Prevalence and Correlates of HIV Infection among Male Prisoners in Tehran, Iran

BACKGROUND: This is a cross-sectional survey conducted on 6900 male prisoners in Great Tehran Prison from October 2013 to May 2014. METHODS: In order to find HIV positive prisoners in the prison's quarantine and two housing units, we used HIV active case finding (ACF) strategies by rapid screening test. In ACF, healthcare staff and trained prisoners asked inmates to answer relevant questions about history of risky behaviors related to HIV as well as to be tested voluntarily by HIV rapid test. A positive result was confirmed by ELISA screening and Western blot tests. Furthermore, to find HIV risk factors in the prison, the prevalence of specific HIV risk factors among prisoners were assessed using a questionnaire, and the results were analyzed by STATA software, providing univariate and multivariate modeling. RESULTS: There were 85 HIV positive patients. The prevalence of HIV was 1.23%. The risk factors independently associated with HIV infection were age (adjusted odds ratio of 3.46 for 35-44 yrs., 95% CI:1.01-11.92), duration of imprisonment (adjusted odds ratio of 4.22 for ≥10 yr., 95% CI: 1.92-9.24 ), history of injection drug use (adjusted odds ratio of 5.01, 95% CI: 2.24-11.18), history of needle sharing (adjusted odds ratio of 2.28, 95% CI: 1.25-4.16) and tattooing (adjusted odds ratio of 1.84, 95% CI: 1.05-3.24). CONCLUSIONS:The prevalence and risk factors of HIV infection should be recognized by policy makers for planning harm reduction programs and reforming the HIV guidelines in prisons.