Sex out of marriage and condom use among homeless youth in Iran.

OBJECTIVES: Sexual behaviors of homeless youth in Iran have not been well studied. This study aimed to measure the frequency and associated factors of sex out of marriage and condom use among homeless youth in Kerman, Iran. STUDY DESIGN: In this cross-sectional study, we recruited 202 homeless youth (age: 15-29 years who experienced 30 or more days of homelessness in the last 12 months) from 11 street locations between September to December 2017. METHODS: Of 202 participants, 169 (83.7%) reported sex in the last 12 months and were include in this analysis. We assessed the prevalence of sex out of marriage in the last 12 months, condom use in last sex, and then evaluated their covariates in multivariable logistic regression analysis. RESULTS: The prevalence of sex out of marriage was 19.6% (95% confidence intervals [CIs]: 13.8%, 26.3%) and the prevalence of condom use was 43.8% (95% CI: 36.2%, 51.6%). Sex out of marriage was significantly correlated with male gender (adjusted odds ratio [AOR]: 24.38; 95% CI: 3.1-192.1) and being unmarried (AOR: 5.94; 95% CI: 2.3-15.5). Condom use was significantly correlated with male gender (AOR: 2.16; 95% CI: 1.1-4.2) and higher educational status (AOR: 4.30; 95% CI: 2.1-8.8). CONCLUSION: Our findings indicate that one in five homeless youth had sex out of marriage, and less than half did no use condom. These should be addressed by adapting education and harm reduction programs targeting this specific population in Iran.

Safe sex norm questionnaire for female sex workers: development and validation study in Iran.

OBJECTIVES: The aim of the present study was to develop and validate a safe sex norm questionnaire as an appropriate instrument which would be adaptable to the female sex worker (FSW) population. STUDY DESIGN: A mixed method study. METHODS: Appropriate content was prepared through a literature review. Content validation indices were assessed using interviews with content experts and lay experts. A conservative approach was used to assess the inter-rater agreement among the participants about the instrument relevance and clarity. The scale content validity index was computed using the average method. Non-parametric Mokken scale analysis was used for assessing scalability and unidimensionality of the questionnaire in a sample of 170 FSWs in Tehran. To evaluate the reliability and internal consistency of the questionnaire intra-class correlation and Cronbach's alpha were employed. RESULTS: A list of 34 items was finalized, with subscales for actual behavioral norms and for perceived norms. The relevance of the actual and perceived norms subscales in the final questionnaire was higher than 96%; clarity of the subtests was 99% and higher. The comprehensiveness of the actual and perceived norms subscales was 85% for both. Mokken scale analysis showed that the two subscales were distinct constructs, and all items are good indicators for the constructs. CONCLUSION: Our findings support that the safe sex norm questionnaire is a valid and reliable measure that would be useful to harm reduction programs and help effective HIV prevention among female sex workers.

The role of high-sensitivity C-reactive protein for assessing coronary artery disease severity and left ventricular end diastolic pressure in patients with suspected coronary artery disease.

OBJECTIVE: Much attention has recently been focused on the underlying role of circulating inflammatory biomarkers such as high-sensitivity C-reactive protein for predicting cardiovascular disease progression. We therefore set out to assess the relationship between the value of high-sensitivity C-reactive protein and (i) coronary artery disease severity, and (ii) left ventricular end diastolic pressure. DESIGN: A cross-sectional study. SETTING: The Shafa hospital in Kerman, Iran. PATIENTS: A total of 107 consecutive patients referred for coronary angiography from January 2008 to January 2009 were prospectively studied. INTERVENTION AND MAIN OUTCOME MEASURES: All patients underwent coronary angiography. They all had undergone left ventricular end diastolic pressure measurement, involving a 6-Fr pigtail catheter and a properly zeroed fluid-filled pressure transducer. For each patient, the level of high-sensitivity C-reactive protein was also determined using enzyme-linked immunosorbent assay kits. RESULTS: The high-sensitivity C-reactive protein levels could strongly predict increased left ventricular end diastolic pressure (standardised beta=1.010; P=0.008), with other patient variables being confounders, but there was no significant association between these levels and Gensini scores. Multiple linear regression analysis showed that among the study parameters, systolic hypertension (standardised beta=1.611; P=0.047) and a family history of coronary artery disease (standardised beta=1.911; P=0.005) were the main predictors of high Gensini scores in study patients. CONCLUSION: High-sensitivity C-reactive protein level is a clinical parameter that could predict left ventricular end diastolic pressure and left ventricular dysfunction, but was not associated with the severity of coronary artery disease.

Is opium addiction a risk factor for bone loss?

BACKGROUND: Drug abuse is one of the most important public health problems worldwide as in Iran. The aim of present study was to determine whether opium addiction can affect bone mineral density or not. METHODS: Fifty opium addicted and 50 non-addicted volunteer men aged between 25-45 were enrolled. The subjects with positive history of other osteoporosis risk factors were excluded. The vertebral bone density and potential confounders (age, cigarette smoking and body mass index) were measured in all subjects. RESULTS: Twenty six percent of non-addicted vs. 56% of addicted subjects had vertebral osteopenia. According to adjusted ORs, addiction to opium (OR: 3.08, CI95% 1.20-7.92) and age (OR: 1.11 CI95% 1.03-1.20) were significantly related to vertebral bone loss. CONCLUSION: Opium addicted patients were more susceptible to bone loss than non-addicted individuals. So,early screening and conducting prevention programs should be taken into consideration for this high risk group.