Evidence map›Paper›PMID 39773185›Full record

ArticleHarm reduction journal2025

Facilitators and Barriers to adherence to antiretroviral therapy among incarcerated people living with HIV in Iran: insights from a qualitative study.

Azam Bazrafshan, Ali Ahmad Rafiei-Rad, Maliheh Sadat Bazrafshan, Nima Ghalekhani, Soheil Mehmandoost, SeyedAhmad SeyedAlinaghi, Fatemeh Mehrabi, Mehrdad Khezri, Gelareh Mostashari, Mohammad Karamouzian and 1 more

Abstract read
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Article in Harm reduction journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Azam BazrafshanHIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
Ali Ahmad Rafiei-RadDepartment of Sociology, Allameh Tabatabai University, Tehran, Iran.
Maliheh Sadat BazrafshanHIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
Nima GhalekhaniHIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
Soheil MehmandoostHIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
SeyedAhmad SeyedAlinaghiIranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran.
Fatemeh MehrabiStudent Research Committee, Kerman University of Medical Sciences, Kerman, Iran.
Mehrdad KhezriHIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
Gelareh MostashariUnited Nations Office on Drugs and Crime, Country Office in the Islamic Republic of Iran, Tehran, Iran.
Mohammad KaramouzianHIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
Hamid SharifiHIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran. sharifihami@gmail.com.

Funding

United Nations Office on Drugs and Crime Number: 2300202362
6 · The paper itself

Abstract

backgroundEnsuring consistent adherence to antiretroviral therapy (ART) is crucial for effective HIV treatment and achieving viral suppression. Within prisons, the prevalence of HIV is notably high, and incarcerated individuals face an increased risk of transmitting the virus both during and after incarceration. However, facilitators and barriers to ART adherence among these individuals in low- and middle-income countries remain inadequately explored. This study applied the Social Ecological Model (SEM) to investigate how various individual, interpersonal, organizational, community and policy-level factors impact ART adherence among incarcerated populations in Iran during and post-incarceration.

methodsThis study employed a phenomenological qualitative approach using semi-structured interviews to gather insights. The research population consisted of people living with HIV (PLHIV) who had experienced incarceration and had been prescribed ART during their latest incarceration. Eleven PLHIV from two prisons located in Kerman and Tehran, Iran, formed the study group. Qualitative findings from the interviews were analyzed using a thematic approach. The findings were organized within the SEM framework to highlight key themes influencing ART adherence during and after incarceration.

resultsParticipants had an average age of 45.1 years (± 5.6). Various factors influence ART adherence during and post-incarceration. Participants highlighted the individual (e.g., HIV knowledge, previous treatment history, mental and physical health), interpersonal (e.g., family, friends, other incarcerated people, and prison health staff), organizational (e.g., ART treatment interventions, methadone maintenance therapy, and other health protocols), community (e.g., stigma, social isolation, discrimination and lack of access to community health services), and policy (e.g., financial interventions, and providing shelters) level factors influence ART adherence during and post-incarceration.

conclusionsThis study provides insights into the multi-level approach to ART adherence among PLHIV during and post-incarceration. It recommends implementing public health activities at the proposed multi-levels to maximize the synergies of intervention for the greatest impact.

Indexed as

HIV InfectionsMedication AdherencePrisonersQualitative ResearchAdultAnti-HIV AgentsFemaleHumansIranMaleMiddle AgedSocial StigmaAnti-HIV AgentsAIDSAntiretroviral therapyHIVIncarcerationIranMedication adherence

Identifiers

PMID39773185
PMCPMC11708189

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.