OBJECTIVES: To our knowledge, no previous study has systematically assessed the role of economic status in risky sexual behavior among people who inject drugs (PWID) in Iran. In this study, we used Blinder-Oaxaca (BO) decomposition to explore the contribution of economic status to inequality in unprotected sex among PWID in Tehran and to decompose it into its determinants. METHODS: Behavioral surveys among PWID were conducted in Tehran, the capital city of Iran, from November 2016 to April 2017. We employed a cross-sectional design and snowball sampling methodology. We constructed the asset index (weighted by the first principal component analysis factor) using socioeconomic data and then divided the variable into 3 tertiles. We used the BO method to decompose the economic inequality in unprotected sex. RESULTS: Of the 520 recruited individuals, 20 were missing data for variables used to define their economic status, and were therefore excluded from the analysis. Not having access to harm reduction programs was the largest factor contributing to the economic disparity in unprotected sex, accounting for 5.5 percentage points of the 21.4% discrepancy. Of the unadjusted total economic disparity in unprotected sex, 52% was unexplained by observable characteristics included in the regression model. The difference in the prevalence of unprotected sex between the high-income and low-income groups was 25%. CONCLUSIONS: Increasing needle syringe program coverage and improving human immunodeficiency virus (HIV) knowledge are essential for efforts to eliminate inequalities in HIV risk behaviors among PWID.
Cross-Sectional Studies ; Drug Users ; Harm Reduction ; HIV ; Humans ; Iran ; Methods ; Needles ; Prevalence ; Principal Component Analysis ; Risk-Taking ; Sexual Behavior* ; Socioeconomic Factors ; Syringes ; Unsafe Sex

OBJECTIVES: To our knowledge, no previous study has systematically assessed the role of economic status in risky sexual behavior among people who inject drugs (PWID) in Iran. In this study, we used Blinder-Oaxaca (BO) decomposition to explore the contribution of economic status to inequality in unprotected sex among PWID in Tehran and to decompose it into its determinants.METHODS: Behavioral surveys among PWID were conducted in Tehran, the capital city of Iran, from November 2016 to April 2017. We employed a cross-sectional design and snowball sampling methodology. We constructed the asset index (weighted by the first principal component analysis factor) using socioeconomic data and then divided the variable into 3 tertiles. We used the BO method to decompose the economic inequality in unprotected sex.RESULTS: Of the 520 recruited individuals, 20 were missing data for variables used to define their economic status, and were therefore excluded from the analysis. Not having access to harm reduction programs was the largest factor contributing to the economic disparity in unprotected sex, accounting for 5.5 percentage points of the 21.4% discrepancy. Of the unadjusted total economic disparity in unprotected sex, 52% was unexplained by observable characteristics included in the regression model. The difference in the prevalence of unprotected sex between the high-income and low-income groups was 25%.CONCLUSIONS: Increasing needle syringe program coverage and improving human immunodeficiency virus (HIV) knowledge are essential for efforts to eliminate inequalities in HIV risk behaviors among PWID.
Cross-Sectional Studies ; Drug Users ; Harm Reduction ; HIV ; Humans ; Iran ; Methods ; Needles ; Prevalence ; Principal Component Analysis ; Risk-Taking ; Sexual Behavior ; Socioeconomic Factors ; Syringes ; Unsafe Sex

Objective: To investigate the effect of crocin carotenoid on BNDF and CREB gene expression in the brain ventral tegmental area (VTA) and the serum level of BDNF in morphine-treated rats compared to control. Methods: In this study, 40 male Wistar rats (200-250 g) were used in 5 experimental groups: 1) non morphine treat rats (control); 2) non morphine-treated rats with 25 mg/kg crocin carotenoid (i.p., for 21 d); 3) morphine treated rats (10 mg/kg twice a day, s.c., 21 d); 4 and 5) morphine-treated rats with 12.5 and 25 mg/kg crocin carotenoid, respectively. By the end of research, BDNF and CREB expression was determined by real-time-PCR method. ELISA analysis was also applied for assessing the serum BDNF level. Results: The data indicated that morphine treatment could cause a significant decrease in BDNF and CREB gene expression (P<0.01 and P<0.001, respectively) in brain VTA as well as serum level of BDNF (P<0.01) in comparison to control group. Treatment with 25 mg/kg crocin carotenoid caused a significant enhancement in BDNF and CREF gene expression (P<0.01 and P<0.05, respectively) and serum level of BDNF (P<0.01) in morphine-treated rats in comparison to morphine-treated group. Conclusions: Regarding to obtained results, crocin carotenoid can inhibit unfavorable effects of morphine on the neural system to some extent through enhancing BDNF and CREB gene expression in brain VTA and serum level of BDNF.