Objective: With the availability of specialists and the overflowing information in public and social networks, individuals have easy access to information about HIV and AIDS. However, medical counselling and healthcare settings still have an essential role. The aim of the present study was to analyze phone enquiries directed to the Positive Club of Imam Khomeini Hospital in Tehran; this analysis was based on demographic features of participants.Design/Methodology/Approach: In this cross-sectional study, 5255 questions were extracted and coded from the Positive Club's counselling questionnaires; the coding procedure was based on Huber and Gilapsy's decimal classification. Data were processed by descriptive statistics and SPSS software.Findings: A majority of callers were men (59.43%), most callers were aged between 26 and 30 years, and HIV transmission and high-risk sexual behaviours were among frequently asked questions (47%).Originality/Value: Taking into account that most callers were concern about transmission via sexual contact (anal, vaginal, and oral) rather than injection and its related equipment, it seems reasonable to assume that HIV transmission flow may shift from shared injection equipment to high-risk sexual behaviors

Dadras, Omid

Jozani, Zahra Bayat

Koochak, Hamid Emadi

Mohraz, Minoo

Najafi, Zeinab

Salahshoori, Faridokht

SeyedAlinaghi, SeyedAhmad

Tabatabaei, Reza Adl

English

Synergy Publishers Journal System

 Journal of Therapy and Management in HIV Infection, 2019, 7, 6-9 6 
 
 E-ISSN: 2309-0529/19  © 2019 Synergy Publishers 
Content Analysis of Teleconsultation Enquiries in Positive Health 
Club, Imam Khomeini Hospital, Tehran, Iran 
Faridokht Salahshoori1, Zahra Bayat Jozani1, Omid Dadras2, SeyedAhmad SeyedAlinaghi1, 
Zeinab Najafi1, Reza Adl Tabatabaei1, Hamid Emadi Koochak1,* and Minoo Mohraz1 
1Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran 
University of Medical Sciences, Tehran, Iran 
2Department of Global Health and Socioepidemiology, Graduate School of Medicine, Kyoto University, Kyoto, 
Japan 
Abstract: Objective: With the availability of specialists and the overflowing information in public and social networks, 
individuals have easy access to information about HIV and AIDS. However, medical counselling and healthcare settings 
still have an essential role. The aim of the present study was to analyze phone enquiries directed to the Positive Club of 
Imam Khomeini Hospital in Tehran; this analysis was based on demographic features of participants. 
Design/Methodology/Approach: In this cross-sectional study, 5255 questions were extracted and coded from the Positive 
Club's counselling questionnaires; the coding procedure was based on Huber and Gilapsy's decimal classification. Data 
were processed by descriptive statistics and SPSS software.  
Findings: A majority of callers were men (59.43%), most callers were aged between 26 and 30 years, and HIV 
transmission and high-risk sexual behaviours were among frequently asked questions (47%). 
Originality/Value: Taking into account that most callers were concern about transmission via sexual contact (anal, 
vaginal, and oral) rather than injection and its related equipment, it seems reasonable to assume that HIV transmission 
flow may shift from shared injection equipment to high-risk sexual behaviors.  
Keywords: Remote consultation, AIDS, Content analysis, Iran. 
INTRODUCTION 
There are currently 37.9 million HIV infected 
individuals all over the world and every 16 minutes; a 
patient dies from AIDS [1]. HIV prevention is one of the 
major concerns in developing nations. Availability of 
sufficient information and health services are essential 
indicators of a healthy community. A recent 
breakthrough in technology and communication have 
introduced numerous options to patients for accessing 
medical information. By employing tools such as Email, 
online phone services and numerous applications, 
remote medical consultation has become available and 
easily accessible for patients [2]. 
It is noteworthy to mention that the abundance of 
available information regarding HIV and AIDS has not 
undermined the importance of medical counselling [3]; 
furthermore, in some regions, the general stigma 
surrounds HIV and its related subjects prevents 
individuals to acquire sufficient information, and many 
of their questions will remain unanswered [4]. A 
quintessential would be Mwamwenda's research on 
164 college students in Natal South Africa, in which  
 
 
*Address correspondence to this author at the Iranian Research Center for 
HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran 
University of Medical Sciences, Tehran, Iran; Tel/Fax: +98 (021) 66947984;  
E-mail: emadiham@tums.ac.ir 
46% of the students believed that AIDS was a 
punishment from God [5]. In order to improve the 
access of rural communities to medical information, 
remote medical consultation is a solution which 
reduces the costs but needs to establish new 
healthcare settings [2]. 
The Positive Club in Imam Khomeini Hospital is one 
of the main consultation centers across Iran which 
provides this service. This institution has started its 
activities in 2006 and has encountered an ascending 
rate of enquiries since then, which reflects its 
demanding and beneficial role in the community. In 
addition, due to its collaboration and parallel activities 
with the Iranian Research Center for HIV/AIDS 
(IRCHA), it has served as a flagship for similar facilities 
across the region.  
The necessity of this study emerges from similar 
studies in different regions across the globe. In a study 
performed by Torani in 2011, the avidity of affiliated 
hospitals and healthcare settings to Iran University of 
Medical Sciences regarding remote medical 
counselling was evaluated; this evaluation was based 
on management, workforce and available equipment. 
The study was performed as a cross-sectional analysis 
consisting of 106 individuals from hospital's executive 
and managing staff; data gathering was based on a 
Content Analysis of Teleconsultation Enquiries in Positive Health Club Journal of Therapy and Management in HIV Infection, 2019, Vol. 7      7 
partitioned questionnaire consisted of acquaintance 
and required standards of remote medical counselling 
sections. Results indicated that remote therapeutic 
counselling reduces public health costs and 
establishing such services was recommended by the 
author [2]. 
In Asra's study in 2010, analysing the results of 
1252 enquiries, demonstrated that 700 enquiries were 
made on sexual behaviours, 325 were AIDS specific 
(with 60 of them regarding blood and sexual contacts), 
50 regarding HIV related tests, 100 on signs and 
symptoms and 70 on disease control and the rest on 
stigmas. Results and the authors' recommendation 
were focused on the individual stress level regarding 
HIV/AIDS and its management [4]. 
In a study by Deevey in 2005, 913 reference 
questions asked between May 2002 and August 2004 
in a special library in a mid-western community-based 
AIDS service organization, were analyzed and 
arranged by Huber's decimal classification. Promising 
results were obtained which could benefit the library 
itself; 24% of the questions were based on HIV tests 
and its related information, 18% on physical health, 
lowest frequency on addiction with 2.5% and general 
AIDS information with 2.4% [3]. 
In another study performed by Seth in 2008, using 
content analysis, 944 recorded counselling sessions 
were investigated and results indicated that the high-
risk individuals require the most assistance in gathering 
and assessing correct and sufficient information; 
frequent questions involved prevention and condom 
use (15%), 14% were on signs and symptoms and 11% 
on related tests and procedures [6]. 
In an earlier study by Huber and Jeffrey in 1999, 
192 web enquiries were processed via content 
analysis. 31 of 192 investigations were on medicine 
management, 21 on general information about AIDS, 
21 on disease transmission, 12 on signs and symptoms 
and one enquiry on HIV histology. These results 
indicated that in parallel to HIV prevalence, educational 
and awareness programs should also be enforced and 
reassessed based on public needs [7].  
The aim of the present study was to analyze phone 
enquiries directed to the Positive Club of Imam 
Khomeini Hospital in Tehran. 
MATERIALS AND METHODS 
This is a cross-sectional study based on Huber-
Gilapsy's decimal classification, which consisted of 1- 
Generalities, 2- Epidemiology and transmission. 3- 
Education and prevention, 4- Clinical manifestations of 
HIV and complications, malignancies, and infections 
associated with AIDS, 5- Treatments, therapies, and 
medical management of HIV, 6- Psychosocial and 
religious issues, case management, 7- Legal, ethical, 
economic, and political aspects, 8- Organizations, 
funding opportunities, and health policy, 9- Fine arts 
and 10- Belle letters and non-fiction. 
It is worth mentioning that due to cultural 
differences, some content of Huber-Gilapsy's decimal 
classification had to be readjusted according to the 
opinion of experts and the type of questions, and the 
classification has changed somewhat which included: 
1- General information on AIDS and its related tests, 2- 
Epidemiology and transmission, 3- Education and 
prevention, 4- Signs and symptoms, 5- Medications, 6- 
Religion, and psychological subjects, 7- Political, 
economic and racial status, 8- Health policies, 9- 
Disease's statistical data and 10- Other cases. 
Available documented data in Positive Club of 
Imam Khomeini Hospital, Tehran was used for this 
study. During four consecutive months (2015), 5255 
enquiries were documented by consultants based on 
the person's age, gender, occupation, marital status, 
education and the type of question. Then each enquiry 
was assigned a code by the researcher, and the 
number and percentage of enquiries coded into each 
category, were analyzed. SPSS software (version 22) 
and descriptive analysis (frequency and percentage) 
were employed in this study. 
Ethical Consideration 
The protocol of this study was reviewed and 
approved by the institutional review board (IRB) of 
Tehran University of Medical Science (Ethics No.159-
35127). The content of the interviews was recorded 
and secured in a data file on the personal computer of 
the main researcher. All the authors used a password 
before running the primary data file.  
RESULTS 
Most enquirers were men (59.43%) aged between 
26 and 30, 39.3% of the total enquirers were married, 
and 35.7% were single; in terms of educational status 
and occupation, 58.8% were high school graduates, 
59.4% with senior high school education and 43.66% 
were self-employed (Table 1). 
As depicted in Figure 1, most frequent enquiries 
were about transmission and sexual behaviours 
8     Journal of Therapy and Management in HIV Infection, 2019, Vol. 7 Salahshoori et al. 
(46.9%) followed by general information on the disease 
and its related tests (36.6%); no further enquiries on 
the prevalence of HIV, addiction, treatments and 
medications were made. 
Table 1: Demographic Information of 5255 Enquirers 
from Imam Khomeini Hospital's Consulting 
Center via Hotline 
Demographic characteristics N (%) 
Gender 
Male 3123 (59.43) 
Female 2132 (40.57) 
Age group (years) 
16-20 38 (0.7) 
21-25 1024 (19.5) 
26-30 2604 (49.5) 
30< 1589 (30.3) 
Occupation 
Unemployed 1016 (19.33) 
Self-employed 2291 (43.66) 
Staffer 1472 (28.01) 
Others 476 (9) 
Education level 
Illiterate 3 (0.05) 
Elementary school 34 (0.6) 
Junior high school 251 (4.7) 
Senior high school 3114 (59.4) 
Academic 1853 (35.2) 
Marital status 
Single 1874 (35.7) 
Permanent marriage 2092 (39.9) 
Temporary marriage 896 (17) 
Divorce 247 (4.7) 
Widow 146 (2.7) 
 
 
Figure 1: Frequency of enquiries from Imam Khomeini 
Hospital's consulting center via hotline (N=5255). 
DISCUSSION 
Since its outbreak, HIV has manifested itself as a 
global concern and referring to UNAIDS 2014 global 
AIDS report progress, a global effort for ending AIDS, 
is highly favoured due to its economic and social 
burdens; however, such changes require coordinated 
and abiding arrangements [8-11]. 
The context of our enquiries was different from that 
of the Deevey's study; our results demonstrated that 
most enquirers concerned the HIV transmission rather 
than its general information [3]. Asera's results 
indicated that more than 160 enquiries were about 
transmission and symptoms which portrays the disease 
apprehension and its amplitude in the community [4]. 
This confirms our results and initial concern regarding 
the importance of public information. Providing 
information for community is crucial; even though, it will 
not diminish their fear and anxiety toward the disease. 
Although 34% of the enquirers had tertiary education 
and educational programs have been conducted over 
the years, the lack of sufficient information on HIV and 
its various transmission methods is still evident. 
Seth CK, et al., analyzed 944 questions asked by 
634 patients receiving HIV risk reduction counselling 
services at an urban sexually transmitted infections 
clinic. The most common questions asked by clients 
concerned condoms and other methods of HIV 
prevention (15%), HIV symptoms and progression 
(14%) and HIV antibody testing (11%). The results 
showed that many individuals at high risk for HIV 
infection have substantial information needs. 
Therefore, the basic education about AIDS facts should 
be implemented in HIV prevention interventions. In 
addition, the greatest need for information was related 
to understanding the methods for HIV prevention [6] 
that confirms our study. 
One interesting fact was that the enquiries 
dramatically increased as the study progressed toward 
its end; it is quite understandable that the community is 
seeking a safe and reliable source of information to 
interact with it. This gap can be filled by employing 
social network, websites, and applications such as 
YouTube, Twitter, etc., to educate and interact with 
individuals. Furthermore, this method can be employed 
by health care providers as an augmented version of 
their awareness program. 
 
Content Analysis of Teleconsultation Enquiries in Positive Health Club Journal of Therapy and Management in HIV Infection, 2019, Vol. 7      9 
CONCLUSION 
This study analyzed the content of teleconsultation 
at Positive Club of Imam Khomeini Hospital, Tehran, 
Iran. The findings indicated that considering the fact 
that most callers concerned about transmission via 
sexual intercourse (anal, vaginal, and oral) rather than 
injection and its related paraphernalia; It seems that 
route of HIV transmission shifted from shared 
paraphernalia to high-risk sexual behaviour in recent 
years in Iran. This shift exposes our future generation 
at a greater risk of HIV infection; however, it can be 
averted by orchestrating educational programs through 
media, public libraries, academic institutions, health 
care settings and communal environments.  
CONFLICT OF INTEREST 
The authors have no conflict of interest. 
REFERENCES 
[1] https://www.unaids.org/en 
[2] Torani S, Khamarnia M, Delgoshaei B. The ability of special 
hospitals of Iran University of Medical Sciences in stablishing 
remote medical advice. Health Information Management 
2011; 8(6): 794. 
[3] Deevey SH, Behring M. HIV/AIDS Reference questions in an 
AIDS service organization special library. Medical Reference 
Services Quarterly 2005; 24(3): 29-37. 
https://doi.org/10.1300/J115v24n03_03 
[4] Asera R, Bagarukayo H, Shuey D, Barton T. An epidemic of 
apprehension: questions about HIV/AIDS to an east African  
 
newspaper health advice column. AIDS Care: Psychological 
and Socio-Medical Aspects of AIDS/HIV 9(1): 5-12. 
https://doi.org/10.1080/09540129750125299 
[5] Tuntufye S. Three educational and moral questions 
regarding AIDS among South African education students. 
Psychological Reports 2003; 92: 349-50. 
https://doi.org/10.2466/pr0.2003.92.1.349 
[6] Seth CK, Cain D, Knecht J, Hill J. HIV/AIDS information 
needs of sexually transmitted infection clinic patients: a 
content analysis of question asked during prevention 
education counselling. Sex Education: Sexuality, Society and 
Learning 2008; 8(1): 11-23. 
https://doi.org/10.1080/14681810701811787 
[7] Whiteside A. The key questions in the AIDS epidemic in 
2015. Review of African Political Economy 2015; 42(145): 
455-66. 
https://doi.org/10.1080/03056244.2015.1064371 
[8] Huber JT, Fogel C. HIV/AIDS-Related electronic queries and 
responses. Medical Reference Services Quarterly 1999; 
18(4): 19-32. 
https://doi.org/10.1300/J115v18n04_03 
[9] SeyedAlinaghi SA, Paydary K, Afsar Kazerooni P, Hosseini 
M, Sedaghat A, Emamzadeh-Fard S, Mohraz M. Evaluation 
of Stigma Index Among People Living With HIV/AIDS 
(PLWHA) in Six Cities in Iran. Thrita 2013; 2(4): 69-75. 
https://doi.org/10.5812/thrita.11801 
[10] Zeynolabedin SM, Jabbari H, Bayat Jozani Z, Haji 
Abdolbaghi M, Mohraz M, Arabzade A, Farrokhi M, 
SeyedAlinaghi SA. An Estimation of HIV/AIDS’s Cost in the 
Voluntary Counseling and Testing Center of Imam Khomeini 
Hospital in 2010-2011. Journal of Therapy and Management 
in HIV Infection 2018; 6: 41-44. 
https://doi.org/10.12970/2309-0529.2018.06.07 
[11] Rasoolinejad M, Naghib Sadat B, Najafi Z, Baesi K, Heidari 
H, SeyedAlinaghi SA. Epidemiological and Clinical 
Information of People At Risk for HIV Referred to the 
Voluntary Counseling and Testing Center, Tehran, Iran, 
2013-2014. Journal of International Translational Medicine 
2018; 6(4): 176-180.  
https://doi.org/10.11910/2227-6394.2018.06.04.04 
 
Received on 21-05-2019 Accepted on 27-07-2019 Published on 18-09-2019 
 
DOI: https://doi.org/10.12970/2309-0529.2019.07.02 
© 2019 Salahshoori et al.; Licensee Synergy Publishers. 
This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License 
(http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in 
any medium, provided the work is properly cited. 
 
 


Content Analysis of Teleconsultation Enquiries in Positive Health Club, Imam Khomeini Hospital, Tehran, Iran

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