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BackgroundStreet-based female sex workers (FSWs) are highly at risk of HIV and other harms associated with sex work. We assessed the prevalence of non-injection and injection drug use and their associated factors among street-based FSWs in Iran.MethodsWe recruited 898 FSWs from 414 venues across 19 major cities in Iran between October 2016 and March 2017. Correlates of lifetime and past-month non-injection and injection drug use were assessed through multivariable logistic regression models. Adjusted odds ratios (AOR) and 95% confidence intervals (CI) were reported.ResultsLifetime and past-month non-injection drug use were reported by 60.3% (95% CI 51, 84) and 47.2% (95% CI 38, 67) of FSWs, respectively. The prevalence of lifetime and past-month injection drug use were 8.6% (95% CI 6.9, 10.7) and 3.7% (95% CI 2.6, 5.2), respectively. Recent non-injection drug use was associated with divorced marital status (AOR 2.00, 95% CI 1.07, 3.74), temporary marriage (AOR 4.31 [1.79, 10.40]), had > 30 clients per month (AOR 2.76 [1.29, 5.90]), ever alcohol use (AOR 3.03 [1.92, 6.79]), and history of incarceration (AOR 7.65 [3.89, 15.30]). Similarly, lifetime injection drug use was associated with ever alcohol use (AOR 2.74 [1.20-6.20]), ever incarceration (AOR 5.06 [2.48-10.28]), and ever group sex (AOR 2.44 [1.21-4.92]).ConclusionsNon-injection and injection drug use are prevalent among street-based FSWs in Iran. Further prevention programs are needed to address and reduce harms associated with drug use among this vulnerable population in Iran.

The aim of the present study was to determine the prevalence of non-fatal overdose among people who use illicit opioids (PWUIOs) and determine the demographic and behavioral characteristics associated with non-fatal overdose among this population. Studies in English published before February 1, 2021, were searched for on PubMed, Scopus, Cochrane, and Web of Science to identify primary studies on the factors associated with non-fatal overdose among PWUIOs. After reviewing for study duplicates, the full-texts of selected papers were assessed for eligibility using PICOs criteria. After a detailed assessment of over 13,845 papers, a total of 67 studies met the eligibility criteria. The findings showed a past-year pooled prevalence rate of non-fatal overdose among PWUIOs of 26% (95% CI, 23% −29%). Greater odds of non-fatal overdose among PWUIOs was associated with (i) being younger, (ii) being female, (iii) being homeless, (iv) individuals who received money, goods, or drugs in exchange for sex, (v) individuals who had witnessed somebody else have an overdose, (vi) individuals who had used public spaces as primary injection locations, (vii) individuals who reported polydrug use, (vii) use of non-injection methamphetamine, and (viii) high injecting frequency (more than two daily drug injections). Harm-reduction programs should consider the provision of education concerning overdose-related risk factors to the vulnerable and hard-to-reach PWUIOs. [ABSTRACT FROM AUTHOR]

This study aimed to identify risk and protective factors associated with substance use among Iranian university students. We searched for studies in English published from January 1, 1995 to February 20, 2021, on PubMed, Scopus, Cochrane, and Web of Science to identify primary studies on the factors associated with substance use among university students. Out of 8,481 articles, 39 studies met eligibility criteria. Our findings showed a pooled prevalence rate of alcohol use 23% (95% CI, 8% 39%), smoking 21% (95% CI, 6% 37%) and other drug use 14% (95% CI, 10% 18%) in the last year among student. Hookah use, living alone, being a current cigarette smoker, and other drug use were significantly associated with alcohol use. The findings of the present study showed that being male, older age, alcohol use, had depression, had parents or friends who smoke, and religious beliefs were significantly associated with smoking among students. This meta-analysis also showed that living alone, alcohol use, history of drug use, and hookah use were significantly associated with drug use among students. Substance use prevention programs provided by universities could be improved by signifying high-risk populations addressed by the related literature. [ABSTRACT FROM AUTHOR]

The present study aimed to determine the association between drug type, risk behaviors and non-fatal overdose among people who use drugs (PWUD). We searched for studies in English published before February 1, 2021, on PubMed, Scopus, Cochrane, and Web of Science to identify primary studies on the factors associated with non-fatal overdose among PWUD. After reviewing for study duplicates, the full-text of selected articles were assessed for eligibility using Population, Intervention, Comparator, Outcomes (PICO) criteria. After a detailed assessment of over 13,845 articles, a total of 49 studies met the eligibility criteria. We found that non-injection opioid use, heroin injection, cocaine use, concurrent use of buprenorphine and benzodiazepines, benzodiazepine use, incarceration, injecting drugs, and duration of injecting were associated with greater odds of non-fatal overdose among PWUD. The findings of the current meta-analysis support the requirement to improve suitable harm reduction strategies for drug users, such as peer-based overdose management, and further focusing on the need to balance the current emphasis on enforcement-based responses to illegal drug use with health-related interventions. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this systematic review was to assess the impacts of oral health determinants (eg frequency of brushing < 2 day, poor life style and non‐white ethnicity) and clinical oral caries indices (eg Decayed, Missing, and Filled Teeth (DMFT)) and periodontal disease) on Poor Quality of Life (PQoL) among PW. Methods: The search strategy was restricted to publications in English before 1 December 2019 in the PsycINFO, PubMed, SciELO, Scopus and Web of Science databases. We only included oral diseases considered as public health issues with a global burden. As a result, investigations reporting the frequency of brushing, poor lifestyle behaviours, non‐white ethnicity, DMFT scores and periodontal disease as an outcome were included. The two reviewers resolved any disagreements. Reviewers analysed the full texts, considering the inclusion and exclusion criteria. Also, a manual search of the reference lists was performed on all the selected studies. Results: In total, 11 publications were included in the meta‐analysis. Findings indicate a positive association between non‐white ethnicity and PQoL among PW. Among PW, those who had non‐white ethnicity were 1.43 times more likely to have PQoL (OR = 1.43, 95% CI = 1.17, 1.70). A positive association between DMFT and poor QoL among PW was also observed. Those who has suffered DMFT were 1.4 times more likely to have poor QoL (OR = 1.4, 95% CI = 1.24, 1.55). Conclusions: Results from this meta‐analysis support the need for behavioural interventions for improving oral hygiene in expectant mothers. This could help to decrease periodontal conditions and improve their oral and general life quality. [ABSTRACT FROM AUTHOR]

Background: The objective of this study is, to describe patterns (or "classes") used latent class analysis (LCA) to examine patterns of drug use profiles among people who inject drugs (PWIDs) then to examine factors associated with each identified classes membranes in PWIDs in Iran. Methods: In a cross-sectional survey, using snow-ball sampling, we recruited 500 PWIDs in Tehran. Clustering of the behaviors was investigated using exploratory LCA. After identification of the latent classes and optimal number of latent classes, we used multi-nominal regression to identify factors associated with class membership. Results: The mean, standard deviation (SD) and median durations of injection drug use were 6.0 ± 4.6 and 3.2 (IQR, 3.6–11.1) years the adjusted odds ratios (AOR) represented that the class 1 members had higher odds of being homeless (AOR = 2.6, 95% CI: 1.4–5.7); in past 12 months. Unemployed status predicted membership in the class. Odds of class 1 membership was higher in PWIDs who were Unemployed (AOR = 1.9, 95% CI: 0.52–2.63), and reported HIV-positive (AOR = 3.2, 95% CI: 1.74–6.52) Conclusion: PWIDs who reported being the human immunodeficiency viruses (HIV) positive were significantly more likely to belong to class 1, being primarily methamphetamine users who initiated injection at age 22 years or younger. [ABSTRACT FROM AUTHOR]

The aim of this meta-analysis is to summarize the available evidence on the social and demographic determinants of health-related quality of life (QoL) for HIV-infected populations in order to provide a direction to policy makers, planners, and program developers on how best to use their resources to improve the QoL of HIV-infected people. PubMed, Science Direct, Web of Science, and Cochrane electronic databases were searched (up to February 2017) to identify the relevant studies. A meta-analysis was conducted with procreate polled odds ratios (ORs and β) and the confidence intervals of 95% on determining factors of QoL in social and demographic terms. Random effect model was applied to calculate pooled estimation, due to varied sampling methods of researches. In total, 5607 papers were identified from 4 databases and additional search in reference lists. Of these, 2107 articles were selected for full-text review. We included 19 studies that met the eligibility criteria. The pooled effect size shows a relative positive impact of social support for QoL among HIV/AIDS patients and its lower boundary is about 0.61 and the higher about 1.49. The pooled effect size has a considerable negative impact stigma on people who live with HIV/AIDS (PWLHs') QoL ranges from −0.34 to −0.32. Low socioeconomic status (poverty situation) was found to have a degenerative impact with PWLHs' QoL. Our finding indicates an association between younger 35 and QoL is negative with a relatively wide range, the minimum level of education has a weak association with PWLHs' QoL (ES: 0.14–0.2). There are several sociodemographic determinants of QoL among PWLHs and in this study, we found that stigma, low level of socioeconomic status, and being younger than 35 years old have a negative association with QoL, while the social support showed a positive association and a minimum level of education did not show a rigorous negative or positive association. [ABSTRACT FROM AUTHOR]

Objectives: Relapse is very much associated with the management of disorder during the treatment, but also many other factors could trigger it. The aim of this study was to explore classes and patterns of relapse risk in patients with schizophrenia of Razi Hospital. Methods: Using random sampling techniques, we recruited 300 participants with a diagnosis of schizophrenia in Razi hospital of Tehran (Iran) between January and May 2017 in a cross -sectional survey. We used latent class analysis (LCA) to establish a baseline model of risk profiles and to identify the optimal number of latent classes, and we used ordinal regression to identify factors associated with class membership. Results: Three classes of multiple relapse risk were identified. LCA showed that, overall, 52%, 22% and 26% of participants with schizophrenia were divided into class 1, class 2 and class 3, respectively. Compared to members in the lowest -risk class (reference group), the highest -risk class members had higher odds of being the age of disorder onset under 25 (OR = 1.4; CI: 1.42-2.33). Participants with schizophrenia who were unemployed were more likely to categorize in the highest -risk class than members of the low -risk class (OR = 2.5; CI: 1.44-4.1). Also, female patients were more likely to belong to members of the high -risk class than members of the low -risk class (OR = 2.22; CI: 1.74-7.64). Conclusion: These findings emphasize the importance of having targeted prevention programs for all domains of Age of onset, female and unemployed related. So, current study suggested that interventions should focus on these risk factors. Furthermore, Increasing the Job opportunities for participants with schizophrenia is warranted so as to prevent of schizophrenia disorder. [ABSTRACT FROM AUTHOR]

Background: In Iran there are limited data regarding HIV risk perceptions among people who inject drugs (PWID). The objective of this study was to explore HIV risk perception and to examine factors associated with the perception of HIV risk among PWID in Iran. Methods: We surveyed 433 PWID in Kermanshah concerning demographic characteristics, sexual risk behaviors, HIV risk perception, and drug-related risk behaviors in the month prior to the study. Two classes of HIV risk perception (high vs. low) were identified. We used logistic regression to identify factors associated with high HIV risk perception. Result: Of 433 PWID who participated in this study, 36% (95% confidence interval; CI95%: 25.3%, 42.2%) of participants reported high HIV risk perception. Methamphetamine use (adjusted odds ration; AOR = 3.7,p < 0.05), or use of multiple drugs at the same time (AOR = 1.7,p < 0.05) was associated with higher HIV risk perception. Moreover, PWID who were NSP users had 2.8 times the odds of high risk perception compared with non-Needle and Syringe Program (NSP) users (AOR = 2.8) . Conclusion: This study implies that initiating drug use at a younger age, using methamphetamine, polydrug use, and needle- and syringe-exchange program utilization were predictors of higher HIV risk perception among PWID in Iran. [ABSTRACT FROM PUBLISHER]