Epidemiology of HIV in Iran.

Iran has been one of the active countries fighting against HIV/AIDS in the Middle East during the last decades. Moreover, there is a strong push to strengthen the national health management system concerning HIV prevention and control. In Iran, HIV disease has its unique features, from changes in modes of transmission to improvement in treatment and care programs, which can make it a good case for closer scrutiny. The present review describes the HIV epidemic in Iran from the first case diagnosed until prevention among different groups at risk and co-infections. Not only we addressed the key populations and community-based attempts to overcome HIV-related issues in clinics, but we also elaborated on the efforts and trends in society and the actual behaviors related to HIV/AIDS. Being located in the Middle East and North Africa (MENA) region, given the countryspecific characteristics, and despite all the national efforts along with other countries in this region, Iran still needs to take extra measures to reduce HIV transmission, especially in health education. Although Iran is one of the pioneers in implementing applicable and appropriate policies in the MENA region, including harm reduction services to reduce HIV incidence, people with substance use disorder continue to be the majority of those living with HIV in the country. Similar to other countries in this region, the HIV prevention and control programs aim at 90-90-90 targets to eliminate HIV infection and reduce the transmission, especially the mother-to-child transmission and among other key populations.

Stigma and Dissatisfaction of Health Care Personnel in HIV Response in Iran: A Qualitative Study.

BACKGROUND AND AIMS: With regard to the disease pandemics of HIV/AIDS, it is clear that there is need for prevention, treatment, care, and support of HIV positive patients in the health care system. In order to achieve these goals, job satisfaction should be a priority for health care staff. This study examined the problems of health care personnel and the behavior of patients undergoing HIV/AIDS counseling at Imam Khomeini Hospital in Tehran, Iran. METHODS: Interviews were conducted individually with 5 health care personnel who participated in this study. Participants had 30 to 45 minutes each per session at the clinic, during which they were able to discuss the problems they faced in their careers. All conversations were officially recorded. RESULTS: The most common problems mentioned by these health care workers included the lack of safety and standardization of work conditions, the lack of appropriate equipment, limited space, high numbers of patients, low staffing levels and financial and morale problems compounded by the lack of support by hospital authorities. CONCLUSION: The authorities need to allocate more funds to provide facilities and appropriate working conditions for health care staff in order to increase job satisfaction and enable staff to provide the best services and care to HIV positive patients.

Prevalence survey of infection with Treponema pallidum among HIV-positive patients in Tehran

Objective: To identify the frequency of syphilis among Iranian HIV-positive patients. Methods:A cross-sectional study on the prevalence of syphilis and HIV co-infection among 450 patients diagnosed with HIV infection was conducted between 2004 and 2008 at Imam Khomeini hospital, Tehran, Iran. The lab tests including CD4 cell count, cerebrospinal fluid, veneral disease research laboratory (VDRL), fluorescent treponema antibody-absorption (FTA-Abs) and viral load were performed for all the patients. Data regarding medical history and their demographics were also collected. Results: Of all 450 HIV-positive patients, 24 (5.3%) had a positive VDRL test and only two men had a FTA-Abs positive test which means 0.45% of them had a definite co-infection of syphilis. 65.3% of the HIV-positive patients were injection drug users that the co-infection prevalence of them was 0.7%. We did not find any patient with neurosyphilis. Conclusions: Considering the increasing prevalence of HIV and also extensive use of highly active antiretroviral therapy in developing nations, the diagnosis of syphilis should be timely established using screening tests among such patients.