Seroepidemiology of Human Immunodeficiency Virus in IllicitSubstance Users in Ahvaz, Iran: 2005-2006

A high seroprevalence rate of human immunodeficiency virus (HIV) infection has been reported among Iranian illicit substance users (ISUs). Objectives: The aim of this study was to evaluate the prevalence of HIV and its risk factors in this population. Patients and Methods: A total of 228 ISUs were included in this cross-sectional study, which was conducted in Ahvaz, southern Iran, from 2005 to 2006. The study population was randomly selected from available ISUs in prisons and addiction treatment centers. Subjects were tested for the presence of anti-HIV antibodies using the enzyme linked immunosorbent assay (ELISA) method. Drug use behaviors associated with HIV transmission (i.e., high-risk behaviors) and their current sexual risk behaviors were examined. Results: Sixty two (27.2 %; 95 % CI: 22.5 % - 31.8 %) of the 228 men were HIV positive. The prevalence of HIV positivity in injecting, inhalant and oral users was 50.2 %, 10.4 %, and 7.6 %, respectively. HIV was positive in heroin, crack and opium users with a rate of 96.2 %, 83.3 %, and 1.4 %, respectively. Among the HIV infected cases, the vast majority had engaged in high-risk behaviors, including sharing needles (72 %), the majority of the injectors had also had unprotected sex with women (67.7 %), or with men (22.6 %). Conclusions: Illicit substance usage is associated with an increased risk of exposure to HIV and this results in a high prevalence of HIV infection. Heroin injecting, sexually transmitted diseases (STD), having sex with multiple partners, unprotected sex, a long period in prison, early adulthood, and family contact with HIV infected cases, are considered to be the main risk factors for HIV infection.