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Background We aimed to investigate risky sexual behaviors (RSBs) and condom use barriers in Iranian men with substance use disorders (SUDs). Methods Of the total 1800 outpatient drug free (ODF) and methadone maintenance treatment program (MMTP) active centers in Tehran, Iran, six were selected to participate in the current study. Data were collected (n = 300 men) using three questionnaires including a demographic questionnaire, the Risky Sexual Behavior Questionnaire (RSBQ), and the Condom Barriers Scale (CBS). The statistical software R, analysis of variance post hoc and multivariate analysis of variance (MANOVA) logistic regression tests were used in data analysis. Findings The majority, (n = 194, 64.7%) reported at least one lifetime episode of RSBs. Compared to married participants (23.1%), 88.5% of single and 87.0% of divorced men had a history of RSB. Generally, the lowest and highest subscale scores of the CBS were related to sexual experience (2.60 ± 0.71) and access/availability structure (3.77 ± 0.54), respectively. The results of MANOVA analysis showed that there was a statistically significant difference between the CSB subscales based on the participants' education and marital status (P < 0.001). Only the partner barrier subscale had a significant negative relationship (P = 0.003) with RSB. Conclusion Sexual dynamic of Iranian men with SUDs is different. Barriers to condom use seem to be socio-culturally determined. Culturally acceptable strategies need to be utilized in Iranian clinical settings reaching beyond simply condom accessibility for this at risk population.

Background Drug abuse is one of the important variables influencing protective sexual behavior. The objective of this study was to explore how risky sexual behaviors develop in drug abusing women using human ecological theory. Methods In this study, we used a descriptive exploratory approach. The participants were 32 drug abusing women from two of the selected drop-in centers (DICs) in south Tehran, Iran, where we could have access to a vast number of female drug users. Data was collected using semi-structured face-to-face interviews. Qualitative content analysis was used to analyze the data using Graneheim and Lundman procedure. Findings Risky sexual behavior in drug use disorders in women was found in four themes with thirteen emerged; sexual untaught at micro-system with two subthemes “unsafe home” and “drop out of school”, Perception of differences at meso-system with three subthemes “lack of link between family and school”, “doing manly behavior” and “low awareness of health puberty than peers”, inappropriate marriages at exo-system with three subthemes “stigma”, “fear of losing love relationship” and “self-devotion”, marginalization at macro-system with four subthemes “barrier access to rights”, “selling sex as a tool of security”, “lack of belief as a sex worker” and “mistrust and doubt partner” using implication of human ecological theory. Conclusion Findings suggest that strategies supporting the discovery of risky sexual behaviors in drug use disorders in women are important in order to provide counseling and education to form their decisions toward safety sex.

Background Pregnant women rely heavily on informal information while making a decision about the mode of delivery they would rather have, either as normal vaginal delivery (NVD) or cesarean section (CS). Through recognition of social attitudes towards different modes of delivery, societies can be directed towards a positive understanding of vaginal delivery, which can ultimately lead to maternal health promotion. Thus, this study aimed to explore the common beliefs, values and traditions surrounding women’s preferred mode of birth in the North of Iran. Methods Using a focused ethnographic approach, twelve pregnant women, 10 women with previous experience of childbirth, seven midwives, seven obstetricians, and nine non-pregnant women were included in this study through a purposeful sampling in health clinics of Tonekabon in the North of Iran. Semi-structured interviews and participant observations were used for data collection. Study rigor was confirmed through prolonged engagement, member check, expert debriefing, and thick description of the data. Data were analysed using Braun & Clarke thematic analysis (2006) and MAXqda software. Results Through analysis, three major themes and 10 subthemes emerged. They included: 1) sociocultural childbirth beliefs with five subthemes: a) CS as protector of genital tract integrity, b) blind imitation in choosing mode of birth, c) NVD as a low cost type of delivery, d) CS as a prestigious mode of birth and, e) NVD as a symbol of woman’s power and ability; 2) traditional health beliefs with two subthemes: a) NVD as a guarantee for woman’s health, b) traditional childbirth facilitators; 3) religious beliefs and values with three subthemes: a) NVD as a symbol of God’s power, b) call for help from the Mighty God, and c) NVD as a sacred phenomenon. Conclusion The results of this study indicated that cultural beliefs, values and traditions can significantly affect individuals’ attitudes towards modes of delivery, their definitions of different modes, and the decisions they make in this regard. In order to develop a positive cultural and religious attitude towards vaginal delivery, women’s awareness has to be raised through various ways and the existing misconceptions need to be corrected.

Background: Data was reported in Iran in 2013 has shown that almost 42 percent of deliveries in public hospitals and 90 percent in private hospitals were carried out with cesarean section. This high rate of cesarean requires careful consideration. It seems that making decision for cesarean is done under the influence of cultural perceptions and beliefs. So, this study was conducted to explore pregnant women's preferences and perceptions regarding cesarean delivery. Materials and Methods: A focused ethnographic study was used. 12 pregnant women and 10 delivered women, seven midwives, seven gynecologist and nine non-pregnant women referred to the health clinics of Tonekabon, who selected purposively, were included in the study. To collect data semi-structured in-depth interviews and participant observation were used. Study rigor was confirmed through prolonged engagement, member check, expert debriefing, and thick description of the data. Data were analysed using thematic analysis and MAXQDA software. Results: Four themes emerged from the data including personal beliefs, fear of vaginal delivery, cultural norms and values and also social network. These concepts played main roles in how women develop meanings toward caesarean, which affected their perceptions and preferences in relation to caesarean delivery. Conclusion: Most of pregnant women believed that fear of vaginal delivery is a major factor to choose caesarean delivery. Hence, midwives and physicians could help them through improving the quality of prenatal care and giving them positive perception towards vaginal delivery through presenting useful information about the nature of different modes of delivery, and their advantages and disadvantages, as well as the alternative ways to control labor pain.