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.
Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
Drug Alcohol Depend. 2021 Apr 1;221:108655. doi: 10.1016/j.drugalcdep.2021.108655. Epub 2021 Feb 26.
Illicit drug use is a prevalent risk behavior among female sex workers (FSWs) as it increases the vulnerability of this marginalized population to negative health outcomes, including HIV infection. This systematic review and meta-analysis aimed to estimate the prevalence of injection and non-injection drug use among FSWs in Iran.
Systematic searches of PubMed, Embase, Web of Science, Scopus, and PsycINFO (for English records), along with Iranian databases including IranMedex, Iran Psych Magiran, Scientific Information Database, and Irandoc (for Farsi records) were conducted for studies published from inception through to July 2020. We included quantitative studies on injection and non-injection drug use among FSWs. The pooled prevalence and 95% confidence intervals (CI) of recent and lifetime drug injection and non-injection were estimated using random-effects meta-analysis.
Of 458 screened records, 19 met the inclusion criteria. The pooled prevalence of recent non-injection drug use and injection drug use was 56.94% (95% CI: 44.68, 68.78) and 5.67% (95% CI: 2.09, 10.73), respectively. Opium (33.00%, 95% CI: 24.53, 42.05) and crystal methamphetamine (20.68%, 95% CI: 13.59, 28.79) were the most prevalent recent non-injection drugs used. Additionally, the pooled prevalence of lifetime non-injection drug use was 76.08% (95% CI: 66.81, 84.27) and injection drug use was 10.72% (95% CI: 7.02, 15.07).
This systematic review shows that drug use, both injection and non-injection, is prevalent among FSWs in Iran. These findings highlight the importance of evidence-based harm reduction and treatment programs to reduce the burdens of drug use and its associated potential consequences among these underserved women.
非法药物使用是性工作者（FSWs）普遍存在的风险行为，因为这会增加这一弱势群体面临负面健康后果的脆弱性，包括 HIV 感染。本系统评价和荟萃分析旨在估计伊朗 FSWs 中注射和非注射药物使用的流行率。
对 PubMed、Embase、Web of Science、Scopus 和 PsycINFO（英文记录）以及伊朗数据库（包括 IranMedex、Iran Psych Magiran、Scientific Information Database 和 Irandoc）进行了系统检索，检索时间从建库至 2020 年 7 月。我们纳入了关于 FSWs 中注射和非注射药物使用的定量研究。使用随机效应荟萃分析估计最近和终身注射和非注射药物使用的合并流行率和 95%置信区间（CI）。
在 458 条筛选记录中，有 19 条符合纳入标准。最近非注射药物和注射药物使用的合并流行率分别为 56.94%（95%CI：44.68，68.78）和 5.67%（95%CI：2.09，10.73）。最近使用的最常见非注射药物是鸦片（33.00%，95%CI：24.53，42.05）和冰毒（20.68%，95%CI：13.59，28.79）。此外，终生非注射药物使用的合并流行率为 76.08%（95%CI：66.81，84.27），注射药物使用的合并流行率为 10.72%（95%CI：7.02，15.07）。
本系统评价表明，伊朗 FSWs 中存在注射和非注射药物使用的情况。这些发现强调了基于证据的减少伤害和治疗方案的重要性，以减少这些服务不足的妇女面临的药物使用负担及其相关潜在后果。
