Mansoori Yasaman, Mehmandoost Soheil, Khezri Mehrdad, Mirzazadeh Ali, Haghdoost Ali Akbar, Tavakoli Fatemeh, Nasiri Naser, Sharifi Mohammad, Rashidi Hamidreza, Iranpour Abedin, Shokoohi Mostafa, Ghalekhani Nima, Pedarzadeh Marjan, Fuladi Surur, Karamouzian Mohammad, Sharifi Hamid
Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran.
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.
Subst Abuse Treat Prev Policy. 2025 Apr 7;20(1):19. doi: 10.1186/s13011-025-00645-x.
Methamphetamine use is a pressing public health concern among people who inject drugs (PWID) worldwide. This study aimed to estimate the prevalence of methamphetamine use and its correlates in a nationwide survey among PWID in Iran in 2020.
We recruited 2,684 PWID in 11 major cities from July 2019 to March 2020 using respondent-driven sampling (RDS). Participants were eligible if they were ≥ 18 years old, self-reported drug injection in the last 12 months, resided in the city of the study, and provided a valid RDS coupon. Behavioral data was collected using a standard questionnaire via face-to-face interviews. 2,259 PWID (84.2%) with valid responses to the primary outcome (i.e., methamphetamine use (either injecting or non-injection use) in the last three months) were included in the analysis. We used RDS-Gile's SS weighted analysis for descriptive statistics and a survey package (svy) using linearized variance estimations and stratification by cities for bivariable and multivariable logistic regression analyses.
The last 3-month prevalence of methamphetamine use among PWID was 47.0% (95% CI: 44.9, 49.1). The following factors were significantly associated with methamphetamine use in the last three months: history of homelessness in the last 12 months (aOR = 1.57; 1.77, 2.10), drug use onset before the age 18 (aOR = 1.40; 1.05, 1.87), injecting drug for more than ten years (aOR = 1.47; 1.11, 1.95), using non-injection (aOR = 7.18; 4.93, 10.47) and injecting illicit opioids (aOR = 2.98; 2.03, 4.36) in the last three months, as well as having multiple sex partners in the last 12 months (aOR = 1.60; 1.50, 2.73) and region (north: aOR = 5.42; 2.92 10.03; south: aOR = 2.95; 2.04, 4.27; east: aOR = 24.43; 15.62, 38.22).
The frequency of methamphetamine use among PWID is considerable in Iran. Our findings underscore the importance of implementing tailored comprehensive harm reduction services for this sub-population of PWID. They also emphasize the urgent need for evidence-based interventions to address the harms associated with the increasing co-use of opioids and methamphetamine among PWID.
在全球范围内，使用甲基苯丙胺是注射吸毒者（PWID）中一个紧迫的公共卫生问题。本研究旨在通过2020年在伊朗全国范围内对注射吸毒者进行的一项调查，估计甲基苯丙胺的使用流行率及其相关因素。
我们在2019年7月至2020年3月期间，使用应答者驱动抽样（RDS）方法，在11个主要城市招募了2684名注射吸毒者。参与者符合以下条件：年龄≥18岁，在过去12个月内自我报告有药物注射行为，居住在研究城市，并提供有效的RDS优惠券。通过面对面访谈，使用标准问卷收集行为数据。对主要结局（即过去三个月内使用甲基苯丙胺（注射或非注射使用））有有效应答的2259名注射吸毒者（84.2%）纳入分析。我们使用RDS - Gile的SS加权分析进行描述性统计，并使用一个调查软件包（svy），通过线性化方差估计和按城市分层进行双变量和多变量逻辑回归分析。
注射吸毒者中过去三个月内甲基苯丙胺的使用流行率为47.0%（95%置信区间：44.9，49.1）。以下因素与过去三个月内使用甲基苯丙胺显著相关：过去12个月内有无家可归史（调整后比值比[aOR]=1.57；1.77，2.10），18岁之前开始吸毒（aOR = 1.40；1.05，1.87），注射毒品超过十年（aOR = 1.47；1.11，1.95），过去三个月内使用非注射方式（aOR = 7.18；4.93，10.47）和注射非法阿片类药物（aOR = 2.98；2.03，4.36），以及过去12个月内有多个性伴侣（aOR = 1.60；1.50，2.73）和地区（北部：aOR = 5.42；2.92，10.03；南部：aOR = 2.95；2.04，4.27；东部：aOR = 24.43；15.62，38.22）。
在伊朗，注射吸毒者中甲基苯丙胺的使用频率相当高。我们的研究结果强调了为这一注射吸毒者亚群体实施量身定制的全面减少伤害服务的重要性。它们还强调迫切需要基于证据的干预措施，以应对与注射吸毒者中阿片类药物和甲基苯丙胺共同使用增加相关的危害。
