HIV Infection in Iran: An Update on Epidemiology, Testing and Gaps
-
Seyed Ahmad Seyed Alinaghi
,
Mohammad Mahdi Roozbahani
,
Behnam Farhoudi
,
Seyed Ali Dehghan Manshadi
,
Shayesteh Jahanfar
Abstract
The HIV epidemic continues to disproportionately affect young and active individuals in developing and low-income countries, including Iran. Among high-risk populations in Iran, HIV prevalence peaks at 3.5% among people who inject drugs and 2.5% among men who have sex with men. Despite progress in achieving the UNAIDS 95-95-95 targets for HIV diagnosis, treatment, and viral suppression, significant gaps remain in early detection and reaching vulnerable populations, including pre-exposure prophylaxis and targeted outreach to key populations. Education and awareness campaigns are crucial for preventing the spread of HIV, particularly among young people. However, there is a need to improve education and access to information and HIV services for key populations. Expanding HIV testing and counselling services is vital for early diagnosis and treatment. Addressing the issue of late diagnosis, which can negatively impact treatment outcomes and mortality rates, is essential. Integrating HIV services into primary healthcare can improve access and outcomes. A holistic and multi-sectoral approach, encompassing education, prevention, treatment, and care, is necessary to curb the spread of HIV and improve the quality of life for individuals affected by HIV infection in Iran.
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2. UNAIDS. Country progress report – Iran. (Accessed 2020; at https://www.unaids.org/sites/default/files/country/documents/IRN_2020_countryreport.pdf).
3. Gökengin D, Doroudi F, Tohme J, Collins B, Madani N. HIV/AIDS: trends in the Middle East and North Africa region. Int J Infect Dis 2016;44:66-73.
4. UNAIDS. Country progress report, Iran. (Accessed 2023; at https://www.unaids.org/en/regionscountries/countries/islamicrepublicofiran.)
5. Seyedalinaghi S, Taj L, Mazaheri-Tehrani E, Ahsani-Nasab S, Abedinzadeh N, Mcfarland W, et al. HIV in Iran: onset, responses, and future directions. Aids 2021;35:529-42.
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7. Sharifi HEA. Behavioral and Serological HIV Care in MSM in Iran - First Phase (1401)2022, Regional Training Center for HIV/AIDS Care System, Kerman University of Medical Sciences, Kerman, Iran, Project Report.
8. Nematollahi A, Gharibzadeh S, Damghanian M, Gholamzadeh S, Farnam F. Sexual Behaviors and Vulnerability to Sexually Transmitted Infections in Transgender Women. BMC Womens Health 2022;22:170.
9. Izadi N, Gouya MM, Akbarpour S, Zareie B, Moradi Y, Afsar Kazerooni P, et al. HIV prevalence and associated factors among female sex workers in Iran: a bio-behavioral survey in 2020. AIDS Behav 2023;27:909-18.
10. Khezri M, Shokoohi M, Mirzazadeh A, Tavakoli F, Ghalekhani N, Mousavian G, et al. HIV prevalence and related behaviors among people who inject drugs in Iran from 2010 to 2020. AIDS Behav 2022;26:2831-43.
11. Mohraz M, SeyedAlinaghi SA, Asadollahi-Amin A, Golrokhi R, Merghati Khoei E, Yousefi H, et al. Sociodemographic Characteristics, HIV-Related Risk Behaviors and HIV Prevalence of Vulnerable Men in Tehran, Iran. Curr HIV Res 2021;19:352-7.
12. Akbari E. Knowledge attitude and practice of female and male (10-19 y/o) adolescents about health of puberty. Report of the project, 1997.
13. Mehmandoost S, Khezri M, Mousavian G, Tavakoli F, Mehrabi F, Sharifi H, et al. Prevalence of HIV, hepatitis B virus, and hepatitis C virus among incarcerated people in Iran: a systematic review and meta-analysis. Public Health 2022;203:75-82.
14. Shahesmaeili A, Karamouzian M, Tavakoli F, Shokoohi M, Mirzazadeh A, Hosseini-Hooshyar S, et al. HIV prevalence and continuum of care among incarcerated people in Iran from 2010 to 2017. Harm Reduction J 2022;19:93.
15. SeyedAlinaghi MP, Eskandari M, Boosiraz A, Marvi F, Abdoli F. Prevalence of HIV among garbage collectors in Tehran, Iran: A cross-sectional study. HIV&AIDS Review 2024. (In Press)
16. Ghalekhani N, Mirzazadeh A, Tavakoli F, Mousavian G, Khezri M, Zamani O, et al. HIV Continuum of Care Among People Who Inject Drugs in Iran: A Cross-sectional Study. J Assoc Nurses AIDS Care 2023;34:182-7.
17. Gholami J, Rostam-Abadi Y, Rahimi Y, Fotouhi A, Amin-Esmaeili M, Rahimi-Movaghar A. HIV prevalence among non-injecting people who use drugs and related factors in Iran: A systematic review and meta-analysis. Drug Alcohol Rev 2022;41:666-76.
18. Greene ME. The Islamic Republic of Iran: strong policies difficult to document in practice. In this generation: Sexual and reproductive health policies for a youthful world. Population Action International, 2002.
19. Simbar M, Tehrani F, Hashemi Z. Reproductive health knowledge, attitudes and practices of Iranian college students. East Mediterr Health J 2005;11:888-97.
20. Behrooz A, Esmaeeli S, Riyahi L, SeyedAlinaghi SA, Foroughi M. The effects of a social-cognitive method based education on knowledge and attitudes intentions with respect to HIV transmission among students in Maragheh, Iran. Asian Pac J Trop Dis 2014;4:166-8.
21. SeyedAlinaghi S, Sadrizadeh B, Mohrez M, Gouya MM. A study of the knowledge on HIV in regards to routes of transmission and sexual practices in men between the ages of 20 to 50 in Tehran. Asian Pac J Trop Dis 2014;4:S621-3.
22. Kirby D. No easy answers: Research findings on programs to reduce teen pregnancy. 1997: National Campaign to Prevent Teen Pregnancy.
23. Christopher FS Roosa MW. An evaluation of an adolescent pregnancy prevention program: is" just say no" enough? Family Rel 1990;39:68-72.
24. Chandra-Mouli V. Drawing in, working with and supporting communities in sexual health promotion. Sex Health Exch 1999:1-3.
25. Taghizadeh Asl R, Eshrati B, Dell CA, Taylor K, Afshar P, Kamali M, et al. Outcome assessment of a triangular clinic as a harm reduction intervention in Rajaee-Shahr Prison, Iran. Harm Reduct J 2013;10:1-11.
26. Pourjam R, Rahimi Khalifeh Kandi Z, Estebsari F, Karimi Yeganeh F, Safari M, Barati M, et al. An Analytical Comparison of Knowledge, Attitudes, and Practices Regarding HIV/AIDS Among Medical and Non-Medical Students in Iran. HIV AIDS (Auckl) 2020;12:165-73.
27. Gheibi Z, Fararouei M, Afrashteh S, Akbari M, Afsar Kazerooni P, Shokoohi M. Pattern of contributing behaviors and their determinants among people living with HIV in Iran: A 30-year nationwide study. Front Public Health 2023;11:1038489.
28. Khezri M, Goldmann E, Tavakoli F, Karamouzian M, Shokoohi M, Mehmandoost S, et al. Awareness and willingness to use HIV self-testing among people who inject drugs in Iran. Harm Reduct J 2023;20:145.
29. WHO. HIV, STI, hepatitis. (Accessed at https://www.emro.who.int/iran/priority-areas/hiv-sti-hepatitis.html.)
30. Tavakoli F, Dehghan M, Haghdoost AA, Mirzazadeh A, Gouya MM, Sharifi H. A qualitative study exploring approaches, barriers, and facilitators of the HIV partner notification program in Kerman, Iran. BMC Health Serv Res 2024;24:570.
31. Sharafi M, Mirahmadizadeh A, Hassanzadeh J, Seif M, Heiran A. Duration of delayed diagnosis in HIV/AIDS patients in Iran: a CD4 depletion model analysis. Front Public Health 2023;11:1029608.
32. Sharafi M, Mirahmadizadeh A, Hassanzadeh J, Seif M. Prevalence of late presenters and advanced HIV disease in HIV patients and their related factors in Iran: Results from 19 years of national surveillance HIV data. AIDS Res Hum Retroviruses 2022;38:890-7.
33. Gheibi Z, Joulaei H, Fararouei M, Shokoohi M, Foroozanfar Z, Dianatinasab M. Late diagnosis of HIV infection and its associated factors in Shiraz, Southern Iran: a retrospective study. AIDS Care 2022;34:1321-9.
34. SeyedAhmad S. Frontiers in HIV Research. Volume 2. EBSCO eBooks. Sharjah, United Arab Emirates: Bentham Science Publishers; 2016.
35. Mayhew S. Integrating MCH/FP and STD/HIV services: current debates and future directions. Health Policy Plan 1996;11:339-53.
36. Beaglehole R, Epping-Jordan J, Patel V, Chopra M, Ebrahim S, Kidd M, et al., Improving the prevention and management of chronic disease in low-income and middle-income countries: a priority for primary health care. Lancet 2008;372:940-9.
37. Walton DA, Farmer PE, Lambert W, Léandre F, Koenig SP, Mukherjee JS. Integrated HIV prevention and care strengthens primary health care: lessons from rural Haiti. J Public Health Policy 2004;25:137-58.
38. Nuwaha F, Kabatesi D, Muganwa M, Whalen CC. Factors influencing acceptability of voluntary counseling and testing for HIV in Bushenyi district of Uganda. East African Med J 2002;79:626-32.
39. Pfeiffer J, Montoya P, Baptista AJ, Karagianis M, Pugas MDM, Micek M, et al. Integration of HIV/AIDS services into African primary health care: lessons learned for health system strengthening in Mozambique-a case study. J Int AIDS Soc 2010;13:3.
40. Yamamoto T, Satoko I. JCIE. Fighting a rising tide: the response to AIDS in East Asia; 2006.
41. Price JE, Leslie JA, Welsh M, Binagwaho A. Integrating HIV clinical services into primary health care in Rwanda: a measure of quantitative effects. AIDS Care 2009;21:608-14.
42. Yu D, Souteyrand Y, Banda MA, Kaufman J, Perriëns JH. Investment in HIV/AIDS programs: does it help strengthen health systems in developing countries? Global Health 2008;4:8.
43. Mohraz M, Gooya MM. [Recommended Model for Integration of HIV/AIDS in Primary Health Network]. Project Rep 2011.
2. UNAIDS. Country progress report – Iran. (Accessed 2020; at https://www.unaids.org/sites/default/files/country/documents/IRN_2020_countryreport.pdf).
3. Gökengin D, Doroudi F, Tohme J, Collins B, Madani N. HIV/AIDS: trends in the Middle East and North Africa region. Int J Infect Dis 2016;44:66-73.
4. UNAIDS. Country progress report, Iran. (Accessed 2023; at https://www.unaids.org/en/regionscountries/countries/islamicrepublicofiran.)
5. Seyedalinaghi S, Taj L, Mazaheri-Tehrani E, Ahsani-Nasab S, Abedinzadeh N, Mcfarland W, et al. HIV in Iran: onset, responses, and future directions. Aids 2021;35:529-42.
6. Uploadkon. (Accessed 13 December; 2024; at https://uploadkon.ir/uploads/560108_24DrMoradi.pdf. )
7. Sharifi HEA. Behavioral and Serological HIV Care in MSM in Iran - First Phase (1401)2022, Regional Training Center for HIV/AIDS Care System, Kerman University of Medical Sciences, Kerman, Iran, Project Report.
8. Nematollahi A, Gharibzadeh S, Damghanian M, Gholamzadeh S, Farnam F. Sexual Behaviors and Vulnerability to Sexually Transmitted Infections in Transgender Women. BMC Womens Health 2022;22:170.
9. Izadi N, Gouya MM, Akbarpour S, Zareie B, Moradi Y, Afsar Kazerooni P, et al. HIV prevalence and associated factors among female sex workers in Iran: a bio-behavioral survey in 2020. AIDS Behav 2023;27:909-18.
10. Khezri M, Shokoohi M, Mirzazadeh A, Tavakoli F, Ghalekhani N, Mousavian G, et al. HIV prevalence and related behaviors among people who inject drugs in Iran from 2010 to 2020. AIDS Behav 2022;26:2831-43.
11. Mohraz M, SeyedAlinaghi SA, Asadollahi-Amin A, Golrokhi R, Merghati Khoei E, Yousefi H, et al. Sociodemographic Characteristics, HIV-Related Risk Behaviors and HIV Prevalence of Vulnerable Men in Tehran, Iran. Curr HIV Res 2021;19:352-7.
12. Akbari E. Knowledge attitude and practice of female and male (10-19 y/o) adolescents about health of puberty. Report of the project, 1997.
13. Mehmandoost S, Khezri M, Mousavian G, Tavakoli F, Mehrabi F, Sharifi H, et al. Prevalence of HIV, hepatitis B virus, and hepatitis C virus among incarcerated people in Iran: a systematic review and meta-analysis. Public Health 2022;203:75-82.
14. Shahesmaeili A, Karamouzian M, Tavakoli F, Shokoohi M, Mirzazadeh A, Hosseini-Hooshyar S, et al. HIV prevalence and continuum of care among incarcerated people in Iran from 2010 to 2017. Harm Reduction J 2022;19:93.
15. SeyedAlinaghi MP, Eskandari M, Boosiraz A, Marvi F, Abdoli F. Prevalence of HIV among garbage collectors in Tehran, Iran: A cross-sectional study. HIV&AIDS Review 2024. (In Press)
16. Ghalekhani N, Mirzazadeh A, Tavakoli F, Mousavian G, Khezri M, Zamani O, et al. HIV Continuum of Care Among People Who Inject Drugs in Iran: A Cross-sectional Study. J Assoc Nurses AIDS Care 2023;34:182-7.
17. Gholami J, Rostam-Abadi Y, Rahimi Y, Fotouhi A, Amin-Esmaeili M, Rahimi-Movaghar A. HIV prevalence among non-injecting people who use drugs and related factors in Iran: A systematic review and meta-analysis. Drug Alcohol Rev 2022;41:666-76.
18. Greene ME. The Islamic Republic of Iran: strong policies difficult to document in practice. In this generation: Sexual and reproductive health policies for a youthful world. Population Action International, 2002.
19. Simbar M, Tehrani F, Hashemi Z. Reproductive health knowledge, attitudes and practices of Iranian college students. East Mediterr Health J 2005;11:888-97.
20. Behrooz A, Esmaeeli S, Riyahi L, SeyedAlinaghi SA, Foroughi M. The effects of a social-cognitive method based education on knowledge and attitudes intentions with respect to HIV transmission among students in Maragheh, Iran. Asian Pac J Trop Dis 2014;4:166-8.
21. SeyedAlinaghi S, Sadrizadeh B, Mohrez M, Gouya MM. A study of the knowledge on HIV in regards to routes of transmission and sexual practices in men between the ages of 20 to 50 in Tehran. Asian Pac J Trop Dis 2014;4:S621-3.
22. Kirby D. No easy answers: Research findings on programs to reduce teen pregnancy. 1997: National Campaign to Prevent Teen Pregnancy.
23. Christopher FS Roosa MW. An evaluation of an adolescent pregnancy prevention program: is" just say no" enough? Family Rel 1990;39:68-72.
24. Chandra-Mouli V. Drawing in, working with and supporting communities in sexual health promotion. Sex Health Exch 1999:1-3.
25. Taghizadeh Asl R, Eshrati B, Dell CA, Taylor K, Afshar P, Kamali M, et al. Outcome assessment of a triangular clinic as a harm reduction intervention in Rajaee-Shahr Prison, Iran. Harm Reduct J 2013;10:1-11.
26. Pourjam R, Rahimi Khalifeh Kandi Z, Estebsari F, Karimi Yeganeh F, Safari M, Barati M, et al. An Analytical Comparison of Knowledge, Attitudes, and Practices Regarding HIV/AIDS Among Medical and Non-Medical Students in Iran. HIV AIDS (Auckl) 2020;12:165-73.
27. Gheibi Z, Fararouei M, Afrashteh S, Akbari M, Afsar Kazerooni P, Shokoohi M. Pattern of contributing behaviors and their determinants among people living with HIV in Iran: A 30-year nationwide study. Front Public Health 2023;11:1038489.
28. Khezri M, Goldmann E, Tavakoli F, Karamouzian M, Shokoohi M, Mehmandoost S, et al. Awareness and willingness to use HIV self-testing among people who inject drugs in Iran. Harm Reduct J 2023;20:145.
29. WHO. HIV, STI, hepatitis. (Accessed at https://www.emro.who.int/iran/priority-areas/hiv-sti-hepatitis.html.)
30. Tavakoli F, Dehghan M, Haghdoost AA, Mirzazadeh A, Gouya MM, Sharifi H. A qualitative study exploring approaches, barriers, and facilitators of the HIV partner notification program in Kerman, Iran. BMC Health Serv Res 2024;24:570.
31. Sharafi M, Mirahmadizadeh A, Hassanzadeh J, Seif M, Heiran A. Duration of delayed diagnosis in HIV/AIDS patients in Iran: a CD4 depletion model analysis. Front Public Health 2023;11:1029608.
32. Sharafi M, Mirahmadizadeh A, Hassanzadeh J, Seif M. Prevalence of late presenters and advanced HIV disease in HIV patients and their related factors in Iran: Results from 19 years of national surveillance HIV data. AIDS Res Hum Retroviruses 2022;38:890-7.
33. Gheibi Z, Joulaei H, Fararouei M, Shokoohi M, Foroozanfar Z, Dianatinasab M. Late diagnosis of HIV infection and its associated factors in Shiraz, Southern Iran: a retrospective study. AIDS Care 2022;34:1321-9.
34. SeyedAhmad S. Frontiers in HIV Research. Volume 2. EBSCO eBooks. Sharjah, United Arab Emirates: Bentham Science Publishers; 2016.
35. Mayhew S. Integrating MCH/FP and STD/HIV services: current debates and future directions. Health Policy Plan 1996;11:339-53.
36. Beaglehole R, Epping-Jordan J, Patel V, Chopra M, Ebrahim S, Kidd M, et al., Improving the prevention and management of chronic disease in low-income and middle-income countries: a priority for primary health care. Lancet 2008;372:940-9.
37. Walton DA, Farmer PE, Lambert W, Léandre F, Koenig SP, Mukherjee JS. Integrated HIV prevention and care strengthens primary health care: lessons from rural Haiti. J Public Health Policy 2004;25:137-58.
38. Nuwaha F, Kabatesi D, Muganwa M, Whalen CC. Factors influencing acceptability of voluntary counseling and testing for HIV in Bushenyi district of Uganda. East African Med J 2002;79:626-32.
39. Pfeiffer J, Montoya P, Baptista AJ, Karagianis M, Pugas MDM, Micek M, et al. Integration of HIV/AIDS services into African primary health care: lessons learned for health system strengthening in Mozambique-a case study. J Int AIDS Soc 2010;13:3.
40. Yamamoto T, Satoko I. JCIE. Fighting a rising tide: the response to AIDS in East Asia; 2006.
41. Price JE, Leslie JA, Welsh M, Binagwaho A. Integrating HIV clinical services into primary health care in Rwanda: a measure of quantitative effects. AIDS Care 2009;21:608-14.
42. Yu D, Souteyrand Y, Banda MA, Kaufman J, Perriëns JH. Investment in HIV/AIDS programs: does it help strengthen health systems in developing countries? Global Health 2008;4:8.
43. Mohraz M, Gooya MM. [Recommended Model for Integration of HIV/AIDS in Primary Health Network]. Project Rep 2011.
| Files | ||
| Issue | Vol 62 No 4 (2024) | |
| Section | Review Article(s) | |
| DOI | https://doi.org/10.18502/acta.v62i4.17430 | |
| Keywords | ||
| HIV Iran Epidemiology HIV testing Gaps Prevention Diagnosis | ||
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How to Cite
1.
Seyed Alinaghi SA, Roozbahani MM, Farhoudi B, Dehghan Manshadi SA, Jahanfar S. HIV Infection in Iran: An Update on Epidemiology, Testing and Gaps. Acta Med Iran. 2024;62(4):173-181.
