance rate, including timely compliance and early and late compliance, was 16.5% in men and 23.3% in women. The study found that cardiovascular risk factors such as diabetes, hypertension, hypercholesterolemia, and being underweight were associated with lower compliance. The higher calculated risk of CVD was associated with higher compliance, but after adjusting for cardiovascular risk factors, high-risk individuals showed lower compliance. There was negligible interaction between sex and other factors for compliance.ConclusionThe compliance rate with scheduled programs for cardiovascular preventive strategies was very low, and high-risk individuals were less compliant, regardless of their high level of risk factors. The study recommends further training to increase awareness and knowledge regarding the IraPEN program and the prevention of non-communicable diseases among high-risk populations.