As a concentrated epidemic, human immunodeficiency virus (HIV) is spreading rapidly in one or more groups in Iran, but in the general population its prevalence is relatively low. Female sex workers (FSWs) and their partners are at greater risk for HIV infection. To determine the prevalence of HIV and sexually transmitted infections (STIs) including gonorrhoea, Chlamydia, herpes simplex type 2 and syphilis among FSWs. We conducted a cross-sectional study of 278 FSWs in Shiraz, by using respondent-driven sampling, from June to March 2010. The recruitment chain started with 14 seeds, and FSWs were tested for HIV, syphilis, herpes simplex type 2, gonorrhoea and Chlamydia. HIV prevalence was 4.7% (13/278); the most prevalent STI was herpes simplex type 2, 9.7% (27/278), followed by Chlamydia 9% (25/278), gonorrhoea 1.4% (4/278) and syphilis (0/278). The FSWs reported drug use (69.9%) of which 16.4% had history of injecting drug use. Unprotected sex in the past month was reported by 24.4% of FSWs. Urgent education and risk reduction programmes are needed in this population.

This quasi-experimental, before-after study was designed to assess the effect of an educational intervention on knowledge and attitudes about sexually transmitted infections, HIV and preventive behaviours among female sex workers in Shiraz, Iran. A single-group pre-post test design was used and the study was done between August and December 2009. The participants were 80 female sex workers recruited from three drop-in centers in Shiraz, with stratified random sampling. Pre-intervention knowledge was assessed by interview with a standard questionnaire. The educational intervention consisted of a lecture, face-to-face education, printed information, an educational movie, role playing and a contest. After 2 months, the effect of the intervention was evaluated (post-test). The average age of the participants was 32.6 ± 9.1 years. After the intervention, the mean score for general knowledge about HIV and sexually transmitted infections increased from 13.7 ± 0.95 (pre-test) to 19.47 ± 11.62 (post-test, p<0.001). There were significant improvements in attitude and the number of participants who self-reported preventive behaviours such as using a condom consistently (from 45 to 63) (p<0.001). The results show that the educational programme was successful in increasing the participants' HIV- and AIDS-related knowledge and attitudes, and in decreasing their risk behaviours.

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Background: Psychological problems have significant associations with HIV-related high-risk behaviors among female sex workers (FSWs). Objectives: The present study aimed to investigate the relationship between mental health and high-risk behaviors among FSWs in Shiraz, Iran. Patients and Methods:This cross-sectional study, conducted from October 2011 to May 2012, used a convenience sampling method to recruit 125 FSWs and 125 control women. After providing informed consent, each participant completed a validated questionnaire (SCL-90-R and high-risk behaviors). Results: In comparison to the control group, the mean age at first sexual relationship was lower among sex workers, and most of them (80.4%) had not used condoms in their most recent sexual intercourse. The mean scores on all subscales of the SCL-90-R were lower in the control group (P < 0.003), whereas psychological symptoms were significantly more prevalent among FSWs. A significant inverse relationship was found between global severity indexes (GSR) scores and use of condom in the most recent sexual intercourse. Conclusions: Considering the association of high-risk behaviors with lower mental health among FSW, psychological interventions are needed in order to prevent high-risk behaviors and HIV transmission.