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Drug use patterns and associated factors among female sex workers in Iran
Mostafa Shokoohi1, Mohammad Karamouzian2, Greta R Bauer3
1HIV/STI Surveillance Research Center, and WHO Collaborating for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran; Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, The University of Western Ontario, Ontario, Canada.
Objective:
This study examines the prevalence of drug and poly-drug use and their associated factors among female sex workers (FSW) in Iran.
Methods:
We analyzed data from a bio-behavioral surveillance survey of 1347 FSW across 13 major cities in Iran in 2015. Two outcome measures were defined: i) past-month "any drug use", a binary variable defined as none or any; and ii) a three-category past-month "poly-drug use" variable defined as none, only one drug, and more than one drug. Correlates of these two study outcomes were assessed using multivariable logistic regression and multinomial logistic regression, respectively. Adjusted odds ratios (AOR) and 95% confidence intervals (CI) were reported.
Results:
We found that 24.9% (95% CI: 16.1, 36.4) and 13.5% (95% CI: 8.1, 21.5) of FSW reported past-month any drug use and poly-drug use, respectively. Longer sex work career (AOR 2.44 [95% CI: 1.28, 4.63]), unstable housing (AOR 2.56 [1.17, 5.64]), past-year experience of sexual violence (AOR 1.61 [1.15, 2.27]), and incarceration (AOR 2.02 [1.23, 3.32]) were positively associated with any drug use. Similarly, FSW who were unstably housed (AOR 3.4 [1.06, 10.95]), reported past-year experience of sexual violence (AOR 2.06 [95% CI: 1.24, 3.41]) and incarceration (AOR 2.82 [1.60, 4.97]) were positively associated with past-month poly-drug use.
Conclusion:
Drug use is frequent among Iranian FSW, particularly among those who experienced sexual violence, unstable housing or incarceration. Programs to reduce harms associated with drug and poly-drug use should target FSW as a priority population.
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