Prevalence of HIV and Hepatitis C Virus Infections and Related Behavioral Determinants among Injecting Drug Users of Drop-in Centers in Iran

Background: Drop-in centers (DICs) are set up to reduce the harms of high-risk behaviors in high-risk groups especially in injecting drug users (IDUs). This study aimed to determine the prevalence of high-risk behaviors in hepatitis C virus (HCV), and human immunodeficiency virus (HIV) in IDUs seeking harm reduction services in DICs in Iran. Methods: Fifteen out of 48 centers covered by universities of medical sciences were enrolled through a systematic random sampling method. Information on demography, high-risk behaviors, and HIV and HCV infections of all IDUs (N=1531) were obtained through interview over a one month period. Results: Among 1531 subjects analyzed, 96.1% were male, 47.8% were single, and 35.1% married. The mean age of the participants was 33±9.0 years and the most prevalent age group was 26-35 years (45%). The median durations of drug abuse and injection were 12 (ranging 1 to 43) and 5 (ranging to 37) years, respectively. 20.5% (95% CI: 17.94, 23.22) of the participants were HIV positive test cases, while the prevalence of HCV was 43.4% (95% CI: 40.17, 46.62). The median number of injections was 21 times per week for all injections and zero for injection with shared needles and syringes. 47.4% of the IDUs had sexual contact with someone other than their spouse. The proportions of unprotected homo- and heterosexual contacts among IDUs were 19.4% and 37.4%, respectively. Conclusion: IDUs had a high rate of unsafe sexual contact and injection related behaviors. The high prevalence of HIV and HCV infection among this group implies a high rate of transmission and exposure to the risk of serious diseases. The study showed the necessity of establishing and developing harm reduction support to the majority of IDUs, to reduce transmission and burden of HIV and hepatitis C in Iran.