Correlates of quality of life and mental health among youth experiencing homelessness in Iran.

BACKGROUND: Quality of life (QOL) and mental health among marginalized populations, including people experiencing homelessness in Iran, are understudied. We assessed the QOL and mental health status as well as their associated factors among youth experiencing homelessness in Kerman, Iran. METHOD: We recruited 202 participants using a convenience sampling method from 11 locations, including six homeless shelters, three street outreach sites, and two drop-in service centers, from September to December 2017. Data were collected using a standardized questionnaire that included QOL, mental health, demographics, drug use, and sexual behaviors questions. Scores in each domain were indexed with a weight of 0-100. The higher score indicated a higher QOL and mental health status. Bivariable and multivariable linear regression models were performed to examine correlates of QOL and mental health. RESULT: The mean (SD) score of QOL and mental health were 73.1 (25.8) and 65.1 (22.3), respectively. Multivariable analysis showed that youth experiencing homelessness who were aged 25-29 years old (ß = -5.4; 95% CI: -10.51; -0.30), and lived on the streets (ß = -12.1; 95% CI: -18.19; -6.07) had a lower mental health score. Moreover, those who had higher education (ß = 5.4; 95% CI: 0.58; 10.38), had no history of carrying weapons (ß = 12.8; 95% CI: 6.86; 18.76), and had a higher QOL score (ß = 0.41; 95% CI: 0.31; 0.50) had a higher mental health score. CONCLUSION: This study highlights that QOL and mental health among youth experiencing homelessness in Iran are concerning, particularly among those who were older, were less educated, were living on the street, and had a history of carrying a weapon. Community-based programs, including mental health care and affordable housing are needed to improve QOL and mental health among this population in Iran.

Quality of Life and Its Association With HIV-Related Stigma Among People Living With HIV in Kerman, Iran: A Cross-Sectional Study.

ABSTRACT: This study aimed to evaluate the quality of life (QoL) and its association with HIV-related stigma among people living with HIV (PLHIV) in Kerman province, southeast Iran. A convenience sample of 104 PLHIV was recruited. Data on QoL were collected using the HIV/AIDS-Targeted QoL instrument. Internal and external stigma were measured using an instrument developed by UNAIDS. The average QoL score was 52.5 ( SD =13.9). In multivariable model, PLHIV who experienced higher external stigma score (B = -1.9; 95% confidence interval [CI]: -2.6 to -1.1) and higher internal stigma score (B = -1.1; 95% CI: -1.5 to -0.6) had lower level of QoL. The low level of QoL among PLHIV in Iran indicates the need for initiatives to increase QoL among this population. Our data suggest that QoL in PLHIV could be improved by interventions aimed at reducing stigma in both community and health care settings.

Associated factors of first-birth interval among women in reproductive age, addressing maternal and child health.

BACKGROUND: The first-birth interval directly influences family size and maternal and child mortality. The objective of this study is to investigate factors associated with the time of the first-birth after the first marriage among women in Iran. METHODS: In this cross-sectional study, the first birth history of 1350 women aged 15-49 years was collected in Kerman (southern Iran) in 2018. To assess the predictor variables of the first-birth interval and calculate the adjusted hazard ratios, multivariate Cox regression was used. The P-value < 0.05 was considered as significant. The statistical analysis of data was performed using SPSS version 22. RESULTS: The average of the first-birth interval was 2.5 ∓ 0.8 years. Woman's age at marriage (HR 1.48, 95% CI 1.32-2.48), husband's age at marriage (HR 1.88, 95% CI 1.62-2.03), age at the first menstruation (HR 1.53, 95% CI 1.24-2.53), being rural residents (HR 2.041, 95% CI 1.26-2.95), and having engagement period (HR 1.85, 95% CI 1.52-3.05) were associated with short first-birth interval, and woman's BMI (HR 1.72, 95% CI 1.54-2.77), woman's university educational level (HR 1.47, 95% CI 1.35-2.57), husband' s university educational level (HR 1.39, 95% CI 1.32-2.51), contraception use (HR 2.28, 95% CI 1.12-2.86) and income sufficiency (HR 2.25, 95% CI 1.12-2.96) were associated with long first-birth interval. CONCLUSIONS: Being a rural resident is the most influential predictor of short first-birth interval and income sufficiency is the most influential predictor of long first-birth interval.

Total Fertility Rate, which is the average number of live births that would be born to a woman over her reproductive life if she experiences the current age-specific fertility rates throughout her lifetime. The fertility pattern can be measured by several indicators such as the first-birth interval (FBI) after marriage. FBI is defined as the duration of time spent by married couples to have their first child since the first day of marriage. Some studies have demonstrated that the length of FBI subsequently influences spacing and childbearing pattern of a family. The aim of this study is first to determine the mean of FBI and second to explore the associated factors of FBI in Kerman, southern Iran. We analyzed data for 1350 women 15­49 years old. The outcome variable was the first-birth interval (FBI). Results showed that the average of FBI was 2.5 years. There is a positive association between FBI and age of wives at marriage, first menace age, wives' BMI, wives and husbands' educational level, contraception use, age of husbands at marriage, residence place, income sufficiency, and having engagement period. The women and men who got married at older ages were more likely to report short FBI. It was indicated that Educated women and men and women who experience menstruation at a younger age are more likely to report longer FBI. The knowledge about importance of FBI should be more announced for couples by health services in order to help them manage their child-spacing and fertility. The government also should pay attention on FBI as an important index in determining the average age of country population.

Associated factors of pregnancy spacing among women of reproductive age Group in South of Iran: cross-sectional study.

BACKGROUND: Optimal pregnancy spacing is an important incidence in reproductive women's health. Short or long pregnancy spacing leads to the greatest health, social and economic problems such as increase in maternal and infant mortality and morbidity, and adverse pregnancy outcomes. The aim of this study is to assess the mean of pregnancy spacing and associated factors of pregnancy spacing among women of reproductive age group with recurrent event analysis. METHODS: The fertility history of 1350 women aged 15-49 years was collected in this cross-sectional study. The women were selected through multistage random sampling method from a list of clinics in 2018. Some predictors were collected from their records and others were collected by face-to-face interview. The recurrent event survival analysis was used to explore the effect of predictors on pregnancy spacing. The R software program was used for analysis. RESULTS: There were nine predictors that had significant effect on pregnancy spacing. These predictors included the age of mother at marriage, mother's BMI, contraception use, breast feeding duration of the previous child, the education level of husband, the sex preference of the mother, presence of abortion or stillbirth in the preceding pregnancies, income sufficiency, and mother's awareness of optimum pregnancy interval. The most influential predictors; contraception use (HR = 2.34, 95%CI = 1.23 to 2.76, P < 0.001) and income sufficiency (HR = 2.046, 95%CI = 1.61 to 3.02, P = 0.018) lead to longer and son preference of mother (HR = 2.231, 95%CI = 1.24 to 2.81, P = 0.023) lead to shorter pregnancy spacing. CONCLUSION: The up to date contraception tool should be at hand for couples to manage their pregnancy intervals. The unfavorable economic situation of a family leads to long pregnancy spacing. Despite the relative equality of the status of girls and boys in today's societies, the desire to have a son child is still an important factor in shorter pregnancy spacing. The benefit of optimal pregnancy spacing should be more announced.