Evidence map›Paper›PMID 40170019›Full record

ArticleBMC public health2025

Correlates of duration between initial drug use and first drug injection among people who inject drugs in Iran, 2020.

Zahra Abdolahinia, Zahra Jaafari, Ali Karamoozian, Soheil Mehmandoost, Nima Ghalekhani, Mehrdad Khezri, Ghazal Mousavian, Mostafa Shokoohi, Ali Mirzazadeh, Ali Akbar Haghdoost and 5 more

Abstract read
In one paragraph

Article in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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

What it found

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2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

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

15 authors.

Zahra AbdolahiniaHIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
Zahra JaafariHIV/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 KaramoozianModeling in Health Research Center, 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.
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.
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.
Ghazal MousavianHIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
Mostafa ShokoohiHIV/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 MirzazadehHIV/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 Akbar HaghdoostHIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
Mohammad KaramouzianCentre on Drug Policy Evaluation, MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, ON, Canada.
Mohammad Mehdi GooyaCenter for Disease Control, Ministry of Health and Medical Education, Tehran, Iran.
Samaneh AkbarpourOccupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, 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.
Fatemeh TavakoliHIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran. fatemehtavakoli98@yahoo.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPeople who use non-injection drug use are at risk of transitioning to injecting drugs, which increases their vulnerability to HIV and other blood-borne infections. This study aimed to investigate the correlates of the duration between the first drug use and the first drug injection among people who inject drugs (PWID) in Iran, as well as the reasons for injection initiation.

methodsWe analyzed data from the fourth national bio-behavioral surveillance survey among PWID in Iran, conducted in 2020 across 11 cities using respondent-driven sampling (n = 2,684). A generalized linear mixed model with a gamma-distributed dependent variable and log link function was used to investigate the correlates of transition time from non-injection to injection drug use.

resultsAmong 2,356 participants included in the analysis, the mean ± SD of the duration between the first drug use and the first drug injection was 9.37 ± 6.8 years. Factors associated with earlier injection initiation included: age under 30 years (p-value < 0.001), being single (p-value < 0.001) or divorced/widowed (p-value = 0.007), history of incarceration (p-value = 0.001), sexual debut before age 18 (p-value < 0.001), and history of depression (p-value < 0.001). Peer influence (665;29.1%) and pleasure-seeking behavior (534; 23.3%) were the most common motives for injection initiation.

conclusionsThe transition to injection drug use among PWID in Iran often occurs within a decade of initial drug use and is influenced by demographic, social, and psychological factors. Prevention strategies should focus on early intervention for at-risk youth, address mental health needs, and leverage peer influence. Policymakers should prioritize evidence-based, multi-faceted approaches that target both individual and structural factors to delay or prevent the transition to injection drug use and reduce associated health risks.

Indexed as

Drug UsersSubstance Abuse, IntravenousAdolescentAdultFemaleHumansIranMaleMiddle AgedRisk FactorsSurveys and QuestionnairesTime FactorsYoung AdultCross-sectional studiesHarm reductionIranPeople who inject drugsSocial determinants of healthSubstance-related disorders

Identifiers

PMID40170019
PMCPMC11959802

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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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.