Estimativa populacional da prevalência pontual e periódica de infecções sexualmente transmissíveis com base no sistema de vigilância de sintomas iranianos

Sexually transmitted diseases (STDs) are of greate international concerns. The aim of this study was to measure the point and period prevalence of reportable STDs in Iran based on syndromes defined by the Iranian STDs surveillance system. In that regard, the population of Marvdasht, the second largest county of Fars province, was selected. This is a population based cross-sectional study, which was conducted among urban and rural residences of Marvdasht county in 2017. In total, among 11763 randomly sampled individuals, 3879 eligible participants in urban and rural areas of Marvdasht county were interviewed. The participants were on average 33 years old. Overall about 33 percent of men and 70 percent of women reported that, since the age of 15 years, they experienced at least one of the symptoms of selected STDs defined by the Iranian center for disease control (CDC) for surveillance of sexually transmitted infections (STIs). Moreover, %9.7 of men and %28.7 of women were suffering from at least one of the defined symptoms at the time of interview. Regardless of the etiology of the detected syndromes, the results highlight the importance of access to diagnostic and medical services to achieve on time diagnosis and treatment of the patients. Also, sexual health education is needed to be provided to the rural and urban sexually active population of Iran.Las enfermedades de transmisión sexual (ETS) son de gran preocupación internacional. El objetivo de este estudio fue medir la prevalencia de punto y período de las ETS notificables en Irán según los síndromes definidos por el sistema de vigilancia iraní de ETS. En ese sentido, se seleccionó la población de Marvdasht, el segundo condado más grande de la provincia de Fars. Este es un estudio transversal basado en la población, que se llevó a cabo entre las residencias urbanas y rurales del condado de Marvdasht en 2017. En total, entre 11763 individuos de muestra aleatoria, se entrevistaron 3879 participantes elegibles en áreas urbanas y rurales del condado de Marvdasht. Los participantes tenían en promedio 33 años. En general, alrededor del 33 por ciento de los hombres y el 70 por ciento de las mujeres informaron que, desde la edad de 15 años, experimentaron al menos uno de los síntomas de las ETS seleccionadas definidas por el centro iraní para el control de la enfermedad (CDC) para la vigilancia de las infecciones de transmisión sexual ( ITS). Además, el% 9,7 de los hombres y el 28,7% de las mujeres sufrían al menos uno de los síntomas definidos en el momento de la entrevista. Independientemente de la etiología de los síndromes detectados, los resultados resaltan la importancia del acceso a los servicios médicos y de diagnóstico para lograr el diagnóstico y el tratamiento a tiempo de los pacientes. Además, es necesario proporcionar educación sobre salud sexual a la población sexualmente activa rural y urbana de Irán.As doenças sexualmente transmissíveis (DSTs) são de grandes preocupações internacionais. O objetivo deste estudo foi medir a prevalência pontual e periódica de DST notificáveis no Irã com base em síndromes definidas pelo sistema de vigilância de DSTs iranianas. A esse respeito, a população de Marvdasht, o segundo maior condado da província de Fars, foi selecionada. Trata-se de um estudo transversal de base populacional, realizado em residências urbanas e rurais do condado de Marvdasht em 2017. No total, dentre 11763 indivíduos amostrados aleatoriamente, foram entrevistados 3879 participantes elegíveis nas áreas urbana e rural do município de Marvdasht. Os participantes tinham em média 33 anos de idade. No geral, cerca de 33% dos homens e 70% das mulheres relataram que, desde os 15 anos, tiveram pelo menos um dos sintomas das DSTs definidas pelo Centro Iraniano de Controle de Doenças (CDC) para vigilância de infecções sexualmente transmissíveis (DSTs). Além disso, % 9.7 de homens e% 28.7 de mulheres sofriam de pelo menos um dos sintomas definidos no momento da entrevista. Independentemente da etiologia das síndromes detectadas, os resultados destacam a importância do acesso aos serviços médicos e diagnósticos para alcançar o diagnóstico e tratamento oportuno dos pacientes. Além disso, é necessário fornecer educação em saúde sexual para a população rural e urbana sexualmente ativa do Irã

Evaluation of Conducting Phone Interviews on Sexual Behavior: An Iranian Population-Based Study

Background: Phone interview is a safe way for collecting sensitive data due to no need for direct contact with the interviewees and their privacy. Objectives: The purpose of this study was to investigate the feasibility and validity of phone interviewing using mobile phones to collect sensitive information related to the participants’ sexual behavior. Methods: This cross-sectional study was conducted on the sexually active population of Marvdasht, Iran, from 2017-2018. Results: A total of 5,894 individuals (2,991 from urban and 2,903 from rural areas) from both genders (n = 3,202 males vs. n = 2,692 females) with an age range of 18-50 years were included in this study. The participation rate was convincing (92.18%), and the response rate to all questions was also very high (99.1%). According to the results, gender and place of residency had statistically significant associations with the rates of participation and response. Conclusions: The results suggested that a phone interview is a potentially useful method for gathering sensitive information in Iranian population, a community with a religious background

Care-seeking Pattern in the General Iranian Population with Sexually Transmitted Infection Syndromes: A Population-Based Survey

Background: Sexually transmitted infections (STIs) have a high prevalence in developing and least developed countries. Delays in seeking health care are among the main obstacles to the prevention and control of STIs. This study aimed to investigate the care-seeking pattern in the general Iranian population with sexually transmitted infection syndromes. Materials and Methods: This population-based survey was conducted in 2016 among the population of Marvdasht County, who aged 18-50. The random cluster sampling method was used to select the sample. A checklist was used to collect information, and SPSS V.16.0 was used for data analysis. In addition, linear and logistic regressions were used to model the association between contributing factors and the behavioral pattern. Results: A total of 3,879 people with the mean age of 33.85 ± 8.85 participated in this study. The results showed that 31.83 and 3.3 of the males and females, respectively, took no action when experiencing common symptoms of STIs. In addition, the time interval between the onset of symptoms and visiting a medical center was 10.26±2.74 and 7.10±1.45 days in males and females, respectively (P ≤ 0.05). Conclusions: The care-seeking frequency in males with sexually transmitted infection syndromes was low. Furthermore, the time interval between the onset of the syndrome and visiting a medical center was longer in males than in females

Slums’ Access to and Coverage of Primary Health Care Services: A Cross-Sectional Study in Shiraz, a Metropolis in Southern Iran

Background: The United Nations has predicted that the population of slum dwellers will have grown from one billion people worldwide to 2 billion by 2030. This trend is also predictable in Iran. In the Iranian metropolis of Shiraz, more than 10% of the residents live in slum areas. There are several problems regarding the delivery of social services in these areas. The aim of this study was to evaluate slums dwellers’ access to and coverage of health care. Methods: This cross-sectional face-to-face study included 380 household of slum dwellers via stratified random sampling. Demographics, accessibility of health services, coverage of health care, and route of receiving health services were recorded through interviews. Results: Approximately, 21.6% of the households had no physical access to health centers. The coverage rate of family planning programs for safe methods was 51.4% (95% CI: 48.86-53.9%). Vaccination coverage among children under 5 years old was 98% (95% CI: 97-99%). Furthermore, 34% of pregnant women had not received standard health care due to a lack of access to health centers. Conclusion: Limited access to health services along with inadequate knowledge of slum residents about health care facilities was the main barrier to the utilization of the health care in the slums

Survival and associated factors among people living with HIV/AIDS: A 30-year national survey in Iran

Background: The survival in Iranian HIV/AIDS patients based on data from Iran National HIV/AIDS Case Registry System has not been evaluated. This study assessed the survival rates and associated factors among people living with HIV/AIDS in Iran. Materials and Methods: The population in this observational study included 32168 patients diagnosed with HIV/AIDS registered in Iran disease registry system between 1986 and 31 December 2015. Data until June 2016 (the cutoff date of our last data linkage) were investigated to estimate survival and related factors following HIV diagnosis. Results: Of registered patients, 17.7% were diagnosed at AIDS stage. By June 2016, 27.2% of study population progressed to AIDS, and 8081 (25.1%) of patients died. The survival rate was 88%, 85%, 77%, and 67% for 1, 2, 5, and 10 years, respectively. Cumulative proportion surviving was significantly lower in males than in females (P = 0.0001). A higher rate of survival was seen in female patients, who diagnosed after 2010, infected in sexual route, and had CD4 cell count more than 500, nonconfected patients with tuberculosis (TB), and those who received antiretroviral therapy (ART). Based on multivariate model, the mortality risk in female patients, those with CD4 cell count more than 500, patients who received ART, and those with TB and injection drug uses (IDUs) was higher. Conclusion: The survival in studied patients increased in recent time periods, and ART reduced AIDS-related mortality in these patients. The survival can be increased by focus on improvements in patient care among male patients, IDUs, and patients with TB coinfection

Survival rate and the determinants of progression from HIV to AIDS and from AIDS to the death in Iran: 1987 to 2016

Objective: To examine the prognostic factors of progression from HIV to AIDS and AIDS to the death in people living with HIV/AIDS in Iran. Methods: In this registry-based retrospective cohort study, we recruited 28 873 HIV-infected people from 158 Behavioral Diseases Counseling Centers of Iran. Two outcomes of interest included survival rates from HIV diagnosis to AIDS and from AIDS to the death. We used Kaplan-Meier and Cox regression model to investigate survival rate and factors affecting on survival controlling effect of confounding factors. Results: The one, three, five, and ten-year survival rate from HIV to AIDS were 85%, 73%, 61% and 32%, and for AIDS to death were 90%, 81%, 74% and 55%, respectively. Multivariate Cox regression analysis indicated that the risk of progression from AIDS phase toward death in individuals with CD4 less than 200/mm3, infected with tuberculosis (TB) and not treated by antiretroviral therapy (ART) was 2.17 (95% CI: 1.62-2.90), 1.49 (95% CI: 1.01-2.20) and 4.88 (95% CI: 3.42-6.96) times higher respectively. The risk of progression to AIDS in patients with baseline CD4 less than 200/mm3 was 2.32 (95% CI: 2.14, 2.51) times higher than patients with CD4 > 200/mm3 (P=0.001). On the other hand, tuberculosis increases the risk of death by 49.0% (P=0.04). The hazard ratio of death in patients who did not receive ART was 4.88 (95% CI: 3.42, 6.96) times higher than patients who received ART (P<0.001). Conclusion: The early detection of HIV, the screening and treatment of TB and receiving the ART improve the survival of HIV/AIDS patients significantly, and prevent the transmission of HIV to other people

Point and Lifetime Prevalence of Sexually Transmitted Diseases Based on the Definitions of the Iranian Syndrome Surveillance System: A Hospital-Based Survey

Background: Sexually transmitted infections (STIs) are among the most common infectious diseases and a globally concerning public health issue, especially in developing countries. Objectives: This study aimed to evaluate the syndrome-based point and lifetime prevalence of sexually transmitted infections in a big Iranian city. Methods: This cross-sectional study was conducted in 2019 on a hospital-based random sample of 2107 people (men and women aged 15-50) at Marvdasht Central Hospital (Iran). Results: The lifetime prevalence of Sexually Transmitted Diseases (STDs) was significantly higher in women than in men (81.56% vs. 33.60%, P-value < 0.0001). Also, about 20.7% of men and 48.26% of women had at least one of the STIs-associated syndromes at the time of the interview (instantaneous prevalence) (P-Value = 0.001). Conclusions: The estimated prevalence of syndromes associated with sexually transmitted infections is alarmingly high. The results emphasize the need for further studies on effective health care and health promotion services to reduce STIs (including early detection and treatment of infections and public education

Life Satisfaction among People in Reproductive Age: A Survey on Marvdasht City in 2016

Background: Life satisfaction is a comprehensive concept reflecting the general feeling of people about the society in which they live. Previous research has found that health status is associated with life satisfaction. Sexual intercourse is of physiological and psychological needs, which is closely associated with the wellbeing of any individual. In this study, we examined life satisfaction in Marvdasht, Fars province. Methods: This population-based survey was conducted in 2016 among Marvdasht urban and rural population aged 18-50 years. The participants were selected via cluster random sampling. A telephone survey was conducted to complete an interview-administered questionnaire. Significance level in this study was considered 0.05. All stages of data analysis was done in SPSS22 software. Results: A total of 3879 participants from urban and rural areas of Marvdasht were interviewed. There was a difference between urban and rural men in terms of sexual satisfaction (P=0.01) (7.90±2.01 vs. 8.15±1.89) and life satisfaction (P=0.011) (5.64±3.54 vs. 5.14±3.71). Satisfaction in both cases in men in urban areas was better than men in rural areas. Also, the average score of sexual satisfaction was higher in rural men compared with that in urban male residents (P=0.01). Regarding women, at error level of 0.05, there was a difference between urban and rural women in terms of sexual satisfaction (P<0.0001) (8.62±1.502 vs. 9.12±0.789) and life satisfaction (P<0.0001) (8.37±1.641vs. 9.13±0.669), so that satisfaction in both cases in women in rural areas was higher than men in urban areas. Conclusion: Life satisfaction had a close relationship to geographical areas of residence. However, this was for women living in rural areas than women living in urban areas in both cases

Blood-borne hepatitis in opiate users in iran: a poor outlook and urgent need to change nationwide screening policy.

OBJECTIVE: Iran has the highest rate of opiate use worldwide. However, most opiate users are not screened for hepatitis virus infections. This study aimed to provide accurate, detailed data on the size of the opiate user population at risk of developing these infections. METHOD: This seroprevalence study was conducted in the city of Shiraz, southern Iran. All participants were screened for HBV, HCV and HIV infection. The data were analyzed with SPSS. RESULT: Among 569 participants, 233 (40.9%) were injection drug users (IDU), 369 (64.8%) were heterosexual, 84 (14.7%) were bisexual and 15 (2.6%) were homosexual. One hundred nine (19.1%) were HCV antibody-positive, 18 (3.1%) were HBS antigen-positive, 72 (12.6%) were HBc antibody-positive and 23 (4%) were HIV-positive. Among IDU compared to non-IDU, positivity rates for HBS antigen (5.5 vs 1.4%), HBc antibody (22.7 vs 5.6%), HCV antibody (40.3 vs 4.4%) and HIV (7.7 vs 1.4%) were higher (P < 0.05). Most patients with HBV (80.7%) and HCV infection (83.4%) were HIV-negative. In the cumulative analysis, only history of imprisonment was a statistically significant determinant of infection by HCV or HBV in opiate users. CONCLUSION: The current policy of screening only HIV-positive drug users for HBV and HCV in Iran misses most cases of HBV and HCV infection. We therefore recommend urgent revision of the nationwide protocol by the Ministry of Health in Iran to implement routine screening of all opiate users and especially IDU for these viruses, regardless of their HIV status