Mohammad Shahbazi

Injecting Drug Users Retention in Needle-Exchange Program and its Determinants in Iran Prisons

Background: Participation and to stay in a health program depends on many factors. One of these programs is Needle Exchange Program (NEP) in prisons. Objectives: The current study aimed to evaluate the retention of injecting drug prisoners and find the related factors in Iran. Patients and Methods: This cohort study analyzed data about injecting drug male prisoners who were participated in NEP in three Iranian prisons. Data was collected from October 2009 to June 2010. A proper approach of survival analyses including Kaplan-Meier method, Log-Rank test, and Cox Proportional Hazard Model were used to evaluate Injecting Drug Users (IDUs) retention in NEP and its determinants. Results: Out of 320 prisoners, 167 were from Isfahan Central Prison, 82 from Tehran-Ghezel-Hesar Prison, and 71 from Hamadan Central Prison. Two-hundred and fifty prisoners (78.4%) had history of drug injection; and drug injection was the most common choice for 115 persons (35.9%). Participants were followed up for 29 weeks, the mean (SD) time of retention in the program was 24.1 (0.6) weeks. There was a significant relationship between age, number of used needles per week, duration of addiction, age of addiction onset, as well as imprisonment age, main method of drug use, type of main using drug, Hepatitis B Virus (HBV) infection, job status, reason of arrestment, history of involvement in harm reduction programs, and the length of retention (P < 0.05). There was also significant relationship between the history of using harm reduction services (P = 0.007), tattooing (P = 0.01), longer durations of addiction (P = 0.048), and retention. Conclusions: Tattooing and longer duration of addiction were two important factors that significantly increased retention in the program. In contrast, history of using harm reduction services was the factor that decreased persistence. The risk of quitting the program may decrease about 68% in those who did not involve in harm reduction programs.

Advocacy and piloting the first needle and syringe exchange program in Iranian prisons

Background 1-Pilot the PNEP in the Iranian prisons after having received the acceptance of the authorities in the Iranian Judiciary System. 2-Schedule the piloting of the PNEP in the Iranian prisons. 3-Analyse the opinions given by the policy-makers in prisons and the staff to have a better implementation of the programme. (during pre-, while and post-stages) 4-Collect and evaluate demographic crime and drug data of the IDU’s who are easily reached since in this program the IDU’s can quite easily mention their difficulties with drugs. 5 Distribute the sterile syringes among the IDU’s without any limitations and evaluate the data based on the number of sterile received and used returned syringes respectively.

The trend of HIV/AIDS prevalence among IDU's in Iranian prisoners (1376-1386)

Background Prisons are recognized worldwide as important sites for transmission of blood-borne viruses (BBVs). the high prevalence of HIV infection and drug dependence among prisoners, combined with the sharing of injecting drug equipment, make prisons a high-risk environment for the transmission of HIV and the lack of supply of preventive measures (such as sterile needle and syringes or condoms or methadone maintenance therapy). In most prisons of world, because of a variety of social conditions, extra opportunities for BBV transmission are created. HIV prevalence in Iran is generally more than 8 times higher in prisons (1.75) than in general population estimation (0.2) because of the considerable over-representation of injecting drug users (IDUs) among prisoners. We want to study the trend and outcome of interventions of HIV/AIDS in IDU’s prisoners of Iran during 1997-2007.

Prevalence of Tuberculosis in a Prison in Tehran by Active Case Finding

BACKGROUND Tuberculosis [TB] is one of the most important infectious diseases among prisoners. TB Screening plays an important role in prevention among prisoners and their visitors, also better caring of the patients. Active case finding is one of screening methods that is relatively an easy one to find TB suspected prisoners. Therefore, we aimed to assess the prevalence of TB in male prisoners in Tehran, Iran. METHODS This study was conducted among male prisoners in Great Tehran Prison to screen and diagnose TB patients from October 2013 to May 2014. We used active case finding [ACF] as a screening method to find TB suspected prisoners in which healthcare staff explained TB symptoms for prisoners and individuals with those symptoms referred to the clinic for further work up (sputum sample tests). RESULTS In total of 6900 prisoners, 448 (6.5%) prisoners were TB suspected by ACF and only nine patients were diagnosed with tuberculosis, indicating the prevalence of 0.13%. CONCLUSION The relatively low TB prevalence within prisoners besides considering likely common symptoms in ACF may result in many false positive cases during screening (6.5% vs. 0.13%). But, ACF is more fast, easy and affordable method to find TB suspected prisoners. Also, during this active method, prisoners are trained about TB symptoms so, it has a more prolonged effect towards screening goals.

Views of Iranian prison staff towards needle-exchange program in prison

Abstract Aims: Prison staff members have a core role in the provision of harm reduction strategies in prison. This study aimed to evaluate the attitudes of prison directors, managers and health staff toward Needle Exchange Program (NEP) among people who inject drugs in Iranian prisons. Methods: With a grounded theory design, this qualitative study was conducted in 2011 in Iran. The study population included directors of provincial prison organisations, prison managers, heads of health departments in prisons, prison health officers, physicians, counsellors and healthcare workers in prisons. Participants’ responses were collected via focus group discussions. Results: Attitudes of the participants could generally be categorised in three including: Health-related aspects; Behavioural and social aspects; and Legal, organisational and financial aspects. Those who were in line with the existence of NEP in prisons mentioned some pre-requisites for supporting this program in prisons. Conclusion: Positive and negative views of Iranian prison staff toward NEP in prisons suggest that there are many obstacles to the provision of harm reduction strategies in prison. Consideration of socio-cultural parameters of the target community as well as combination of NEP and other harm reduction strategies might help to improve the effectiveness of harm reduction in prisons.