Article Text
Abstract
Background Prisoners are disproportionately at increased risk of HIV infection. Despite the importance of assessing HIV testing rates among key populations at risk of HIV, our understanding of HIV testing practices of Iranian prisoners is limited. This study utilizes data from two repeated behavioral survey studies to shed light on the prevalence and correlates of HIV testing among Iranian prisoners.
Methods Data were obtained from two consecutive surveys in 2009 (N = 5913) and 2013 (N =5430) using a multistage random sampling approach including both large and small prison settings. Having a recent HIV test result was defined as having an HIV test result over the last 12 months. Biological and survey data were collected through dried blood spot testing and standardized risk assessment questionnaire, respectively. Descriptive statistics including frequencies, percentages, and 95% confidence intervals (CI) were reported. Bivariable and multivariable logistic regression models were built to compare the odds of having a recent HIV test result among different subgroups of prisoners.
Results Most participants had never tested for HIV (68.7% in 2009 and 62.2% in 2013). Only 9.9% (in 2009) and 11.6% (in 2013) of the participants had a recent HIV test result. Older age (AOR=1.50), lifetime history of drug use (AOR=1.87) and sexual intercourse (AOR=1.42), and self-perceived risk of HIV (AOR=0.74) were significantly associated with recent HIV testing in 2009. Female sex (AOR=4.03), multiple incarcerations (AOR=1.40), alcohol consumption (AOR=1.23), and STI (AOR=1.79) and HIV knowledge (AOR=1.62) were significant correlates in 2013.
Conclusion HIV testing is extremely low among prisoners in Iran. There is an urgent need to revisit current HIV testing policies across Iranian prisons and identify the barriers to HIV testing within the prison settings. Scaling up rapid tests as well as routine opt-out HIV testing services could help encourage prisoners to further use the available harm reduction facilities inside prisons.
Disclosure No significant relationships.