Journal of Biostatistics and Epidemiology (Dec 2021)
An alarming shift of HIV infection from injection drug to sexual transmission in Mashhad, Iran, 1989-2014
Abstract
ABSTRACT Objectives: Iran is facing a rapid change in the epidemiological pattern of HIV. We examine trends in disease incidence and factors associated with the development of HIV over the last two decades in Iran. Methods: We retrospectively collected data from patients who attended the Behavior Diseases Consultation Center of Mashhad University of Medical Sciences in Iran. Individuals were contributed if they were HIV-positive. We examined baseline factors including demographic, behavioral and clinical characteristics for all participants. Changes in population characteristics were assessed using chi-square test or the Fisher’s exact test. Results: From 1989 to 2014, 584 individuals were eligible for present analysis according to the inclusion criteria. Most patients were men (87%) with most being 36–52 years old, unemployed (58%), married (39.3%), less educated (47.7%) and had a history of imprisonment (83%). The most common modes of HIV transmission were injection drug use (IDU) (51.4%) and IDU along with the sexual relationship (26.5%). These transmission modes varied significantly according to gender (p-value<0.001). Similarly, IDU and sexual relationship were most important transmission modes in males and females, respectively. The incidence rate of HIV through sexual-related modes had a higher proportion than IDU in recent years. Conclusions: In Iran, the pattern of HIV transmission is shifting from unsafe injection drug to unsafe sexual contact for forthcoming years. Also, increasing trend of HIV incidence in women is remarkable. Accordingly, HIV-prevention strategies need to be changed.
