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BackgroundHIV testing is recommended for people who inject drugs (PWID). The aim of this study was to determine the prevalence of lifetime HIV testing among PWID and to better understand the predictors for HIV testing in a convenience sample across Iran.Materials and methodsThis study is a secondary analysis of Iran’s National Rapid Assessment and Response survey conducted between October 2016 and March 2017. Analysis includes the 999 people who reported injecting drugs across the capital cities of 21 provinces. Data were collected by using the venue-based application of the Time Location Sampling (TLS) frame. Chi-square tests were used to examine the difference between HIV testing across different quantitative variables. Logistic regression was used to determine the predictors of life-time HIV testing. Analysis was performed using STATA V.12 software with a significance level of 95%.ResultsMost participants were male (n = 902, 93.50%), and over half (n = 555, 59.17%) were older than 35 years old. About one-third, (n = 326, 38%) of people interviewed were single and another one-third (n = 251, 29%) reported being divorced. Over two-thirds of participants (n = 678, 69.78%) in this study reported lifetime HIV testing. The results from a multiple variable logistic regression showed people with a university education were more likely to have been previously tested for HIV than illiterate people (OR = 18.87, 95%CI 2.85–124.6, value of p = 0.002). Those individuals who reported ever receiving methadone treatment were 2.8 times more likely to have been tested for HIV than individuals without methadone treatment experience (OR = 2.89, 95%CI 1.53–5.42, value of p < 0.001). Needle syringe sharing in last month, was negatively associated with life-time HIV testing (OR = 0.29, 95%CI 0.17–0.48, value of p < 0.001).ConclusionDespite Iran’s wide availability and access to counseling services for HIV testing in key populations, the proportion of PWID being tested for HIV could be improved. Developing effective strategies to increase people’s understanding and awareness of the importance of and need for HIV prevention and familiarity with HIV testing sites is an essential step in increasing HIV testing for this population. Studies on more recent HIV testing are required to better assess and understand the frequency of HIV testing among PWID in Iran.

In this rapid assessment and response (RAR) survey, the demographic and behavioral differences between two sub-groups of people with incarceration histories are described. Data from those who report injecting in prison and those who do not were analyzed. Analysis of data from a sub-set of 1,240 participants recruited to a RAR national survey and reporting a history of incarceration. The prevalence of ever drug injecting in prison was 15.08% (N = 187, CI: 13.3–17.4). Participants with only primary school education were more likely to report injecting (p <.001), were more frequently imprisoned (p <.001) and reported having never heard about HIV (p <.001). The multivariable logistic regression model showed that participants who reported injecting in prison were different in terms of their education (never attending school, OR = 2.29, 95% CI: 1– 5.23) and the number of times they had been in prison (> twice OR = 1.96, 95% CI: 1.15– 3.29). Identifying the factors influencing injection drug use in prison can help design effective strategies to prevent harms in vulnerable prisoners. Alternatives to prison for people who use drugs require further consideration in Iran. [ABSTRACT FROM AUTHOR]

Introduction: Street children, due to their living and working conditions, are exposed to various injuries, and part of these are caused or exacerbated by engaging in high-risk behaviors. This study aims to determine more accurately the situation of street children’s high-risk sexual behavior in Tehran in order to reduce the prevalence of AIDS. Methods: This study was conducted in 2012-13 in Tehran using rapid assessment and response (RAR) method. Data were gathered from a sample of 289 street children (boys and girls), who were selected through time-location sampling (TLS) method, and 16 interviews with key informants and 13 group discussions with street children who were selected through purposive and snowball sampling methods. Results: Children are engaged in sexual relations in two forms: forced and non-forced (mandatory or voluntarily). Among the study’s sample, 8.7% reported a history of sexual abuse, and 21.1% had experienced sexual relations, in which, 37.7% of cases included sexual protection. Summary and discussion: The present study confirms the vulnerability of street children, the negative effects of environmental factors and behavioral determinants of health and well-being, and it emphasizes the need for effective health interventions, particularly education and social support.

Background: HIV testing is recommended for people who inject drugs (PWID). The aim of this study was to determine the prevalence of lifetime HIV testing among PWID and to better understand the predictors for HIV testing in a convenience sample across Iran., Materials and Methods: This study is a secondary analysis of Iran's National Rapid Assessment and Response survey conducted between October 2016 and March 2017. Analysis includes the 999 people who reported injecting drugs across the capital cities of 21 provinces. Data were collected by using the venue-based application of the Time Location Sampling (TLS) frame. Chi-square tests were used to examine the difference between HIV testing across different quantitative variables. Logistic regression was used to determine the predictors of life-time HIV testing. Analysis was performed using STATA V.12 software with a significance level of 95%., Results: Most participants were male ( n  = 902, 93.50%), and over half ( n  = 555, 59.17%) were older than 35 years old. About one-third, ( n  = 326, 38%) of people interviewed were single and another one-third ( n  = 251, 29%) reported being divorced. Over two-thirds of participants ( n  = 678, 69.78%) in this study reported lifetime HIV testing. The results from a multiple variable logistic regression showed people with a university education were more likely to have been previously tested for HIV than illiterate people (OR = 18.87, 95%CI 2.85-124.6, value of p  = 0.002). Those individuals who reported ever receiving methadone treatment were 2.8 times more likely to have been tested for HIV than individuals without methadone treatment experience (OR = 2.89, 95%CI 1.53-5.42, value of p < 0.001). Needle syringe sharing in last month, was negatively associated with life-time HIV testing (OR = 0.29, 95%CI 0.17-0.48, value of p < 0.001)., Conclusion: Despite Iran's wide availability and access to counseling services for HIV testing in key populations, the proportion of PWID being tested for HIV could be improved. Developing effective strategies to increase people's understanding and awareness of the importance of and need for HIV prevention and familiarity with HIV testing sites is an essential step in increasing HIV testing for this population. Studies on more recent HIV testing are required to better assess and understand the frequency of HIV testing among PWID in Iran., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Roshanfekr, Karimi, Narouee, Moftakhar, Vameghi, Ali, Higgs and Soleimanvandiazar.)

Background & Objectives : Children who work or live on the street are one of key populations at risk for HIV and hard to reach for study or providing services. Here, as a methodological paper, we present the methods and steps of a rapid assessment and response (RARE) project conducted among street children in Tehran. Methods : We applied a mixture of qualitative (literature review, focus group discussion, in-depth interview) and quantitative (structure interview) methods to collect data from key informants in non-governmental and governmental agencies as well as street children. We applied targeted sampling to recruit key informants and time location sampling to recruit street children. Results: The study was conducted in eight steps to recognize the involved stakeholders, define target population (street children) and to guide on how to approach them (steps 1 to 2: Initial Consultation, Study Area Profile), to map the venues and gathering spots and ethnographic findings crucial for further recruitment into surveys (steps 3 to 5: Contextual Assessment, Population and Setting Assessment, Health Issues Assessment), assess the risk behaviors (step 6: Assessment Behavior Risk and Health), evaluate the response (step 7: Intervention Assessment), and develop an operational plan for improving the services (step 8: Developing an Action Plan). Conclusion: RARE is a participatory mix research method with sufficient flexibility to study complex health problems such as stigmatized HIV risk behaviors among high risk and hard to reach populations and also to assess the health sector response.

Introduction: Children, who work or live at streets, are one of the HIV high risk groups in Iran, with no comprehensive preventive programs. This study intended to assess substance use among street children in Tehran, Capital of Iran. Methods: This paper is a part of comprehensive rapid assessment and response (RAR) research on street children in Tehran in 2012-13. Data were collected by interview using questionnaires. Two hundred and seventy 289 street children were selected by time-location sampling in Tehran. Results: From the total of 259 street children, 59.4% were Iranian and 74% were boys. Prevalence of drug use among street children was 25.6%. The prevalence of smoking, drug abuse and also drinking alcohol were 8.9% among boys and 1.4% among girls.20.8%, 17.3% and 6.9% of the street children had at least used cigarette, alcohol and drugs once in their lives respectively. There was a significant relationship between consumption of alcohol and other substances among street children with higher age, type of occupation and leaving home experience. Conclusion: Comprehensive preventive programs targeting street children is recommended to be started at lower ages, with the main focus on young boys among street children. In addition family intervention and improvement of children’s lifestyle could be a main strategy for drug use prevention among this population.

Background: The leading cause of death in children in developing countries is protein-energy malnutrition. In Viet Nam, 25.9% of children under 5 experience stunted growth and 6.6% are moderately wasted. Iron deficiency anaemia and vitamin A deficiency contribute to these and other malnutrition conditions.Objectives: Given these factors, more evidence based approaches are required to improve understanding of current attitudes, opinions and behaviours of mothers with young children, in order to operationalise social marketing of nutrition commodities in Viet Nam.Methods and Study Design: A literature review supported a rapid assessment and response method involving semi-structured interviews with 77 stakeholders and focus group discussions with 80 program beneficiaries from four geographic locations in the north and south of Viet Nam. Discussion agendas were developed to address key program issues with grounded theory utilized for data analysis.Results: Data analysis highlighted challenges and opportunities within the six Ps of social marketing: Supply and demand side issues included: cost and the quality of products, the limited scale of interventions and promotional activities. Policy issues identified related to current policies that inhibited the broader promotion and distribution of micronutrient products, and opportunities for improved dialogue with policy partners. Partnerships further emphasized the need for public private partnerships to support the social change process.Conclusion: Implications for theory, policy, and practice indicates that rapid assessment and response is a cost-effective, pragmatic method of public health research, in resource constrained settings, to explore policies and behaviours amenable to change and build stakeholder engagement in the program. [ABSTRACT FROM AUTHOR]

Background: The leading cause of death in children in developing countries is protein-energy malnutrition. In Viet Nam, 25.9% of children under 5 experience stunted growth and 6.6% are moderately wasted. Iron deficiency anaemia and vitamin A deficiency contribute to these and other malnutrition conditions. Objectives: Given these factors, more evidence based approaches are required to improve understanding of current attitudes, opinions and behaviours of mothers with young children, in order to operationalise social marketing of nutrition commodities in Viet Nam. Methods and Study Design: A literature review supported a rapid assessment and response method involving semi-structured interviews with 77 stakeholders and focus group discussions with 80 program beneficiaries from four geographic locations in the north and south of Viet Nam. Discussion agendas were developed to address key program issues with grounded theory utilized for data analysis. Results: Data analysis highlighted challenges and opportunities within the six Ps of social marketing: Supply and demand side issues included: cost and the quality of products, the limited scale of interventions and promotional activities. Policy issues identified related to current policies that inhibited the broader promotion and distribution of micronutrient products, and opportunities for improved dialogue with policy partners. Partnerships further emphasized the need for public private partnerships to support the social change process. Conclusion: Implications for theory, policy, and practice indicates that rapid assessment and response is a cost-effective, pragmatic method of public health research, in resource constrained settings, to explore policies and behaviours amenable to change and build stakeholder engagement in the program. [ABSTRACT FROM AUTHOR]

BACKGROUND: In the last decade new trends in the manufacture and retail of new psychoactive substances (NPS) can be observed as a result of the rapid expansion of the Internet and technological developments. Evidence- based drug policy demands an elaborate assessment of the risks that could be caused by the new trends before control measures and other interventions are applied. AIMS: A systematic conceptual literature review was conducted, with the aims being to: (i) describe currently applied models of risk assessment in practice, (ii) specify the shortcomings of current models that are facing the challenges of new trends in psychoactive substance use, and (iii) propose adaptations of current models to meet these challenges. METHODS: 17 databases of peer-reviewed sources and grey literature were searched with specific search terms in January 2014. 56 relevant documents were further analysed with the use of qualitative content analysis by means of the NVIVO software. FINDINGS: Risk assessment (RA) procedures consist of three main parts - data collection, data evaluation, and data interpretation based on the consensus of experts. RA procedures take a long time and demand high-level scientific data in order to be reliable. The large numbers of newly emerging NPS and the lack of information have led to changes in the RA procedures. First, their duration is shortened. Second, data that has lower scientific reliability but high relevance is being assessed as well, i.e. consumer reports, online discussion forums, drug checking service data, or RAR (risk assessment and response) methods. Further RA procedures could evolve into a continuous process of evaluation and re-evaluation of NPS risks. Local- level risk assessment should be more involved. CONCLUSIONS: The outcomes of RA should include a greater variety of interventions than a suggestion for control (e.g. prevention, treatment, harm reduction measures, or other control instruments than the simple scheduling of the risky NPS). [ABSTRACT FROM AUTHOR]

Background Drug prevention methods tailored to specific target groups have become increasingly important. There is a growing need to find ways to rapidly assess and situate target groups in their particular contexts. This need is associated with the implementation of evidence-based interventions (EBIs) for these specific target groups. Method This article describes the application of Rapid Assessment and Response (RAR) as a necessary first step in designing and implementing a prevention intervention plan for problematic cannabis use among “loitering” youth in the South of the Netherlands. Seven RAR studies were conducted using an innovative stepwise model in which the prevention field worker is central. Results The normative structure for the use of cannabis was found to vary across the neighborhoods of the RAR studies and emerged as the focal point in designing a suitable response. The RAR studies also identified the need in the prevention toolbox for a tailored, low-threshold, effective, individual brief intervention for youth problematic cannabis use. Conclusion The RAR was found to provide a powerful methodology for detecting target groups and generating contextual and normative data that enable the prevention field worker to select and adapt from the spectrum of existing Evidence based Interventions (EBIs) or develop the most promising model for implementation with the specific target group. [ABSTRACT FROM AUTHOR]

The article presents a study which examines substance use among street children in Tehran, Iran. Children were selected by time-location sampling in the capital. The prevalence of drug use, smoking and drinking of alcohol among street children were measured. It recommends comprehensive preventive programs for street children and the use of family intervention and lifestyle improvement as a main strategy for prevention.

Background and Aim: Children who work or live in the streets are one of the high-risk groups for HIV. The high population of street children and lack of comprehensive intervention programs for them increase their risk for HIV in Iran. This study intended to explore the situation of drug abuse in street children in Tehran, the capital city. Materials and Methods: This paper reports part of a comprehensive rapid assessment and response (RAR) research project on street children in Tehran during 2012-13. Data were collected by interviewing subjects using questionnaires. The sample size was 289 street children selected by time-location sampling in Tehran. Results: Data showed that about 25.6% of the street children had had some history of cigarette smoking, alcohol abuse, and/or drug abuse. Most of them were boys aged 15-18 years. The prevalence rate of cigarette and/or hubble-bubble smoking, alcohol consumption and drug abuse during the preceding 6 months 12.1%, 11% and 6.9%, respectively. Significant associations were found between alcohol consumption and drug abuse on the one hand and the children's age, type of occupation and home-leaving experience on the other. Further analysis of the data showed that the main reason for drug abuse was curiosity (56.6%), followed by mere enjoyment (39.6%) and leisure (35.8%). Conclusion: It can be concluded that drug abuse among street children is highly associated with gender, age, alcohol consumption, cigarette smoking and leaving home experience. Therefore, it is recommended to start drug abuse prevention programs at lower ages, with particular emphasis on boys. In addition, family intervention and improvement of children's lifestyle aiming at preventing home-leaving could be a main strategic plan for reducing drug abuse among street children. [ABSTRACT FROM AUTHOR]

Poisonings are the leading cause of adult injury death in the United States. Over 12 weeks in 2011, 143 key informant interviews were conducted using a structured interview guide in three study sites in New England. This analysis focuses on the 24 interviews with emergency department providers, substance use treatment providers, pain specialists, and generalist/family medicine practitioners. Using an iterative coding process, we analyzed statements regarding support and concern about naloxone prescription for pain patients and drug users. The study's implications and limitations are discussed and future research suggested. The Centers for Disease Control and Prevention funded this study. [ABSTRACT FROM AUTHOR]

The objective was to assess need, evaluate projects, and devise a roadmap for future provision given budget cuts. The analysis of 30 substance misuse services in towns and rural areas of Ireland was conducted in 2010. Analysis revealed that 24,315 (95% CI 12,928-40,629) individuals were using illegal drugs in 2006, 893 individuals were using opiates, opiate and cocaine use was increasing as was drug use amongst females. Evaluations demonstrated that not all services were meeting emerging needs, services lacked administrative support, and funding needed to be redirected. The RAR approach was useful for policy decisions and budget cuts in times of economic restraint. [ABSTRACT FROM AUTHOR]