Potential for Sexual Transmission of HIV Infection From Male Injecting-Drug Users Who Have Sex With Men in Tehran, Iran

Iran has responded to the threat of an HIV epidemic among injecting drug users. There is growing concern, however, over the potential for bridging HIV infection from IDUs to other populations, including men who have sex with men, noted the authors of the current study.

From 2003 to 2004, cross-sectional biobehavioral surveys were conducted among 370 IDUs recruited from drug treatment centers, a drop-in center and streets in drug-populated areas of Tehran.

Survey data indicated that about 12 percent of male, sexually experienced IDUs have had same-gender sex. HIV prevalence is high (19 percent), while condom use during last sexual encounter was low (20 percent). A multivariate analysis showed that compared to other sexually experienced IDUs, IDUs who had sex with men (MSM IDUs) are younger (adjusted odds ratio, 0.89; 95 percent confidence interval, 0.81-0.98), more likely to have used a shared needle/syringe for injecting drugs (AOR, 4.29; 95 percent CI, 1.82-10.12), and have had five or more sexual partners in their lifetime (AOR, 2.71; 95 percent CI, 1.14-6.44).

"These results show that MSM IDUs exhibit more drug-related and sexual risk behaviors that may serve as a bridge for sexual transmission of HIV to other populations, including the broader MSM community, in Tehran," concluded the authors. "This report intends to encourage health authorities in Iran to take serious action to prevent sexual transmission of HIV from MSM IDUs to their sexual networks."

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