We used four methods (direct count, indirect count, wisdom of the crowd, and unique object multiplier) to map and estimate the population size of street children in six major cities in Iran in 2017. In aggregate for the six cities, the number of street children was estimated at 5296 (interquartile range [IQR] 4122-7071) using the median of the four methods. This corresponds to a rate of 16.3 (IQR 12.5-24.5) per 10,000 children age 5-18 years old, or 3.2 (IQR 2.4-5.3) per 10,000 total population. The total number for street children in the country is estimated at 26,000 (IQR 20,719) children. Results can help policymakers advocate for resources, plan programs, and evaluate the reach of programs for street children. The maps created through the course of the population size estimation exercise can also guide outreach efforts to provide street children with health and social welfare services.

Background Street-based female sex workers (FSWs) are highly at risk of HIV and other harms associated with sex work. We assessed the prevalence of non-injection and injection drug use and their associated factors among street-based FSWs in Iran. Methods We recruited 898 FSWs from 414 venues across 19 major cities in Iran between October 2016 and March 2017. Correlates of lifetime and past-month non-injection and injection drug use were assessed through multivariable logistic regression models. Adjusted odds ratios (AOR) and 95% confidence intervals (CI) were reported. Results Lifetime and past-month non-injection drug use were reported by 60.3% (95% CI 51, 84) and 47.2% (95% CI 38, 67) of FSWs, respectively. The prevalence of lifetime and past-month injection drug use were 8.6% (95% CI 6.9, 10.7) and 3.7% (95% CI 2.6, 5.2), respectively. Recent non-injection drug use was associated with divorced marital status (AOR 2.00, 95% CI 1.07, 3.74), temporary marriage (AOR 4.31 [1.79, 10.40]), had > 30 clients per month (AOR 2.76 [1.29, 5.90]), ever alcohol use (AOR 3.03 [1.92, 6.79]), and history of incarceration (AOR 7.65 [3.89, 15.30]). Similarly, lifetime injection drug use was associated with ever alcohol use (AOR 2.74 [1.20–6.20]), ever incarceration (AOR 5.06 [2.48–10.28]), and ever group sex (AOR 2.44 [1.21–4.92]). Conclusions Non-injection and injection drug use are prevalent among street-based FSWs in Iran. Further prevention programs are needed to address and reduce harms associated with drug use among this vulnerable population in Iran.

BACKGROUND Sex workers are considered as high-risk groups in the third wave of AIDS transmission in Iran because the risk of sexually transmitted diseases increases by the repeated change of sex partner and unprotected and frequent sexual activities. however, reaching to them to assess their needs and providing services is challenging. OBJECTIVE The main aims of this study was performing a rapid assessment of situation and interventions of HIV/AIDS-related risky behaviors among female sex workers(FSWs) and population size of women sex-worker at national levels in Iran. METHODS A cross-sectional mixed design (quantitative and qualitative) by Rapid Assessment and Response (RAR) method was carried out during 20 weeks in 21 cities (provincial capital) in Iran to explore HIV AIDS related high-risk behavior in female sex-workers. In qualitative phase data collecting, including observation, in-person interviews and group discussions with key informants were used. In quantitative phase, 965 SbFSWs were approached using venue-based application of Time Location Sampling (TLS) method. The sampling frame (venues list) were initially identified by interviewed with key informant in qualitative phase. RESULTS From October 2016 to March 2017 (~20 weeks) 84 focus group-discussions was done and 420 individuals were interviewed. The participants in these groups were included governmental and non-governmental key informants and peer- persons (FSWs, pimps, Ex-FSWs, Customers). we successfully recruited 878 SFSW in 19 cities. the response rate was 93.05%). CONCLUSIONS We found RAR methodology to be feasible and acceptable to approach and recruit street-based female sex worker in many cities in Iran. the study was provided valuable data and evidence from this hard to reach population for policymakers in Iran. Designing and implementation of the study involve contributions from academics as well as program managers and policymakers. This study protocol could be a guide for researchers in this field and could be referenced by other manuscripts that reported the results of this study.

Background Female sex workers (FSWs) are at a disproportionate risk of sexually transmitted infections and they may face significant barriers to HIV testing. This study aimed to examine HIV testing prevalence and its associated factors among street-based FSWs in Iran. Method A total of 898 FSWs were recruited from 414 venues across 19 major cities in Iran between October 2016 and March 2017. Eligible FSWs were women aged 18 years of age who had at least one commercial sexual intercourse in the previous year. HIV testing was defined as having tested for HIV in the lifetime. Bivariable and multivariable logistic regression were used to examine the correlates of HIV testing. We report adjusted odds ratios (aOR) and their 95% confidence intervals (CI). Result Overall, 57.8% (95%CI: 20.0, 88.0) of participants reported having tested for HIV, and HIV prevalence among FSWs who tested for HIV was 10.3% (95%CI: 7.5, 13.0). The multivariable model showed that unstable housing (aOR: 8.86, 95%CI: 2.68, 29.32) and drug use (aOR: 3.47, 95%CI: 1.33, 9.06) were associated with increased likelihood of HIV testing. However, FSWs with a higher level of income were less likely to be tested for HIV (aOR: 0.09, 95%CI: 0.02, 0.43). Conclusion Almost one in ten street-based FSWs had never tested for HIV. These findings suggest the need for evidence-based strategies such as outreach support and HIV self-testing to improve HIV testing in this marginalized population.

Background: Several studies on street children in Iran reported a high prevalence of alcohol consumption among this group. This study assessed the prevalence of lifetime alcohol use and correlated factors among street children in Iran. Methods:We conducted a cross-sectional survey among 856 street children from six provinces of Iran. Behavioral data were collected by trained interviewers using a structured questionnaire. Our target outcome was lifetime alcohol use. We examined associations between individual variables and lifetime alcohol use using the chi-square.A multiple logistic regression model included variables with a p-value < .2. Lastly, we reported the adjusted odds ratio (an OR) point estimate and 95% confidence interval (95% CI) as the effect measure.Results: Mean age and standard deviation (SD) of alcohol drinkers were 14.94 ± 2.16.Overall, 16.6% (CI95%: 14.38%, 19.55%) of participants reported lifetime alcohol use, and almost 60% of children reported alcohol use over three past months. In the final model, factors that were independently associated with alcohol use included the 15-18 age range (AOR 2.35, 95% CI 1.48−3.73), Iranian nationality (AOR 3.36, 95% CI 2.07−5.45), working longer than 5 years in the streets (AOR 2.90, 95% CI 1.72−4.88), father's drug use (AOR 1.93,, and illiteracy (AOR 1.65, 95% CI 1.03−2.66). Conclusions:The results of the present study demonstrated that preventive plans for alcohol use among street children must be addressed using the services provided by governmental and nongovernmental organizations.