Lifetime and past-month substance use and injection among street-based female sex workers in Iran

Payam Roshanfekr,Mohsen Roshanpajouh,Delaram Ali,Ali Mirzazadeh,Mostafa Shokoohi,Mehdi Noroozi,Salah Eddin Karimi,Mehrdad Khezri,Sina Ahmadi,Elahe Ahounbar,Kambiz Mahzari,Meroe Vameghi

doi:10.1186/s12954-021-00477-5

Abstract

BackgroundStreet-based female sex workers (FSWs) are highly at risk of HIV and other harms associated with sex work. We assessed the prevalence of non-injection and injection drug use and their associated factors among street-based FSWs in Iran.MethodsWe recruited 898 FSWs from 414 venues across 19 major cities in Iran between October 2016 and March 2017. Correlates of lifetime and past-month non-injection and injection drug use were assessed through multivariable logistic regression models. Adjusted odds ratios (AOR) and 95% confidence intervals (CI) were reported.ResultsLifetime and past-month non-injection drug use were reported by 60.3% (95% CI 51, 84) and 47.2% (95% CI 38, 67) of FSWs, respectively. The prevalence of lifetime and past-month injection drug use were 8.6% (95% CI 6.9, 10.7) and 3.7% (95% CI 2.6, 5.2), respectively. Recent non-injection drug use was associated with divorced marital status (AOR 2.00, 95% CI 1.07, 3.74), temporary marriage (AOR 4.31 [1.79, 10.40]), had > 30 clients per month (AOR 2.76 [1.29, 5.90]), ever alcohol use (AOR 3.03 [1.92, 6.79]), and history of incarceration (AOR 7.65 [3.89, 15.30]). Similarly, lifetime injection drug use was associated with ever alcohol use (AOR 2.74 [1.20–6.20]), ever incarceration (AOR 5.06 [2.48–10.28]), and ever group sex (AOR 2.44 [1.21–4.92]).ConclusionsNon-injection and injection drug use are prevalent among street-based FSWs in Iran. Further prevention programs are needed to address and reduce harms associated with drug use among this vulnerable population in Iran.

Highlights

The high prevalence of drug use among female sex workers (FSWs) has been reported in different international studies [1, 2]
Participant characteristics A total of 898 FSWs were recruited from 414 VDTs in 19 major cities of Iran
The prevalence of lifetime and past-month injection drug use were 8.6% and 3.7%, respectively (Table 2)

Summary

Introduction

The high prevalence of drug use among female sex workers (FSWs) has been reported in different international studies [1, 2]. Roshanfekr et al Harm Reduct J (2021) 18:33 intercourse, and involvement in group sex practices are of some possible explanations for the increased risk of HIV infection among FSWs [6, 7]. Another study in US reported that their participants were mostly poly drug users, and 80.4% and 68.2% of street-based FSWs reported alcohol use and crackcocaine use, respectively [15]. Street-based female sex workers (FSWs) are highly at risk of HIV and other harms associated with sex work.

Methods

Results

Conclusion