Factors associated with HIV risk perception among people who inject drugs: Findings from a cross-sectional behavioral survey in Kermanshah, Iran

ABSTRACT

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.

KEYWORDS:

• HIV risk perception
• Kermanshah
• people who inject drugs

Acknowledgments

We gratefully thank all staff in the drop-in center in Kermanshah who contributed in recruiting (Ms. Barkhordar) and data collection/interview (Mr. Azad and Mr. Amini). We profoundly thank people who were generous for their time and participated in the study. We also want to appreciate Mostafa Shokoohi and other experts from Regional Knowledge Hub for HIV Surveillance who provided valuable inputs to the study protocol and the questionnaire.

Disclosure of potential conflicts of interest

All other authors had no conflicts of interest to be declared.

Additional information

Notes on contributors

Bahram Armoon

BA and MN helped in study concept and design. MN and AR helped in analysis and interpretation of data. MN and SK drafted the manuscript. Zj, ASH, OR, AF, SA, BM, MA, and FR helped in critical revision of the manuscript.

Mehdi Noroozi

BA and MN helped in study concept and design. MN and AR helped in analysis and interpretation of data. MN and SK drafted the manuscript. Zj, ASH, OR, AF, SA, BM, MA, and FR helped in critical revision of the manuscript.

Zahra Jorjoran Shushtari

BA and MN helped in study concept and design. MN and AR helped in analysis and interpretation of data. MN and SK drafted the manuscript. Zj, ASH, OR, AF, SA, BM, MA, and FR helped in critical revision of the manuscript.

Asaad Sharhani

BA and MN helped in study concept and design. MN and AR helped in analysis and interpretation of data. MN and SK drafted the manuscript. Zj, ASH, OR, AF, SA, BM, MA, and FR helped in critical revision of the manuscript.

Salahedin Karimi

BA and MN helped in study concept and design. MN and AR helped in analysis and interpretation of data. MN and SK drafted the manuscript. Zj, ASH, OR, AF, SA, BM, MA, and FR helped in critical revision of the manuscript.

Sina Ahmadi

BA and MN helped in study concept and design. MN and AR helped in analysis and interpretation of data. MN and SK drafted the manuscript. Zj, ASH, OR, AF, SA, BM, MA, and FR helped in critical revision of the manuscript.

Ali Farhoudian

BA and MN helped in study concept and design. MN and AR helped in analysis and interpretation of data. MN and SK drafted the manuscript. Zj, ASH, OR, AF, SA, BM, MA, and FR helped in critical revision of the manuscript.

Azam Rahmani

BA and MN helped in study concept and design. MN and AR helped in analysis and interpretation of data. MN and SK drafted the manuscript. Zj, ASH, OR, AF, SA, BM, MA, and FR helped in critical revision of the manuscript.

Mohammad Abbasi

BA and MN helped in study concept and design. MN and AR helped in analysis and interpretation of data. MN and SK drafted the manuscript. Zj, ASH, OR, AF, SA, BM, MA, and FR helped in critical revision of the manuscript.

Brandon D.L. Marshal

BA and MN helped in study concept and design. MN and AR helped in analysis and interpretation of data. MN and SK drafted the manuscript. Zj, ASH, OR, AF, SA, BM, MA, and FR helped in critical revision of the manuscript.

Omid Rezaei

BA and MN helped in study concept and design. MN and AR helped in analysis and interpretation of data. MN and SK drafted the manuscript. Zj, ASH, OR, AF, SA, BM, MA, and FR helped in critical revision of the manuscript.

Fatemeh Rezaei

BA and MN helped in study concept and design. MN and AR helped in analysis and interpretation of data. MN and SK drafted the manuscript. Zj, ASH, OR, AF, SA, BM, MA, and FR helped in critical revision of the manuscript.

Mohammad Najafi

BA and MN helped in study concept and design. MN and AR helped in analysis and interpretation of data. MN and SK drafted the manuscript. Zj, ASH, OR, AF, SA, BM, MA, and FR helped in critical revision of the manuscript.