ABSTRACT
OBJECTIVES: In most countries around the world, sex work is an illegal activity. Female sex workers (FSWs) in Iran hide their identities, and they are known to be a hard-to-reach population. Despite free access to HIV testing, fewer than half of FSWs receive HIV testing. The purpose of this study was to characterize the reasons for which FSWs do not seek testing at drop-in centers (DICs) and voluntary counseling and testing (VCT) centers in Iran. METHODS: A qualitative study was conducted in 2016. The participants were 24 FSWs who received services at VCT centers and DICs for vulnerable females in the north of Iran and 9 males who were the clients of FSWs. In this study, we made use of purposive sampling and carried out a thematic analysis. RESULTS: We found 4 major and 6 minor themes. The major themes were: fear of being infected (with HIV), stigma, indifference, and knowledge. CONCLUSIONS: Despite the significant efforts made by the government of Iran to establish and expand DICs for vulnerable females, the number of FSWs receiving services at these centers has not been very considerable. Consequently, by introducing and implementing training programs for peer groups, it may be possible to take steps toward establishing strategic programs for the control and prevention of HIV/AIDS.
Subject(s)
Female , Humans , Male , Counseling , Dacarbazine , Education , Health Services , HIV , Iran , Peer Group , Sex WorkersABSTRACT
Background: Endometriosis is one of the most common diseases with high socio- economic burden in women. The aim of this study was to investigate the factors influencing on endometriosis by logistic regression
Materials and methods: In this case- control study, data were collected from patients records in Hazrat Rasoole Akram Hospital in Tehran. The patients who suffered from endometriosis [250], and their disease was diagnosed by laparoscopy, were selected as case group, and 250 patients with gynecologic disorder, other than endometriosis, confirmed by laparoscopy were chosen as control group. Factors affecting endometriosis were evaluated by logistic regression using the software SPSS. P- value <0.05 was considered significant
Results: Mean age [ +/- standard deviations] of women in case group [34.84 +/- 0.62] was significantly higher than control group [33.75 +/- 0.55] [P=0.02]. Single variable logistic regression for independent variables candidate age, irregular menses, the duration of menstrual cycle, the duration of bleeding, the number of pregnancies, the number of live births, infertility, speck before menstrual bleeding to enter into multi variable logistic regression at error level of 0.2. Variables of age, the number of live births, and premenstrual spotting were predicted as factors influencing endometriosis
Conclusion: According to the result of present study, age, the number of live births, premenstrual spotting were predicted as effective factors for endometriosis. As we know, increasing awareness of women about factors influencing endometriosis may help timely diagnosis and treatment of this important disease
ABSTRACT
Background: Multistate Markov models are frequently used for analyzing data obtained from longitudinal studies and they are typically appropriate in the study of chronic diseases such as liver cirrhosis. Ascites is the most common major complication of liver cirrhosis. This study was done to examine the importance of ascites complications in the survival analysis of patients with cirrhosis
Materials and Methods: In this longitudinal study, 305 patients with liver cirrhosis who had enrolled in a waiting list for liver transplantation in Imam Khomeini Hospital from May 2008 to May 2009 and had been followed up for at least 7 years, were investigated. To analyze the data and estimation of transition intensities, a 4-state Markov model [state 1: liver cirrhosis [without ascites], state 2: ascites complication, state 3: liver transplantation, and state 4: death] was defined. Finally, data analysis was performed using R statistical software
Results: Of the 305 patients studied, 180 [59%] were male. The mean [+/-standard deviation] age of the patients was 43/14 [ +/- 8/39] years. There were 127 patients with ascites during that period. Estimated transition intensities from liver cirrhosis and ascites state to death state were 0.0419 and 0.1731 per year, respectively, and from ascites state to liver transplantation state was 0.2936 per year. 7-year survival probabilities from cirrhosis and ascites state to death state were estimated 48% and 64%, respectively. Estimated mean sojourn times in cirrhosis and ascites state were 4.0166 and 1.912 years. Serum albumin, bilirubin, and prothrombin levels as well as age, and encephalopathy had a significant effect on the transition intensity from liver cirrhosis state to ascites state [p<0.001]
Conclusion: The result of this study indicates that transition from ascites state to liver transplantation or death state occurs faster than transition from liver cirrhosis state. Especially, accompaniment of ascites and encephalopathy increases the transition intensity to death state
The effect of age, and serum bilirubin and prothrombin levels on the survival of patients is important. As ascites complication has an important role in the prognosis of the survival of patients with cirrhotic, it is suggested that ascites would be considered as an effective factor in prioritization of waiting lists for liver transplantation