Hamidreza Setayesh

Integrated bio-behavioural HIV surveillance surveys among female sex workers in Sudan, 2011–2012

Objectives To assess HIV and syphilis prevalence, HIV-related behaviours and testing for HIV in female sex workers (FSW) in Sudan. Design Bio-behavioural surveys using respondent-driven sampling were carried out among FSW in the capital cities of 14 states in Sudan in 2011–2012. HIV and syphilis testing was done by rapid tests. Results 4220 FSW aged 15–49 years were recruited. The median age of recruited women varied from 21 to 28 years per site. The highest HIV prevalence was measured at two sites in the eastern zone (5.0% and 7.7%), while in the other zones it ranged from 0% to 1.5%. Syphilis prevalence ranged from 1.5% in the northern zone to 8.9% in the eastern zone. Ever having been tested for HIV was reported by 4.4%–23.9% of FSW across all sites. Condom use at last sex with a client varied from 4.7% to 55.1%, while consistent condom use with clients in the month preceding the surveys was reported by 0.7%–24.5% of FSW. The highest reporting of ever injecting drugs was measured at a site in the western zone (5.0%). Conclusions The surveys’ findings indicate that the highest burden of HIV in FSW is in the eastern states of the country. Condom use and HIV testing data demonstrate the need for HIV interventions that should focus on HIV testing and risk reduction strategies that include stronger condom promotion programmes in FSW and their clients.

HIV and other sexually transmitted infection research in the Middle East and North Africa: promising progress?

The mere association of the words sexually transmitted infections (STIs), including HIV/AIDS, and sexuality, to Middle East and North Africa (MENA) in any discussion, social or academic, seems to elicit heated debates and controversy. The MENA region is, in the minds of many, an area where socio-cultural sensitivities surrounding sex and disease still abound. Are there HIV epidemics shrouded behind a wall of denial? Is there a ‘conspiracy of silence’ resulting in a failure to confront a public health scourge? Lack of data seems to have fuelled this debate, but the reality of the situation is more nuanced. There are probably shreds of truth in the polemics about HIV infection and other STIs in this region, but partial truths often distort reality. This special supplement of Sexually Transmitted Infections provides a critical piece of the solution to this problem: evidence from the field. This evidence suggests a reality that this region should be able to confront and deal with. The purpose of this special supplement is to showcase the progress of STI research in MENA, and to demonstrate stronger evidence about the HIV epidemic to inform policy and programming. We chose studies that broadened our knowledge in this field, and testified to the feasibility of conducting quality research in this region. To highlight progress, we invited contributors to submit studies dealing with diverse research questions and methodologies. We encouraged novelty and weighed the studies’ potential to impact policy and programming. Our goal was to have a broad representation from the MENA region, but we only achieved partial success. Though eventually the supplement included data from multiple countries in one form or another, the countries with more advanced research capacity contributed more. A few of the invited articles from other countries did not materialise for a variety of reasons. One of …

Risk and vulnerability of key populations to HIV infection in Iran; knowledge, attitude and practises of female sex workers, prison inmates and people who inject drugs

UNLABELLED Background In this study data of three national surveys conducted among female sex workers (FSW), prison inmates and people who inject drugs (PWID) were presented and compared in relation to knowledge, attitude, and practises. METHODS The surveys were conducted in 2009 and 2010 and included 2546 PWID, 872 FSW and 5530 prison inmates. Knowledge, attitude and practises towards HIV were measured through similar questions for each category. RESULTS Over 90% of all participants had ever heard of HIV/AIDS, although only approximately half of them perceived themselves at risk of contracting HIV. More than 80% were able to correctly identify the ways of preventing the sexual transmission of HIV; while more than two-thirds did not use condom in their last sexual contact. Approximately 20% of prisoners and FSW had a history of injecting drugs. Among all participants who have injected drugs, prisoners had the highest unsafe injecting behaviour at the last injection (61%), followed by FSW (11%) and PWID (3%). CONCLUSIONS Despite major efforts to control the HIV epidemic in Iran, the level of risk and vulnerability among prisoners, FSW and PWID is still high. The level of comprehensive knowledge about HIV/AIDS is relatively good; however, their risk perception of contracting HIV is low and high-risk behaviours are prevalent. Therefore, HIV prevention programs should be redesigned in a more comprehensive way to identify the best venues to reach the largest number of people at a higher risk of contracting HIV and decrease their risk overlaps and vulnerability factors.