Risk and vulnerability of key populations to HIV infection in Iran; knowledge, attitude and practices of female sex-workers, prison inmates and people who inject drugs
METHODS: The surveys were conducted in 2009 and 2010 and reached 2546 PWID, 872 FSW and 5530 prison inmates. Knowledge and attitude toward HIV were measure through similar questions.
RESULTS: Over 90% of the participants had heard of HIV, though only 35% of them perceived themselves at risk of HIV. The mean (SD) scores for knowledge, were 78.50 (20.32), 75.42 (21.47), and 72.42 (21.45) out of 100, respectively for PWID, FSW and prisoners. Less than one-third were able to correctly identify the ways of preventing sexual transmission of HIV. Majority of participants reported not using condoms in their last sexual contact, with this reaching 85% amongst prisoners. A remarkable proportion of prisoners and FSWs had a history of injecting drugs. Among all those injecting drugs, unsafe last injection was as high as 61.5% among prisoners, 11.6% among FSW and 3.4% among PWID.
CONCLUSIONS: Despite major efforts to contain HIV epidemic in Iran, the level of risk and vulnerability among prisoners, FSW and PWID is still high. This is evident through low level of comprehensive knowledge, risk perception, and protective practices. HIV prevention programmes should be redesigned in a more comprehensive way and identify the best venues to reach the largest number of those most at risk in order to address risk overlaps and multiple vulnerability factors.