Monday, February 15, 2016

Developing a Brief Scale to Measure HIV Transmission Risk among Injecting Drug Users - Iran

One of the main concerns of policymakers is to measure the impact of harm reduction programs and different interventions on the risk of HIV transmission among Injecting Drug Users (IDUs). Looking simultaneously at multiple factors and conditions that affect the risk of HIV transmission may provide policymakers a better insight into the mixed nature of HIV transmission.

The present study aimed to design a simple, brief, and multi-dimensional scale for measuring HIV transmission risk among IDUs.

From October 2013 to March 2014, we conducted face-to-face interviews with 147 IDUs. Eligible participants were individuals 18 years or older who had injected drugs at least once during the last year and had not participated in similar studies within the 2 months before the interview. To design a scale for measuring HIV transmission risk, we specified 11 items, which address different dimensions of HIV risk taking behaviors/situations based on experts' opinion. We applied exploratory factor analysis (EFA) with principal component extraction to develop scales. Eigen values greater than 1 were used as a criterion for factor extraction.

We extracted 7 items based on first factor, which were accounted for 21% of the variations. The final scale contained 7 items: 4 items were related to injecting practice and 3 items related to sexual behaviors. The Cronbach's α coefficient was 0.66, acceptable for such a brief scale.

Applying a simple and brief scale that incorporates the different dimensions of HIV transmission risk may provide policymakers and harm reductionists with a better understanding of HIV transmission in this key group and may be advantageous for evaluating intervention programs.

The Demographic Characteristics of 147 Injecting Drug Users
Age, y
Mean ± SD37 ± 9.32
Education a
Illiterate or Primary school52 (35.3)
Guidance school56 (38.1)
High school and above39 (26.5)
Marital status a
Single76 (51.7)
Married37 (25.2)
Divorced30 (20.4)
Widowed4 (2.7)
Gender a
Male134 (91.2)
Female13 (8.8)
aValues are presented as number (%).

Factor Loadings of Final 7 HIV Transmission Risk Items Among 147 Injecting Drug Users
NoItemFactor Loading
1The extent to which respondents used a needle that already had been used by someone else within the past 6 months0.84
2The number of people that had used a syringe before respondents used it within the past 6 months0.82
3The extent to which respondents used cookers, rinse water, or cotton after someone else had already used them within the past 6 months0.62
4The proportion of IDUs in the personal network of respondents0.45
5The extent of using condoms during the sexual intercourses within the past 6 months0.52
6The number of sexual partners within the past 6 months0.40
7The use of condoms during the last sexual intercourse0.35

Full article at:

  • 1Regional Knowledge Hub and WHO Collaborating Center for HIV Surveillance, Institute for Future Studies in Health, Kerman University of Medical Sciences, Kerman, IR Iran; Research Center for Modeling in Health, Institute for Future Studies in Health, Kerman University of Medical Sciences, Kerman, IR Iran.
  • 2Research Center for Modeling in Health, Institute for Future Studies in Health, Kerman University of Medical Sciences, Kerman, IR Iran.
  • 3Safety Promotion and Injury Prevention Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
  •  2015 Dec 12;4(4):e26159. doi: 10.5812/ijhrba.26159. eCollection 2015. 

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