HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran; Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, The University of Western Ontario, 1151 Richmond St., London, ON, Canada.
HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran; School of Population and Public Health, Faculty of Medicine, University of British Columbia, 2206 East Mall, Vancouver, BC, Canada.
Drug Alcohol Depend. 2018 Apr 1;185:260-265. doi: 10.1016/j.drugalcdep.2017.12.025. Epub 2018 Feb 14.
Worldwide, crystal methamphetamine (CM) use and associated high-risk sexual behaviors are a concern, but they are less studied among female sex workers (FSW) in developing countries. This study aimed to characterize the prevalence and individual, interpersonal, and structural correlates of self-reported past-month CM use among FSW in Iran.
FSW aged ≥ 18 years who reported penetrative sex with more than one client in the last year were recruited (analytic sample: 1295). Data were collected in one-on-one interviews using a standardized behavioral questionnaire. Poisson regression model was used to assess the correlated of past-month self-reported CM use by crude and adjusted prevalence ratio (APR) and 95% confidence intervals (CI).
Non-injecting and injecting CM use was reported by 15.0% (95% CI: 8.7, 24.7) and 0.9% (95% CI: 0.4, 2.1) of participants. CM use was positively associated with concurrent use of opioids (APR from 2.08 to 3.84, P-value < 0.01), higher number of sexual partners (APR: 2.05, P-value: 0.018), housing instability (APR: 3.54, P-value: 0.001), and history of forced sex (APR: 1.47, P-value: 0.050).
A considerable number of FSWs use CM along with opioids, have a higher number of sexual partners, forced sex, and housing instability. Both prevention strategies as well as strategies to reduce harm associated with CM need to be added to current programs that predominantly focus on opioid dependency and male drug injectors.
在全球范围内，冰毒（CM）的使用和相关的高风险性行为令人担忧，但在发展中国家的女性性工作者（FSW）中，这方面的研究较少。本研究旨在描述伊朗 FSW 过去一个月内自我报告的 CM 使用的流行率以及个体、人际和结构相关因素。
招募年龄≥18 岁、报告在过去一年中与不止一名客户发生过插入性性行为的 FSW（分析样本：1295 人）。使用标准化行为问卷进行一对一访谈收集数据。采用泊松回归模型评估过去一个月自我报告的 CM 使用的相关因素，包括粗患病率比（APR）和 95%置信区间（CI）。
15.0%（95%CI：8.7，24.7）和 0.9%（95%CI：0.4，2.1）的参与者报告了非注射和注射 CM 使用。CM 使用与同时使用阿片类药物（APR 从 2.08 到 3.84，P 值<0.01）、性伴侣数量较多（APR：2.05，P 值：0.018）、住房不稳定（APR：3.54，P 值：0.001）和强迫性性行为史（APR：1.47，P 值：0.050）呈正相关。
相当数量的 FSW 同时使用 CM 和阿片类药物，性伴侣较多，有强迫性行为，住房不稳定。除了目前主要针对阿片类药物依赖和男性吸毒者的方案外，还需要增加预防策略以及减少与 CM 相关的危害的策略。
