Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA 94118, USA.
Int J Drug Policy. 2012 Jul;23(4):333-7. doi: 10.1016/j.drugpo.2011.09.001. Epub 2011 Oct 13.
Driven by opioid use, HIV prevalence is high (15-27%) amongst injection drug users (IDU) in Iran. Harm reduction programmes are associated with a reduction in high risk injecting behaviours; however, Iran has a large number of non-injecting opioid users not immediately targeted by harm reduction programmes. The vast majority of heroin injectors tend to have a history of several years of smoking opium or heroin before transitioning to injection, and a small fraction may even start their drug career by injection of opioids, behaviours that can undermine the effectiveness of the harm reduction programmes. In this study, we have reviewed evidence on the HIV epidemic, extent and pattern of opioid use, and correlates of the transition to injection in Iran. We have concluded that harm reduction policies should also emphasize prevention of the transition to injection amongst high-risk non-injecting opioid users as an additional strategy against the spread of HIV infection in Iran.
受阿片类药物使用的驱使，在伊朗注射吸毒者（IDU）中艾滋病毒的流行率很高（15-27%）。减少伤害方案与高危注射行为的减少有关；然而，伊朗有大量非注射用阿片类药物使用者，这些人没有立即成为减少伤害方案的目标。绝大多数海洛因注射者在转向注射之前，往往有几年吸食鸦片或海洛因的历史，一小部分人甚至可能通过注射阿片类药物开始他们的吸毒生涯，这些行为可能会削弱减少伤害方案的效果。在这项研究中，我们回顾了伊朗艾滋病毒流行情况、阿片类药物使用的程度和模式，以及向注射过渡的相关因素。我们的结论是，减少伤害政策还应强调预防高危非注射用阿片类药物使用者向注射过渡，这是在伊朗遏制艾滋病毒传播的另一项策略。
