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Outcome assessment of a triangular clinic as a harm reduction intervention in Rajaee-Shahr Prison, Iran
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  • 作者：Rahim Taghizadeh Asl (1)
    Babak Eshrati (2)
    Colleen Anne Dell (3)
    Kelli Taylor (4)
    Parviz Afshar (5)
    Mohammad Kamali (6)
    Ali Mirzazadeh (7)
  • 关键词：Triangular clinic ; Injection drug use ; HIV/AIDS ; Health belief model
  • 刊名：Harm Reduction Journal
  • 出版年：2013
  • 出版时间：December 2013
  • 年：2013
  • 卷：10
  • 期：1
  • 全文大小：273 KB
  • 参考文献：1. Drug Control Bureau: / Annual report of drug control. Tehran; 2001.
    2. Momtazi S, Fallahnejad M, Shoghli A, Musavinasab N, Hajkarim B: Study of high-risk behaviors among injecting drug users in Iran. / National Institute of Drug Abuse Conference 2009.
    3. National AIDS Committee Secretariat, Ministry of Health and Medical Education: / Islamic Republic of Iran AIDS Progress Report: On Monitoring of the United Nations General Assembly Special Session on HIV and AIDS. 2012. Retrieved from: http://www.unaids.org/en/dataanalysis/knowyourresponse/countryprogressreports/2012countries/IRIran%20AIDS%20Progress%20Report%2%2002012%20English%20final1_1.pdf.
    4. Ministry of Health and Medical Education: / HIV/AIDS in Iran (in Persian). Tehran; 2007.
    5. Mirzazadeh A, Haghdoost A, Doostmohammadi P: Estimating the time trend of adjusted incidence of opioid dependency and multiple factors related to the lag time: backward calculation method. / J Kerman Med Univ 2007,13(3):164-72.
    6. Khajehkazemi R, Osooli M, Sajadi L, Karamouzian M, Sedaghat A, Fahimfar N, Safaie A, Mostafavi E, Haghdoost A-A: HIV prevalence and risk behaviours among people who inject drugs in Iran: the 2010 national surveillance survey. / Sex Transm Infect 2013, 1-. 10.1136/sextrans-2013-51204
    7. Khajehkazemi R, Osooli M, Sajadi L, Karamouzian M, Sedaghat A, Fahimfar N, Safaie A, Mostafavi E, Haghdoost A-A: HIV Prevalence and risk behaviours among people who inject drugs in Iran: the 2010 National Surveillance Survey. / Sex Transm Infect J 2013, 1-. 10.1136/sextrans-2013-51204
    8. Navadeh S, Mirzazadeh A, Mehdi Gouya M, Farnia M, Alasvand R, Haghdoost A-A: HIV prevalence and related risk behaviours among prisoners in Iran: results of the national biobehavioural survey. / Sex Transm Infect 2013, 1-. doi: 10.1136/sextrans-2013-51295
    9. Zamani S, Kihara M, Gouya M, / et al.: High prevalence of HIV infection associated with incarceration among community-based injecting drug users in Tehran, Iran. / J Acquir Immune Defic Syndr 2006, 42:342-46. CrossRef
    10. Zamani S, Farnia M, Torknejad A, Alaei BA, Gholizadeh M, Kasaree F, Ono-Kihara M, Oba K, Kihara M: Patterns of drug use and HIV-related risk behaviors among incarcerated people in a prison in Iran. / J Urban Health 2010,87(4):603-16. doi:10.1007/s11524-10-450- CrossRef
    11. Tanner I: The Lion Chases Away the Dragon: Iran’s drug treatment programs are among the world’s most progressive. / The Majalla 2013. Retrieved from: http://www.majalla.com/eng/2013/08/article55244942.
    12. Farnia M, Ebrahimi B, Shams A, / et al.: Scaling up methadone maintenance treatment for opioid-dependent prisoners in in Iran. / Int J Drug Policy 2010, 21:422-24. CrossRef
    13. Rosenberg T: An Enlightened Exchange in Iran. / The New York Times: The Opinion Pages 2010. Retrieved from: http://opinionator.blogs.nytimes.com/2010/11/29/an-enlightened-exchange-in-iran/.
    14. Harrison F: Tackling Iran’s growing drugs problem. / BBC News: Middle East 2004. Retrieved from: http://news.bbc.co.uk/2/hi/4054703.stm.
    15. United Nations Office on Drugs and Crime: / Triangular Clinic & Rehabilitation Centre. Iran; 2006. Retrieved from: http://www.unodc.org/treatment/en/Iran_resource_centre_11.html.
    16. Mehta D: AIDS prevention groups want prison needle programs to protect inmates, public. / TV News, The Canadian Press 2013. Retrieved from: http://www.ctvnews.ca/canada/aids-prevention-groups-want-prison-%20needle-programs-to-protect-inmates-%20public-1.1502466.
    17. Eshrati B, Taghizadeh R, Dell CA, Afshar P, Millson PME, Kamali M, Weekes J: Preventing HIV transmission among Iranian prisoners: initial support for providing education on the benefits of harm reduction practices. / Harm Reduct J 2008, 5:21. CrossRef
    18. Lenton S, Single E: The definition of harm reduction. / Drug Alcohol Rev 1998, 17:213-20. CrossRef
    19. Des Jarlais D: The public health paradigm for AIDS and the drug use: shifting the time frame. / Br J Addict 1990, 85:348-49. CrossRef
    20. Shams A, Rabie N, Esmaili A, Baratvand M: The effect of the harm reduction approach in Iran’s prisons. / IPEDR 2011., 20: Retrieved from: http://www.ipedr.com/vol20/37-ICHSC2011-M10018.pdf.
    21. UNODC: / World Drug Report Vienna: United Nations Office on Drugs and Crime. 2005.
    22. Burrows D: Advocacy and coverage of needle exchange programs: results of a comparative study of harm reduction programs in Brazil, Bangladesh, Belarus, Ukraine, Russian Federation, and China. / Cad Saude Publica 2006, 22:871-79. CrossRef
    23. UNAIDS: / Report on the Global AIDS Epidemic Annex 1: HIV and AIDS estimates and data, 2007 and 2001. Geneva; 2008.
    24. Razani N, Mohraz M, Kheirandish P, / et al.: HIV risk behavior among injection drug users in Tehran, Iran. / Addiction 2007, 102:1472-482. CrossRef
    25. Pourahmad M, Javady A, Karimi I, Ataei B, Kassaeian N: Seroprevalence of and risk factors associated with hepatitis B, hepatitis C, and human immunodeficiency virus among prisoners in Iran. / Infect Dis Clin Pract 2007, 15:368-72. CrossRef
    26. Fallahzadeh H, Morowatisharifabad M, Ehrampoosh M: HIV/AIDS epidemic features and trends in Iran, 1986-006. / AIDS Behav 2009, 13:297-02. CrossRef
    27. Zamani S, Vazirian M, Nassirimanesh B, / et al.: Needle and syringe sharing practices among injecting drug users in Tehran: a comparison of two neighborhoods, one with and one without a needle and syringe program. / AIDS Behav 2010,14(4):885-90. CrossRef
    28. Ghanbarzadeh N, Nadjafi Semnani M: A study of HIV and other sexually transmitted infections among female prisoners in Birjand. / J Birjand Univ Med Sci 2006, 13:69-5.
    29. Ghannad M, Arab S, Mirzaei M, Moinipur A: Epidemiologic study of human immunodeficiency virus (HIV) infection in the patients referred to health centers in Hamadan Province, Iran. / AIDS Res Hum Retrov 2009, 25:277-83. CrossRef
    30. Rahimi-Movaghar A, Razaghi E, Sahimi-Izadian E, Amin-Esmaeili M: HIV, hepatitis C virus, and hepatitis B virus co-infections among injecting drug users in Tehran, Iran. / Int J Infec Dis 2010,14(14):e28-e33. CrossRef
    31. Zamani S, Farnia M, Tavakoli S, / et al.: A qualitative inquiry into methadone maintenance treatmenmt for opiod-dependent prisoners in Tehran, Iran. / Int J Drug Policy 2010,21(3):167-72. CrossRef
    32. Rafiey H, Narenjiha H, Shirinbayan P, / et al.: Needle and syringe sharing among Iranian drug injectors. / Harm Reduct J 2009, 6:21. CrossRef
    33. Taylor A, Goldberg D, Hutchinson S, Cameron S, Gore SM, McMenamin J, Green S, Pithie A, Fox R: Prevalence of hepatitis C virus infection among injecting drug users in Glasgow 1990-996: are current harm reduction strategies working? / J Infect 2000, 40:176-83. CrossRef
    34. Vazirian M, Nassirimanesh B, Zamani S, / et al.: Needle and syringe sharing practices of injecting drug users participating in an outreach HIV prevention program in Tehran, Iran: a cross-sectional study. / Harm Reduct J 2005, 2:19. CrossRef
    35. Ruefli T, Rogers SJ: How do drug users define their progress in harm reduction programs? Qualitative research to develop user-generated outcomes. / Harm Reduct J 2004, 1:8. CrossRef
    36. Mohammadpour A, Yekta ZP, Nikbakht Nasrabadi AR, Mohraz M: Coming to terms with a diagnosis of HIV in Iran: a phenomenological study. / J Assoc Nurses AIDS Care 2009, 20:249-59. CrossRef
    37. Jahani MR, Alavian SM, Shirzad H, Kabir A, Hajarizadeh B: Distribution and risk factors of hepatitis B, hepatitis C, and HIV infection in a female population with “illegal social behavior- / Sex Transm Infect 2005, 81:185. CrossRef
  • 作者单位：Rahim Taghizadeh Asl (1)
    Babak Eshrati (2)
    Colleen Anne Dell (3)
    Kelli Taylor (4)
    Parviz Afshar (5)
    Mohammad Kamali (6)
    Ali Mirzazadeh (7)

    1. World Health Organization, Tehran, Iran
    2. Arak University of Medical Science, Arak, Iran
    3. Department of Sociology & School of Public Health, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
    4. Faculty of Medicine/Medical School, University of Calgary, Calgary, Alberta, Canada
    5. Ministry of Welfare, Tehran, Iran
    6. Iran University of Medical Science, Tehran, Iran
    7. Institute for Health Policy Studies, School of Medicine, University of California, San Francisco, USA
  • ISSN：1477-7517
文摘
Background Transmission of the human immunodeficiency virus (HIV) among incarcerated injection drug users (IDU) is a health epidemic in the Islamic Republic of Iran. Triangular clinics (TCs) were established in prisons as a harm reduction measure to decrease the risk of HIV transmission and other blood-borne infections. The objective of this study was to assess the immediate outcomes of one TC among male IDUs in Iran’s Rajaee-Shahr prison. Methods This study was conducted in two stages between 2003 and 2005. In the preparatory stage, focus group data was collected to update the prison’s TC education and medical interventions and construct the self-report questionnaire. In stage two, 150 male IDUs were recruited in a closed cohort study design to assess the immediate outcome of the TC. Participants were measured at baseline and followed up to six months to measure their drug use, attitude toward and knowledge of high risk behaviours, serological conversion for HIV, HBV and HCV, and engagement in risky behaviors. The TC outcomes were determined through random urine analysis testing, a self-administered questionnaire and behaviour report cards, and viral infection testing. Results The findings of the urine analyses indicated a minimal yet consistent decrease in drug use over the six months. The pre and post- self-administered questionnaire data relayed a modest change in IDU risky behaviours associated with sexual practices; this was greater in comparison to the knowledge and attitude measures. It was determined that age may have a detrimental effect as may viral infections (HIV and HBV) on knowledge, attitude and behavior change. Both education and employment may have a protective effect. Data collected from the self-report behaviour cards similarly showed a modest reduction in high risk practices. At the six month follow-up, only one case became HIV positive, 9 HCV and 17 HBV. Conclusions Considering that HIV is concentrated among Iranian prisoners who inject drugs at a high level, the results of this study indicate that TCs are a possible effective intervention. However, many prisoners continued with risky behaviors even if they were participating in harm reduction measures, such as methadone maintenance therapy.

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