HIV/STI Surveillance Research Center, and WHO Collaborating for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran; Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, The University of Western Ontario, Ontario, Canada.
HIV/STI Surveillance Research Center, and WHO Collaborating 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, Vancouver, BC, Canada.
Addict Behav. 2019 Mar;90:40-47. doi: 10.1016/j.addbeh.2018.09.037. Epub 2018 Sep 30.
This study examines the prevalence of drug and poly-drug use and their associated factors among female sex workers (FSW) in Iran.
We analyzed data from a bio-behavioral surveillance survey of 1347 FSW across 13 major cities in Iran in 2015. Two outcome measures were defined: i) past-month "any drug use", a binary variable defined as none or any; and ii) a three-category past-month "poly-drug use" variable defined as none, only one drug, and more than one drug. Correlates of these two study outcomes were assessed using multivariable logistic regression and multinomial logistic regression, respectively. Adjusted odds ratios (AOR) and 95% confidence intervals (CI) were reported.
We found that 24.9% (95% CI: 16.1, 36.4) and 13.5% (95% CI: 8.1, 21.5) of FSW reported past-month any drug use and poly-drug use, respectively. Longer sex work career (AOR 2.44 [95% CI: 1.28, 4.63]), unstable housing (AOR 2.56 [1.17, 5.64]), past-year experience of sexual violence (AOR 1.61 [1.15, 2.27]), and incarceration (AOR 2.02 [1.23, 3.32]) were positively associated with any drug use. Similarly, FSW who were unstably housed (AOR 3.4 [1.06, 10.95]), reported past-year experience of sexual violence (AOR 2.06 [95% CI: 1.24, 3.41]) and incarceration (AOR 2.82 [1.60, 4.97]) were positively associated with past-month poly-drug use.
Drug use is frequent among Iranian FSW, particularly among those who experienced sexual violence, unstable housing or incarceration. Programs to reduce harms associated with drug and poly-drug use should target FSW as a priority population.
本研究旨在调查伊朗女性性工作者（FSW）中药物和多药物使用的流行情况及其相关因素。
我们分析了 2015 年在伊朗 13 个主要城市进行的一项生物行为监测调查中 1347 名 FSW 的数据。定义了两个结果指标：i）过去一个月“任何药物使用”，一个二进制变量，定义为无或有；ii）过去一个月“多药物使用”的三分类变量，定义为无、一种药物和多种药物。使用多变量逻辑回归和多项逻辑回归分别评估这两个研究结果的相关因素。报告了调整后的优势比（AOR）和 95%置信区间（CI）。
我们发现，24.9%（95%CI：16.1，36.4）和 13.5%（95%CI：8.1，21.5）的 FSW 报告过去一个月有任何药物使用和多药物使用。性工作时间较长（AOR 2.44[95%CI：1.28，4.63]）、住房不稳定（AOR 2.56[1.17，5.64]）、过去一年有性暴力经历（AOR 1.61[1.15，2.27]）和监禁（AOR 2.02[1.23，3.32]）与任何药物使用呈正相关。同样，住房不稳定的 FSW（AOR 3.4[1.06，10.95]）、报告过去一年有性暴力经历（AOR 2.06[95%CI：1.24，3.41]）和监禁（AOR 2.82[1.60，4.97]）与过去一个月多药物使用呈正相关。
药物使用在伊朗 FSW 中很常见，特别是在经历过性暴力、住房不稳定或监禁的 FSW 中。减少与药物和多药物使用相关的危害的项目应将 FSW 作为优先人群。
