Evidence map›Paper›PMID 40640741›Full record

ArticleBMC public health2025

Programmatic mapping and size estimation of people who inject drugs to plan targeted HIV prevention and harm reduction programs in iran, a nationwide study.

Nima Ghalekhani, Ahmad Hajebi, Ebrahim Ghodusi, Behnaz Beygi, Toktam Khojasteh Bojnordi, Mohammad Farooq Mashhour, Fatemeh Rezaei Sharif, Farzaneh Rajabzadeh, Hooriyeh Khoshdel, Hamid Reza Fathi and 1 more

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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 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

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

2 citing papers in PubMed.

  1. Article
  2. Long-Term Dynamics of Pelvic Inflammatory Disease Attributable toInternational journal of women's health · 2026
    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

11 authors.

Nima GhalekhaniHIV/STI Surveillance Research Center, WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
Ahmad HajebiResearch Center for Addiction and High-Risk Behaviors, Psychosocial Health Research Institute, Iran University of Medical Sciences, Tehran, Iran.
Ebrahim GhodusiMental Health, Social Health and Addiction Department (MEHSHAD), Ministry of Health and Medical Education (MOHME), Tehran, Iran.
Behnaz BeygiDepartment of Environmental Health Engineering, Faculty of Health, Mashhad University of Medical Science, Mashhad, Iran.
Toktam Khojasteh BojnordiMental Health, Social Health and Addiction Department (MEHSHAD), Ministry of Health and Medical Education (MOHME), Tehran, Iran.
Mohammad Farooq MashhourKhorasan Razavi Management and Planning Organization, Mashhad, Iran.
Fatemeh Rezaei SharifDepartment of Biostatistics and Epidemiology, School of Public Health, Kerman University of Medical Sciences, Kerman, Iran.
Farzaneh RajabzadehMinistry of Education and Training, Tehran, Iran.
Hooriyeh KhoshdelMental Health, Social Health and Addiction Department (MEHSHAD), Ministry of Health and Medical Education (MOHME), Tehran, Iran.
Hamid Reza FathiMental Health, Social Health and Addiction Department (MEHSHAD), Ministry of Health and Medical Education (MOHME), Tehran, Iran. Hamid.fathi.74@gmail.com.ORCID http://orcid.org/0000-0003-2905-2982
Hamid SharifiHIV/STI Surveillance Research Center, WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.

Funding

Wellcome Trust 226825
6 · The paper itself

Abstract

backgroundThe HIV epidemic in Iran has been largely driven by people who inject drugs (PWID). Although harm reduction services have been implemented in Iran, some PWID still lack access to these services. This programmatic mapping aimed to determine the spatial distribution of hotspots, estimate the number of PWID, and assess the coverage of prevention services to plan optimal service locations in Iran.

methodsA cross-sectional key informant-driven mapping and enumeration methodology was used to identify hotspots of illicit drug use in 82 cities across 24 provinces in Iran from August 2020 to March 2021.

resultsWe identified 4,270 active hotspots, of which 3,350 (78.5%) were associated with people who inject drugs (PWID). An estimated 14,737 PWID (92.2% male) were identified, with 261 (1.8%) under 18 years old, 3,643 (24.7%) aged 18-29 years, 10,061 (68.3%) aged 30-59 years, and 775 (5.2%) over 60 years old. Only half of the hotspots for PWID have active programs, with 24% of services overlapping in coverage areas. Under resource limitation with 47% and 93% reduction in the centers and outreach teams, respectively, we can expect just a 14% decline in services, and this would be the optimum decision in the constrained situation.

conclusionsThis study provides conclusive evidence that the current spatial distribution of harm reduction services for PWID in Iran is inefficient, characterized by significant coverage gaps in high-risk areas alongside costly resource redundancy through service overlap. Strategic consolidation based on spatial optimization can dramatically improve efficiency and access under resource constraints.

Indexed as

Harm ReductionHIV InfectionsSubstance Abuse, IntravenousAdolescentAdultCross-Sectional StudiesFemaleHumansIranMaleMiddle AgedYoung AdultHarm reductionHIVIranPeople who inject drugsPopulation size estimationProgrammatic mappingSubstaDrug Use Disorders

Identifiers

PMID40640741
PMCPMC12243317

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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.