Methods: In a cross-sectional study male heterosexual IDUs were sampled from streets of eight different geographical parts of Iran. Variables such as socio-demographics, HIV knowledge 10 items , and HIV attitude 16 items were entered to a logistic regression to determine the predictors of unprotected anal intercourse during the past month. Results: From all, HIV knowledge was not significantly different among IDUs with and without unprotected anal intercourse. Conclusion: Although the results might not be generalizable to all Iranian IDUs, this study findings may still be helpful for design and implementation of public health programs in Iran to prevent sexual transmission of HIV through IDUs.
People who engage in unprotected sex may have different motivations. Some people may want to show intimacy, romance, and trust to a sex partner through practicing unprotected sex 1. Some other people may decline to use condom to express their masculinity and individual choice. Other individuals may practice unprotected sex to achieve more sexual pleasure 2. Making more money is another possible reason for practice of unprotected sex among sex workers 3. Considerable evidence has suggested that likelihood of HIV transmission by unprotected anal intercourse is several times higher than through unprotected vaginal intercourse 4.
Although anal intercourse might be less common than oral or vaginal sex 6 , it is still a common sexual mode among heterosexual couples 5. Through sex with general population, injecting drug users become a source for HIV transmission to the community. This may spread HIV from a concentrated epidemic to a non-concentrated one. Unfortunately, current harm reduction policies have failed to decrease sexually transmitted infections prevalence among IDUs Unfortunately, there are very few studies assessing high-risk sexual behaviors among Iranian IDUs.
Much less has been done to determine the prevalence and associated factors of unprotected anal intercourse among male IDUs in Iran. The current study aimed to assess prevalence and associated factors of unprotected anal intercourse among Iranian male heterosexual injecting drug users. Other reports have been extracted from this data set focusing on causes of condom non-use and syringe sharing 11 , 12 , Rezazade and Ahmadi, under review.
Informed consent was obtained from all participants after they were verbally assured that the information would be kept confidential, especially from the correctional setting. All checklists and questionnaires were anonymous.
