Background HIV prevalence among prisoners is over eight times higher than that of the general in Iran. Considering that sexually transmitted infections (STIs) increase the susceptibility to HIV infection, this study estimates the prevalence and correlates of STI-related symptoms among prisoners in Iran.
Methods In this cross-sectional study, 27 prisons across 16 provinces were selected using a stratified random sampling approach. Men aged ≥18 years who spent at least 1 week in the prison and self-reported having had sex during last year were eligible for this analysis. Participants were asked about their current STI symptoms including penile discharge (PD) and genital ulcers (GU). Demographic variables, HIV/STI-related knowledge, STI care seeking practices, HIV self-perceived risk, as well as history of substance use, incarceration, and sexual behaviours were collected using a face-to-face pilot-tested risk assessment questionnaire. HIV tests were completed using ELISA of dried blood spots. Correlates of having STI symptoms were identified using descriptive statistics and logistic regression models.
Results Out of 2610 male prisoner recruited (Mean age ±SD: 35.7±0.19), 7% reported symptoms for PD, UC, or both; 45% of whom had not sought STI care inside prisons. Having STI-related symptoms were positively associated with a history of injection drug use (adjusted odds ratio [AOR]: 2.1, 95% CI, 1.4–3.1), condom accessibility inside prison (AOR: 1.7, 95% CI , 1.1–2.8), self-perceived risk of HIV (AOR: 1.5, 95% CI , 1.1–2.2), HIV-seropositivity (AOR: 3.3, 95% CI , 1.3–10.6), while negatively associated with having sufficient STI-related knowledge (AOR: 0.6, 95% CI, 0.4–0.8).
Conclusion STI symptoms are notable among prisoners in Iran with a higher prevalence among specific groups (i.e., those who inject drugs and live with HIV). Our findings call for revisiting current HIV/STI prevention policies across Iranian prisons to help improve prisoners’ HIV/STI knowledge and encourage their HIV/STI preventive practices.
Disclosure No significant relationships.
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