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This study aimed to evaluate the quality of life (QoL) and its association with HIV-related stigma among people living with HIV (PLHIV) in Kerman province, southeast Iran. A convenience sample of 104 PLHIV was recruited. Data on QoL were collected using the HIV/AIDS-Targeted QoL instrument. Internal and external stigma were measured using an instrument developed by UNAIDS. The average QoL score was 52.5 (SD =13.9). In multivariable model, PLHIV who experienced higher external stigma score (B = −1.9; 95% confidence interval [CI]: −2.6 to −1.1) and higher internal stigma score (B = −1.1; 95% CI: −1.5 to −0.6) had lower level of QoL. The low level of QoL among PLHIV in Iran indicates the need for initiatives to increase QoL among this population. Our data suggest that QoL in PLHIV could be improved by interventions aimed at reducing stigma in both community and health care settings. [ABSTRACT FROM AUTHOR]

Posttraumatic stress disorder (PTSD) is a common mental disorder following traumatic events. The present study was conducted to understand the prevalence of PTSD after the earthquake in Iran and Pakistan. The review includes all articles published from inception to March 2019. The pooled prevalence for overall PTSD was 55.6% (95% CI: 49.9–61.3). It was 60.2% (95% CI: 54.1–66.3) and 49.2% (95% CI: 39.4–59) for Iranian and Pakistani survivors, respectively. Women experienced higher incidence of PTSD than men. The variation of PTSD based on the clinical interview was lower than the self-report approach. The interval time between the earthquakes and the assessment showed that the prevalence of PTSD decreased over time. The prevalence of PTSD in Iran and Pakistan was higher than the global average, and the rate of the disorder in Iran was higher than in Pakistan. Sex, method of assessment, and time lag between the occurrence of disaster and assessment of PTSD affect the prevalence. [ABSTRACT FROM AUTHOR]

Background: We examined and estimated the trend of breast cancer incidence in Kerman, the largest province in Iran. Method: Having compiling the data of new cases from three sources (cancer registry, pathology, radiotherapy) in this longitudinal study, the number of untouched cases was estimated using log-linear model. We estimated the annual age-standardized rate (ASR) per 100,000 women in 2001-2015. We utilized joint point regression method to estimate the trend of breast cancer incidence during the examined years. Results: The ASR of breast cancer increased from 25 in 2001-2005 to 37 in 2011- 2015, showing that the annual average percentage increased by 5.9% (95% Confidence Interval: 3.5, 8.4, P<0.001). Moreover, during this period, the completeness of the cancer registry increased from 16% in the first five years to 70% in the last five years. Conclusion: Our findings revealed that the coverage of the cancer registry increased significantly. It seems that part of the increasing trend of the reported cancer incidence was attributed to the enhancement of the cancer registry scheme, but our findings suggested that the real incidence of breast cancer had a growing trend. [ABSTRACT FROM AUTHOR]

Background: Network Scale Up (NSU) is applied in many settings to estimate the size of hidden populations. The visibility of alcohol consumption - as a hidden behavior - in Iran has not been yet set. Our aim is to estimate the visibility factor (VF) of alcohol consumption in Iran which is an Islamic country in the Middle East. Methods: Ninety persons who had a history of alcohol consumption were recruited. Relationships in network were aligned in three main subgroups: immediate family, extended family, and non-family. According to the game of contact methodology, participants answered questions about total and aware number of persons they know in each relationship category. VF was calculated by dividing total number of people aware about the respondent's alcohol consumption by total number of respondent's social network. The 95% confidence intervals (CIs) were computed through bootstrapping. Findings: The mean and standard deviation (SD) of participants' age was 32.9 ± 10.2, the sex ratio was 3. Overall VF (95% CI) was 40% (33% to 47%). VF was estimated at 44% and 23% among men and women's network, respectively. The immediate family was the highest informed group, followed by non-family and extended family members. Conclusion: The visibility of alcohol consumption in Iran was not high. This is due to religious and legal prohibitions around it. [ABSTRACT FROM AUTHOR]

Background: Due to the unpredictable nature of disasters, it is crucial to anticipate, define and divide tasks as preparedness activities to respond efficiently. This is because the organizations involved in, becoming aware of their own tasks and other organizations' tasks. The aim of this study is to explore disparities in the viewpoints of members of Kerman University of medical sciences and Red Crescent in emergent tasks after Bam Earthquake in Iran. Materials and Methods: During January and February 2017 a total of 30 members from Kerman Red Crescent and Kerman University of Medical Sciences were recruited through snowball sampling with exploratory interviews and Self-administered questionnaire. The content validity of the questions was tested through obtaining opinion of expert which was acceptable (CVR=0.6, CVI=0.8). Results: The results of our study showed that there was no predefined agreement about emergent tasks over response phase to the Bam earthquake; buried corpses, and management of received national and international aids from other organizations. Also, involved organizations were not aware the specific tasks of other organizations. Conclusion: During the disaster response phase in Bam earthquake, there was no agreement about the responsible of organizations for undertaking emergent tasks. This disparity was a barrier for effective response for involved organization. [ABSTRACT FROM AUTHOR]

Background: Network Scale Up (NSU) is a promising tool for size estimation of sensitive issues. In this study we investigated the important methodological considerations to employ this method for estimating behaviors, such as abortion, which happens in a particular age-gender group. Methods: We recruited 1250 males and 1250 females aged 18 to 50. Abortion rate was calculated through direct question and NSU methodology. The NSU was applied on three sub-samples (male, female and aggregate). Integrating replies to 25 reference groups, we estimated the network size (C) of respondents and its age-gender structure. To calculate the part of network that is subject to abortion, we compared two approaches: proportional and data based. The Visibility Factor (VF) was calculated through 222 females who had abortion. Direct estimate was considered as gold standard. Results: Using C’s derived from proportional method, the Relative Bias (RB) in the male and female samples was 33% and 84%. Applying the data-based C’s, the RB in the gender-specific and aggregate samples was 5% and 2%. Conclusion: The proportional method overestimates the prevalence. The data-based method to calculate the C is superior. The determination of the age-sex distribution of the network and the specific VF is essential. [ABSTRACT FROM AUTHOR]

HIV-1 Circulating Recombinant Form 35_AD (CRF35_AD) has an important position in the epidemiological profile of Afghanistan and Iran. Despite the presence of this clade in Afghanistan and Iran for over a decade, our understanding of its origin and dissemination patterns is limited. In this study, we performed a Bayesian phylogeographic analysis to reconstruct the spatio-temporal dispersion pattern of this clade using eligible CRF35_AD gag and pol sequences available in the Los Alamos HIV database (432 sequences available from Iran, 16 sequences available from Afghanistan, and a single CRF35_AD-like pol sequence available from USA). Bayesian Markov Chain Monte Carlo algorithm was implemented in BEAST v1.8.1. Between-country dispersion rates were tested with Bayesian stochastic search variable selection method and were considered significant where Bayes factor values were greater than three. The findings suggested that CRF35_AD sequences were genetically similar to parental sequences from Kenya and Uganda, and to a set of subtype A1 sequences available from Afghan refugees living in Pakistan. Our results also showed that across all phylogenies, Afghan and Iranian CRF35_AD sequences formed a monophyletic cluster (posterior clade credibility> 0.7). The divergence date of this cluster was estimated to be between 1990 and 1992. Within this cluster, a bidirectional dispersion of the virus was observed across Afghanistan and Iran. We could not clearly identify if Afghanistan or Iran first established or received this epidemic, as the root location of this cluster could not be robustly estimated. Three CRF35_AD sequences from Afghan refugees living in Pakistan nested among Afghan and Iranian CRF35_AD branches. However, the CRF35_AD-like sequence available from USA diverged independently from Kenyan subtype A1 sequences, suggesting it not to be a true CRF35_AD lineage. Potential factors contributing to viral exchange between Afghanistan and Iran could be injection drug networks and mass migration of Afghan refugees and labours to Iran, which calls for extensive preventive efforts. [ABSTRACT FROM AUTHOR]

Background: Controlling and preventive measures considerably reduced malaria incidence in Iran over the past few years, which confined the endemic areas to some regions in the southeastern Iran. The National Malaria Elimination Programme commenced in 2010. With regard to the presumption that the elimination programme interventions have accelerated the declining trend of malaria incidence across the endemic areas of Iran, the present study attempted to assess the effectiveness of the elimination programme by reviewing malaria incidence status, over a 14-year period, and comparing the trend of malaria incidence across malaria-endemic areas between the control and pre-elimination phase, and the elimination phase. Methods: A retrospective analysis of malaria surveillance data was conducted in a 14-year period (2001-2014), using multilevel Poisson regression. The epidemiological malaria maps and indicators also were developed and compared between the control and pre-elimination phase, and the elimination phase. Results: The mean of malaria incidence was 2.2 (1.7-2.7) for the entire study period. This rate was 3.4 (2.6-4.1) in the control and pre-elimination phase, and 0.41 (0.25-0.57) for the elimination phase. During the malaria elimination phase, the decline of annual malaria incidence had significantly accelerated and autochthonous cases had the greatest difference in malaria incidence decline (compared to the control and pre-elimination phase), whereas, falciparum cases had the lowest difference in malaria incidence decline, followed by non-Iranian and imported cases. Furthermore, there was a decline in Iranians to non-Iranians ratio and an increase in the ratios of over 15 to under 15, as well as male to female, in the elimination phase in comparison to the control and pre-elimination phase. Conclusions: It seems that the decline of malaria transmission, which has been initiated over the past few years, has accelerated as a result of the elimination programme, and Iran is approaching the goals set regarding the elimination of this disease. [ABSTRACT FROM AUTHOR]

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People living with HIV (PLWH) are often subject to discrimination. The causes, types, and consequences of this stigma in Iran are not yet fully understood. In-depth, semi-structured interviews were held with a purposively selected group of 25 PLWH recruited from a triangular HIV clinic in Kerman, Iran. Almost all participants reported experiencing internal and external stigma in a variety of contexts. Participants mentioned at least three major types of internal stigma (silence, shame, and feeling miserable). PLWH also reported experiencing external stigma from their families, communities, and the health care system. While previous studies have demonstrated that the Iranian public has reported fairly positive attitudes toward PLWH, our participants' experiences tell a different story. Therefore, it is imperative to engage both public and private sectors in continuing education programs to reduce the level of stigma faced by PLWH. [ABSTRACT FROM AUTHOR]