HIV testing among incarcerated people with a history of HIV-related high-risk behaviours in Iran: Findings from three consecutive national bio-behavioural surveys

BMC Infectious Diseases

Research

Ahmad Danesh¹  Fatemeh Tavakoli²  Naser Nasiri²  Mehrdad Khezri²  Armita Shahesmaeili²  Hamid Sharifi²  Iman Ghasemzadeh²  Ali Akbar Haghdoost²  Mohammad Karamouzian³  Mostafa Shokoohi⁴  Najmeh Parhizgari⁵  Ivana Bozicevic⁶ 

[1] Golestan Research Center of Psychiatry, Golestan University of Medical Sciences, Gorgan, Iran;HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran;HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran;Centre on Drug Policy Evaluation, St. Michael’s Hospital, Toronto, ON, Canada;Brown School of Public Health, Brown University, Providence, RI, USA;HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran;Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada;Medical Virology Department, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran;WHO Collaborating Centre for HIV Strategic Information, School of Medicine, Zagreb, Croatia;

关键词: HIV testing;    Prison;    Sexual behaviour;    Injection drug use;    Iran;   

DOI  :  10.1186/s12879-022-07897-z

 received in 2022-04-16, accepted in 2022-11-25,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundIncarcerated people are at a disproportionate risk of contracting HIV. We estimated the prevalence and correlates of HIV testing among incarcerated people with a history of HIV-related high-risk behaviours in Iran.MethodsData for this analysis were obtained from three consecutive nationwide bio-behavioural surveillance surveys of a random sample of incarcerated people in 2009 (n = 5953), 2013 (n = 5490), and 2017 (n = 5785). History of testing for HIV in the last 12 months was the primary outcome variable. HIV testing was examined among those with a history of HIV-related high-risk behaviours (i.e., having multiple sex partnerships, injection drug use practices, or a history of having a tattoo). The outcome variable was divided into three categories: Never tested for HIV, ever tested for HIV inside the prison in the last 12 months, and ever tested for HIV outside the prison in the last 12 months. We used multivariable multinomial logistic regression models to examine factors associated with HIV testing.ResultsOverall, 8,553 participants with a history of HIV-related high-risk behaviors with valid responses to the HIV testing question were included in the analysis. Although HIV testing inside prison has increased (23% [2009], 21.5% [2013], and 50.3% [2017]: P-value < 0.001), the prevalence of HIV testing outside prison has decreased (7.7% [2009], 7.5% [2013], 4.1% [2017]: P-value < 0.001) over time. Our multivariable multinomial regression model showed older age (Relative-risk ratio [RRR]: 1.24, 95% Confidence Intervals [CI]: 1.05, 1.47), history of the previous incarceration (RRR: 1.46, 95% CI: 1.24, 1.71), currently receiving methadone maintenance therapy inside prison (RRR: 2.09, 95% CI: 1.81, 2.43), having access to condoms inside prison (RRR: 1.42, 95% CI: 1.20, 1.68) and sufficient HIV knowledge (RRR: 1.74, 95% CI: 1.47, 2.05) were significantly associated with an increased probability of having an HIV test in the last 12 months inside prison.ConclusionHIV testing among high-risk Iranian prisoners has increased from 2009 to 2017. However, HIV testing remains considerably low, and half of the incarcerated people with a history of HIV-related high-risk behaviours had never tested for HIV inside prison. Evidence-based programs are needed to optimize HIV testing inside and outside prisons and identify those at greater risk of HIV.

【 授权许可】

CC BY   
© The Author(s) 2022

【 图 表 】

Fig. 7