Zahra Bayat Jozani - Academia.edu (original) (raw)

Papers by Zahra Bayat Jozani

PLOS ONE

Introduction The COVID-19 pandemic and its consequences have caused fear and anxiety worldwide an... more Introduction The COVID-19 pandemic and its consequences have caused fear and anxiety worldwide and imposed a significant physical and psychological burden on people, especially women living with HIV (WLHIV). However, WLHIV were not studied as well as others during the pandemic. Hence, this study aimed to determine the relationships between COVID-19 phobia, health anxiety, and social relations in WLHIV. Materials and methods This cross-sectional study enrolled 300 WLHIV who had records at the Iranian Research Center for HIV/AIDS of Tehran University of Medical Sciences. Data were collected using sociodemographic questionnaire, the fear of COVID-19 scale, the social relations questionnaire, the socioeconomic status scale and the health anxiety inventory. Path-analysis was used to assess the direct and indirct associations between variables. Results Based on the path analysis, among variables that had significant causal relationships with social relations, socioeconomic status (β = -0....

Journal of International Translational Medicine, 2019

To assess knowledge, attitude and practice (KAP) towards HIV/AIDS and to perform HIV, HBV, HCV an... more To assess knowledge, attitude and practice (KAP) towards HIV/AIDS and to perform HIV, HBV, HCV and HSV2 serosurveys among girls from dysfunctional families in Tehran, Iran. A standard questionnaire was used to assess participants knowledge, attitude and practice towards HIV/AIDS by pre and post- tests within a three months interval. We also performed HIV, HBV, HCV and HSV2 serostatus assessment in our study group in post- test phase. Ninety eight (52.2%) of the participants had good knowledge about HIV/AIDS before our educational intervention, after which this was raised to 133 (70.7%) (Mc Nemar's test, P = 0.031). Importantly, 177 (94.1%) of participants were willing to be tested for HIV before counseling. There was no positive result for HIV, HBV, HCV and HSV2 serosurvey. HIV/AIDS education and counseling significantly increased knowledge, attitudes and practice of girls from dysfunctional families regardless of their HIV, HBV, HCV, or HSV2 serostatus findings.

Menstrual Characteristics and Patterns of Menstrual Disorders among Women Living with HIV in Tehran, Iran

Journal of International Translational Medicine, 2019

Background: The relation between Human Immunodeficiency Virus (HIV) serostatus and menstrual irre... more Background: The relation between Human Immunodeficiency Virus (HIV) serostatus and menstrual irregularities is controversial. Toward a better understanding of menstrual abnormalities among HIV infected women and the role of HIV related variables, we conducted the present study. Materials and methods: This cross-sectional study was conducted between September 2016 and December 2017 among 111 eligible HIV infected women and in Imam Khomeini Hospital, Tehran, Iran. Participant were recruited based on convenience sampling method. We addressed the menstrual data of 102 participants (returning at least three consecutive menstrual calendars) through a self-constructed questionnaire. We also assessed HIV viral load and CD4 cells count of each participant at the time of study enrollment. Descriptive statistics as well as Kruskal-Wallis test and Bonferroni post hoc tests were used to address our objectives, so we used Statistical Package for the Social Sciences (SPSS) version 16.0 for windows...

Journal of International Translational Medicine, 2018

Background: Development of tailored interventions to promote condom use seems essential in countr... more Background: Development of tailored interventions to promote condom use seems essential in countries with traditional gender role definitions. Learning condom influence strategies could be helpful when it is difficult for women to initiate sexual communication. These strategies have been targeted in a safer sex skills building intervention among high-risk women in Tehran, Iran. Methods: We conducted this study among 50 high-risk women who registered for counseling and HIV testing at Imam Khomeini Hospital in Tehran, Iran, 2012-2013. Participants were assigned to two groups: 1) routine 15 minute pre-test HIV counseling, or 2) routine counseling besides communication skills building monthly sessions for six months. Pre and post-tests were taken at baseline and six months. We designed an intervention based on Information-Motivation-Behavior theory. Condom influence strategies were used in the construct of the questionnaire and intervention materials. Results: After six months participa...

Journal of Mazandaran University of Medical Sciences, 2019

Background and purpose: Normal amount of saliva is necessary for prevention of oral lesions, cari... more Background and purpose: Normal amount of saliva is necessary for prevention of oral lesions, caries, and proper speech. The purpose of this research was to study the salivary flow rate in HIV-1 seropositive attending Tehran Imam Khomeini Hospital. Materials and methods: A cross-sectional study was conducted in 50 individuals including 25 HIV-1 seropositive patients (case group) and 25 healthy people (control group) attending the Counseling Center for Behavioral Diseases in Tehran Imam Khomeini Hospital, Tehran. The saliva rate was measured during 10 min. The case and control groups were matched in terms of age, gender, history of smoking, and other drugs (p< 0.9). People with history of drug abuse, alcohol, and systemic diseases were excluded from the study. Data analysis was done in SPSS. Results: Salivary flow rate in controls and case group were 4.6±0.86 ml/min and 3.6±1.8 ml/min, respectively. In the case group, the salivary rate was significantly lower than that of the contr...

Journal of Family & Reproductive Health, 2018

Objective: Over the past years, the prevalence and the progression rate of HIV infection in Iran ... more Objective: Over the past years, the prevalence and the progression rate of HIV infection in Iran especially through high-risk sexual relationships have regrettably been reported at very high levels. This cross-sectional study tries to analyze stigma, mental health, and coping skills on risky behaviors in HIV-positive adults in Tehran- Iran. Materials and methods: This cross-sectional study was conducted on a sample of 450 HIV-positive adults. Participants completed a socio-demographic questionnaire, the General HealthQuestionnaire-28, the Berger HIV Stigma Scale as well as the Lazarus Ways of Coping Questionnaire (WOCQ). To analyze the data, the independent-samples t-test and Pearson Correlation were used. Results: The findings of this study revealed that mental health, stigma, and avoidance-escape coping mechanisms were correlated with risky behaviors (p ˂ 0.05).Furthermore, the amount of stigma among female individuals compared to men was reported at higher levels and mental healt...

The effects of an educational program based on the health belief model on information-motivation-skill-behavioral skills among women living with human immunodeficiency virus

BACKGROUND: Human immunodeficiency virus (HIV) is a kind of behavioral disease in that adopting b... more BACKGROUND: Human immunodeficiency virus (HIV) is a kind of behavioral disease in that adopting behavioral changes is the only way to control and stop the epidemic. The aim of this study is to investigate the effect of education base on the health belief model (HBM) on health-seeking behavior among HIV-positive women. MATERIALS AND METHODS: This study is a paralleled, randomized controlled clinical trial done with control group among HIV-positive women who were registered at the voluntary and counseling testing center of Imam Khomeini hospital in Tehran. Data were gathered by using information obtained from the Motivation-Skill-Behavior questionnaire and demographic data. The women were divided by permuted block and were randomized into two groups. Interventional group participated in six HBM educational classes and used routine counseling guidelines, but the control group used only routine counseling protocol. Data were collected before, immediately after, and 3 weeks after interfe...

Objective: We conducted the present study to investigate the potential effects of hormonal contra... more Objective: We conducted the present study to investigate the potential effects of hormonal contraception (HC) on disease progression in women living with HIV (WLWH). Methods: In a historical cohort study, the demographic, medical, and reproductive profiles of 50 women registered at a referral HIV clinic, receiving hormonal contraceptives, were selected and compared with a matched control group of female patients who had consistent condom use. Disease progression was monitored for nine months, considering the time of CD4 cell count below 200, the time of antiretroviral therapy initiation, HIV-RNA viral load, CD4+ T-cell count, and finally, death. Results and Discussion: The mean HIV-1-RNA plasma viral loads and mean CD4+ T-cell counts differed significantly in time points among patients using hormonal contraceptives, while no significant changes were observed among condom users. The mean age was 31.34 (21-51) years, and the meantime from diagnosis was four years. In pap smear result,...

HIV & AIDS Review, 2017

Introduction: Acquired immune deficiency syndrome (AIDS) is generally related to reproductive hea... more Introduction: Acquired immune deficiency syndrome (AIDS) is generally related to reproductive health and is most commonly transmitted through injection addiction, sexual relationship, pregnancy, and breastfeeding. Therefore, the promotion of reproductive health of women with human immunodeficiency virus (HIV) is very important. The aim of this study was to investigate the effect of counselling on cognitive-behavioural therapy (CBT) on reproductive health in women with HIV. Material and methods: This randomised controlled trial was conducted in 2017. Sixty HIV-infected women who referred to Imam Khomeini Hospital Consultation Centre for clients with risky behaviour in Tehran participated in this study. The sampling method was census, and samples were randomly assigned to two groups: control and intervention. In addition to routine care, the intervention group received seven cognitive-behavioural counselling sessions on reproductive health. The questionnaire used in this study was a reproductive health assessment scale for HIV-positive women. Results: There was no statistically significant difference between the demographic characteristics in the control and intervention groups. The result of repeated measures test showed that the length of time affects the total score of reproductive health (p < 0.000) and there was a significant difference between the two groups (p < 0.000). Conclusions: It is suggested that CBT counselling approaches be included in educational programs for the health of women with HIV. Given the widespread dimensions of reproductive health, counselling with a cognitive therapy approach in each dimension with the number of further sessions is suggested.

International Journal of Epidemiologic Research, 2017

Background and aims: Behavioral counseling centers are the main health organizations which are re... more Background and aims: Behavioral counseling centers are the main health organizations which are responsible for providing treatment and care for the patients living with HIV (PLWH). HIVpositive patients receive services through a unique counseling process called voluntary counseling and confidential testing (VCCT). Although there are reports regarding VCCT evaluation from other countries, not such an evaluation was found in Iran until this study, to the best of our knowledge. The study was performed to fulfill this necessity. Methods: Using consecutive method sampling, 314 subjects were sampled from the patients referred to Behavioral Counseling Center of Imam Khomeini hospital, Tehran, Iran. A combination of process and output evaluation of VCCT was performed in the biggest Behavioral Counseling Center of Iran at Imam Khomeini hospital, Tehran, Iran. Data were analyzed using descriptive statistics (percentages and averages). Results: Participants' response rate was 95.54%. Two shortcomings were found in the counseling process. Cronbach alpha reliability coefficient for this scale was 0.899, which was a desirable reliability for the questionnaire. As the main finding of the study, 48.33% of patients were not using antiretroviral medications regularly. An average number of patients (2.88) had HIV related stigma and fear of disclosure. In a quantitative study before testing in the study, it has been found that HIV patients did not have adequate information about their disease. Conclusion: Defects in the consultation process for the patients with HIV infection in the hospital were concluded. The quantity of consulting services for patients was in low level; therefore it is essential to improve consulting services for health promotion of the HIV patients.

HIV & AIDS Review, 2019

Introduction: The third wave of human immunodeficiency virus (HIV) is rising due to high-risk sex... more Introduction: The third wave of human immunodeficiency virus (HIV) is rising due to high-risk sexual behaviours in Iran. In spite of launching programs to combat HIV in Iran, condom use frequency has not yet reached the optimal level, especially in high-risk groups. The aim of this study was to assess the sexual protection behaviours and awareness among HIV-positive women. Material and methods: This descriptive study was performed on 100 HIV-positive women who referred to the Voluntary and Counselling Centre (VCT) in Tehran and were recruited using a purposive sampling method. Data collection was carried out using HIV/acquired immunodeficiency syndrome (AIDS) awareness and sexual protection behaviour questionnaires. Results: Condom use was practiced only by 22.2% in all their vaginal and anal sexual intercourse during the three months, and 77.8% of the women never used condoms or failed to use them continuously. Their sexual partners were HIV-positive in 71% of cases. The mean ± SD of awareness score about HIV/AIDS was 7.60 ± 3.31, indicating average awareness of the subjects in the study. A total of 49.1% of the participants stated that their sexual partners' reluctance was the most important reason for non-use of condoms, while women were not willing to use condoms in 18.2% of cases. Conclusions: The results of the present study indicated poor sexual protection behaviours in HIV-positive women. As a result, gender-based harm reduction programs to promote safe sexual behaviour, awareness level, and negotiation power for condom use in HIV-positive women is more important than ever.

Content Analysis of Teleconsultation Enquiries in Positive Health Club, Imam Khomeini Hospital, Tehran, Iran

Journal of Therapy and Management in HIV Infection, 2019

HIV & AIDS Review, 2019

Introduction: Health seeking behavior (HSB) is a highly important concept for assessment of healt... more Introduction: Health seeking behavior (HSB) is a highly important concept for assessment of health access and services. This study was performed to evaluate the validity and reliability of the Persian version of the Questionnaire of Health Seeking Behavior of women living with human immunodeficiency virus (HIV). Material and methods: After obtaining permission from the questionnaire author we started our study in April 2018. We used the forward-backward method according to World Health Organization guidelines. In the first stage, qualitative assessment for assessing face and content validity was done by using 10 experts' and 10 HIV-positive women's ideas during panel and quantitative assessment was done using the content validity ratio (CVR) and content validity index (CVI). Reliability assessment was done among 80 HIV women by Cronbach's α. We conducted a pre-test among 10 HIV-positive women to discover any possible problems or issues. Results: Internal reliability, and construct validity of the questionnaire were determined among expert and HIV-positive women participants. Overall internal reliability (Cronbach's α = 0.81) was high. SPSS 16 was used to analyze data, using analytical statistical methods including the χ 2 test. After considering the quality of validity and the content of comments, the values of all the items, such as the CVI 0.93 and CVR 0.97, were obtained. Conclusions: The results represented the validity and reliability of the Persian version of the questionnaire to estimate the HSB, and it is possible to use it as an assessment tool.

Evaluation of Acquired HIV Drug Resistance among People Living with HIV Who Have Taken Antiretroviral Therapy for 9–15 Months in 14 Triangular Clinics in Iran, 2015–2016

Intervirology, 2018

Aims: The aim of this study was to evaluate drug resistance patterns among Iranian people living ... more Aims: The aim of this study was to evaluate drug resistance patterns among Iranian people living with HIV who have taken antiretroviral therapy for 9–15 months. Methods: A cross-sectional study was conducted between December 2015 and May 2016. Two hundred fifty-two blood samples were collected from all eligible HIV-infected patients at fourteen healthcare settings, located in major provinces in Iran. The samples were examined for presence of drug resistance strains and viral load level. Moreover, a phylogenetic tree, using neighbor joining, was constructed and HIV subtypes were determined. Results: The most common subtypes were CRF35-AD (47.6%) and A1 (42.8%), followed by 45_CPX (4.8%) and C (4.8%). The resistance to non-nucleoside reverse transcriptase inhibitors (NNRTIs), nucleoside reverse transcriptase inhibitors (NRTIs), and protease inhibitors was reported as 19.2, 19.2, and 10.3%, respectively. M184I/V mutation was the most frequent (31.6%) mutation among NRTI-based regimens....

An Estimation of HIV/AIDS’s Cost in the Voluntary Counseling and Testing Center of Imam Khomeini Hospital in 2010-2011

Journal of Therapy and Management in HIV Infection, 2018

Drugs Side Effects in Pregnant Women Infected with HIV Referred to Imam Khomeini Hospital, Voluntary Counseling and Testing Center Tehran, Iran 2009 – 2013

Journal of Therapy and Management in HIV Infection, 2018

Acta medica Iranica, 2017

There are limited documents about HIV patients switched to second-line antiretroviral therapy (AR... more There are limited documents about HIV patients switched to second-line antiretroviral therapy (ART) in resource-limited countries. We aimed to assess the efficacy of second-line ART for HIV patients following first-line ART failure. This was a cohort study of HIV/AIDS patients with first-line ART treatment failure switched to second-line ART between January 2004 and March 2014, who followed for at least 12 months after switching. Fifty of studied patients (85%) were treated with regimens containing lopinavir/ritonavir (Kaletra) and nine of them (15%) treated with other regimes. Seven patients were experienced opportunistic infections in accordance with stage III and IV WHO classification. In this way, 11.8% of patients had aclinicalfailure, and 37 of them (62%) had immunological responses. Weight gain was evident in these patients, and there was a significant correlation between theincrease in CD4 and weight gain (P=0.007). Only 13 patients achieved HIV viral load testing that 6 of ...

Iranian journal of allergy, asthma, and immunology, 2016

Vaccines against the HIV-1 virus offers the best hope for eliminating HIV-associated mortality. R... more Vaccines against the HIV-1 virus offers the best hope for eliminating HIV-associated mortality. Recombinant adenovector type 5 (rAd5) vaccine is a potential candidate for preventive vaccine strategies. In this study, we evaluated the rAd5 prime/protein boost strategy in a murine model. We used rAd5 harboring single HIV-1 genes. These genes, including gag (p24) and exon1 of tat, were amplified from HIV-1 (clade A) RNA using nested PCR. Recombinant vectors were constructed, purified and then injected at 1012 viral particles into four groups, each comprising five mice. The groups were each assigned to receive one of rAd5 prime/protein boost Gag, Tat with and without recombinant granulocyte-macrophage colony-stimulating factor (rGM-CSF), and rAd5 with and without genes. The humoral responses were evaluated using ELISA and cellular immune responses checked by cell proliferation and ELISpot assays (IL-2, IL-4 and IFN-γ). It was shown that compared with the rAd5 injection alone, the rAd5 p...

Global Journal of Health Science, 2015

Background: The application of family planning methods to people with HIV not only prevents unwan... more Background: The application of family planning methods to people with HIV not only prevents unwanted pregnancy, but also leads to a reduction in the possibility of transmission of the virus from the patient to the sexual partner and the fetus. In order to prevent the spread of HIV and enhance reproductive rights, it is necessary to inform women with HIV of the contraception methods. Objective: The aim of this study was to explore experiences of HIV positive women about contraception use. Method: This qualitative study was conducted on 18 women with HIV who were at reproductive age and had referred the Center for clients with Risky Behavior in Imam Khomeini Hospital. Data were analyzed using the conventional content analysis method in MAXQDA 10. Results: The following two themes were derived from descriptions of the use of contraception methods by women with HIV: 1) Contraception is the forgotten component of reproductive health services; 2) inconsistent condom use. Each theme also contained three sub-themes. Conclusion: Results of investigations showed that Risky Behavior consultation Centers mostly stress the use of condom for husband/sexual partners without HIV. In addition, since health care practitioners play an important role in provision of reproductive health services, their lack of knowledge and cooperation considerably contribute to the spread of the disease and violation of patient rights.

World Journal of AIDS, 2014

Background: This study was undertaken to address the controversy regarding immunologic response t... more Background: This study was undertaken to address the controversy regarding immunologic response to combination antiretroviral therapy (cART) among older patients. Methods: In a crosssectional study all patients attending the HIV Clinic at Imam Khomeini Hospital (Tehran) from 2010 to 2011 were evaluated. Immunologic response was investigated using consecutive CD4+ T-cell counts in a one-year interval and outcomes were analyzed for older (>=50 yrs) and younger (<50 yrs) patients using SPSS version 16.0. Results: A total of 714 patients were actively enrolled in the clinic while 24 were 50 years or older, and had initiated ART; a similar random group of younger patients was selected as the control. Hepatitis C was the most prevalent co-infection in both groups. Patients with no serologic evidence of hepatitis B and C had significantly higher CD4+ T-cell counts than HIV/HBV co-infected patients after 12 months (p = 0.04). The average increased CD4+ T-cell counts in 6, 9, and 12 months of cART initiation were lower among older patients but the difference was not significant (50.75 vs. 123.08; p = 0.37, 132.87 vs. 710.58; p = 0.25, 271.27 vs. 500; p = 0.65). Conclusion: About 11% of the registered HIV-positive patients at our clinic were 50 years or older while their immunologic response to cART showed to be different. Specific needs of older HIV infected patients are highly recommended to be addressed in future treatment and care programs.

PLOS ONE

Introduction The COVID-19 pandemic and its consequences have caused fear and anxiety worldwide an... more Introduction The COVID-19 pandemic and its consequences have caused fear and anxiety worldwide and imposed a significant physical and psychological burden on people, especially women living with HIV (WLHIV). However, WLHIV were not studied as well as others during the pandemic. Hence, this study aimed to determine the relationships between COVID-19 phobia, health anxiety, and social relations in WLHIV. Materials and methods This cross-sectional study enrolled 300 WLHIV who had records at the Iranian Research Center for HIV/AIDS of Tehran University of Medical Sciences. Data were collected using sociodemographic questionnaire, the fear of COVID-19 scale, the social relations questionnaire, the socioeconomic status scale and the health anxiety inventory. Path-analysis was used to assess the direct and indirct associations between variables. Results Based on the path analysis, among variables that had significant causal relationships with social relations, socioeconomic status (β = -0....

Journal of International Translational Medicine, 2019

To assess knowledge, attitude and practice (KAP) towards HIV/AIDS and to perform HIV, HBV, HCV an... more To assess knowledge, attitude and practice (KAP) towards HIV/AIDS and to perform HIV, HBV, HCV and HSV2 serosurveys among girls from dysfunctional families in Tehran, Iran. A standard questionnaire was used to assess participants knowledge, attitude and practice towards HIV/AIDS by pre and post- tests within a three months interval. We also performed HIV, HBV, HCV and HSV2 serostatus assessment in our study group in post- test phase. Ninety eight (52.2%) of the participants had good knowledge about HIV/AIDS before our educational intervention, after which this was raised to 133 (70.7%) (Mc Nemar's test, P = 0.031). Importantly, 177 (94.1%) of participants were willing to be tested for HIV before counseling. There was no positive result for HIV, HBV, HCV and HSV2 serosurvey. HIV/AIDS education and counseling significantly increased knowledge, attitudes and practice of girls from dysfunctional families regardless of their HIV, HBV, HCV, or HSV2 serostatus findings.

Menstrual Characteristics and Patterns of Menstrual Disorders among Women Living with HIV in Tehran, Iran

Journal of International Translational Medicine, 2019

Background: The relation between Human Immunodeficiency Virus (HIV) serostatus and menstrual irre... more Background: The relation between Human Immunodeficiency Virus (HIV) serostatus and menstrual irregularities is controversial. Toward a better understanding of menstrual abnormalities among HIV infected women and the role of HIV related variables, we conducted the present study. Materials and methods: This cross-sectional study was conducted between September 2016 and December 2017 among 111 eligible HIV infected women and in Imam Khomeini Hospital, Tehran, Iran. Participant were recruited based on convenience sampling method. We addressed the menstrual data of 102 participants (returning at least three consecutive menstrual calendars) through a self-constructed questionnaire. We also assessed HIV viral load and CD4 cells count of each participant at the time of study enrollment. Descriptive statistics as well as Kruskal-Wallis test and Bonferroni post hoc tests were used to address our objectives, so we used Statistical Package for the Social Sciences (SPSS) version 16.0 for windows...

Journal of International Translational Medicine, 2018

Background: Development of tailored interventions to promote condom use seems essential in countr... more Background: Development of tailored interventions to promote condom use seems essential in countries with traditional gender role definitions. Learning condom influence strategies could be helpful when it is difficult for women to initiate sexual communication. These strategies have been targeted in a safer sex skills building intervention among high-risk women in Tehran, Iran. Methods: We conducted this study among 50 high-risk women who registered for counseling and HIV testing at Imam Khomeini Hospital in Tehran, Iran, 2012-2013. Participants were assigned to two groups: 1) routine 15 minute pre-test HIV counseling, or 2) routine counseling besides communication skills building monthly sessions for six months. Pre and post-tests were taken at baseline and six months. We designed an intervention based on Information-Motivation-Behavior theory. Condom influence strategies were used in the construct of the questionnaire and intervention materials. Results: After six months participa...

Journal of Mazandaran University of Medical Sciences, 2019

Background and purpose: Normal amount of saliva is necessary for prevention of oral lesions, cari... more Background and purpose: Normal amount of saliva is necessary for prevention of oral lesions, caries, and proper speech. The purpose of this research was to study the salivary flow rate in HIV-1 seropositive attending Tehran Imam Khomeini Hospital. Materials and methods: A cross-sectional study was conducted in 50 individuals including 25 HIV-1 seropositive patients (case group) and 25 healthy people (control group) attending the Counseling Center for Behavioral Diseases in Tehran Imam Khomeini Hospital, Tehran. The saliva rate was measured during 10 min. The case and control groups were matched in terms of age, gender, history of smoking, and other drugs (p< 0.9). People with history of drug abuse, alcohol, and systemic diseases were excluded from the study. Data analysis was done in SPSS. Results: Salivary flow rate in controls and case group were 4.6±0.86 ml/min and 3.6±1.8 ml/min, respectively. In the case group, the salivary rate was significantly lower than that of the contr...

Journal of Family & Reproductive Health, 2018

Objective: Over the past years, the prevalence and the progression rate of HIV infection in Iran ... more Objective: Over the past years, the prevalence and the progression rate of HIV infection in Iran especially through high-risk sexual relationships have regrettably been reported at very high levels. This cross-sectional study tries to analyze stigma, mental health, and coping skills on risky behaviors in HIV-positive adults in Tehran- Iran. Materials and methods: This cross-sectional study was conducted on a sample of 450 HIV-positive adults. Participants completed a socio-demographic questionnaire, the General HealthQuestionnaire-28, the Berger HIV Stigma Scale as well as the Lazarus Ways of Coping Questionnaire (WOCQ). To analyze the data, the independent-samples t-test and Pearson Correlation were used. Results: The findings of this study revealed that mental health, stigma, and avoidance-escape coping mechanisms were correlated with risky behaviors (p ˂ 0.05).Furthermore, the amount of stigma among female individuals compared to men was reported at higher levels and mental healt...

The effects of an educational program based on the health belief model on information-motivation-skill-behavioral skills among women living with human immunodeficiency virus

BACKGROUND: Human immunodeficiency virus (HIV) is a kind of behavioral disease in that adopting b... more BACKGROUND: Human immunodeficiency virus (HIV) is a kind of behavioral disease in that adopting behavioral changes is the only way to control and stop the epidemic. The aim of this study is to investigate the effect of education base on the health belief model (HBM) on health-seeking behavior among HIV-positive women. MATERIALS AND METHODS: This study is a paralleled, randomized controlled clinical trial done with control group among HIV-positive women who were registered at the voluntary and counseling testing center of Imam Khomeini hospital in Tehran. Data were gathered by using information obtained from the Motivation-Skill-Behavior questionnaire and demographic data. The women were divided by permuted block and were randomized into two groups. Interventional group participated in six HBM educational classes and used routine counseling guidelines, but the control group used only routine counseling protocol. Data were collected before, immediately after, and 3 weeks after interfe...

Objective: We conducted the present study to investigate the potential effects of hormonal contra... more Objective: We conducted the present study to investigate the potential effects of hormonal contraception (HC) on disease progression in women living with HIV (WLWH). Methods: In a historical cohort study, the demographic, medical, and reproductive profiles of 50 women registered at a referral HIV clinic, receiving hormonal contraceptives, were selected and compared with a matched control group of female patients who had consistent condom use. Disease progression was monitored for nine months, considering the time of CD4 cell count below 200, the time of antiretroviral therapy initiation, HIV-RNA viral load, CD4+ T-cell count, and finally, death. Results and Discussion: The mean HIV-1-RNA plasma viral loads and mean CD4+ T-cell counts differed significantly in time points among patients using hormonal contraceptives, while no significant changes were observed among condom users. The mean age was 31.34 (21-51) years, and the meantime from diagnosis was four years. In pap smear result,...

HIV & AIDS Review, 2017

Introduction: Acquired immune deficiency syndrome (AIDS) is generally related to reproductive hea... more Introduction: Acquired immune deficiency syndrome (AIDS) is generally related to reproductive health and is most commonly transmitted through injection addiction, sexual relationship, pregnancy, and breastfeeding. Therefore, the promotion of reproductive health of women with human immunodeficiency virus (HIV) is very important. The aim of this study was to investigate the effect of counselling on cognitive-behavioural therapy (CBT) on reproductive health in women with HIV. Material and methods: This randomised controlled trial was conducted in 2017. Sixty HIV-infected women who referred to Imam Khomeini Hospital Consultation Centre for clients with risky behaviour in Tehran participated in this study. The sampling method was census, and samples were randomly assigned to two groups: control and intervention. In addition to routine care, the intervention group received seven cognitive-behavioural counselling sessions on reproductive health. The questionnaire used in this study was a reproductive health assessment scale for HIV-positive women. Results: There was no statistically significant difference between the demographic characteristics in the control and intervention groups. The result of repeated measures test showed that the length of time affects the total score of reproductive health (p < 0.000) and there was a significant difference between the two groups (p < 0.000). Conclusions: It is suggested that CBT counselling approaches be included in educational programs for the health of women with HIV. Given the widespread dimensions of reproductive health, counselling with a cognitive therapy approach in each dimension with the number of further sessions is suggested.

International Journal of Epidemiologic Research, 2017

Background and aims: Behavioral counseling centers are the main health organizations which are re... more Background and aims: Behavioral counseling centers are the main health organizations which are responsible for providing treatment and care for the patients living with HIV (PLWH). HIVpositive patients receive services through a unique counseling process called voluntary counseling and confidential testing (VCCT). Although there are reports regarding VCCT evaluation from other countries, not such an evaluation was found in Iran until this study, to the best of our knowledge. The study was performed to fulfill this necessity. Methods: Using consecutive method sampling, 314 subjects were sampled from the patients referred to Behavioral Counseling Center of Imam Khomeini hospital, Tehran, Iran. A combination of process and output evaluation of VCCT was performed in the biggest Behavioral Counseling Center of Iran at Imam Khomeini hospital, Tehran, Iran. Data were analyzed using descriptive statistics (percentages and averages). Results: Participants' response rate was 95.54%. Two shortcomings were found in the counseling process. Cronbach alpha reliability coefficient for this scale was 0.899, which was a desirable reliability for the questionnaire. As the main finding of the study, 48.33% of patients were not using antiretroviral medications regularly. An average number of patients (2.88) had HIV related stigma and fear of disclosure. In a quantitative study before testing in the study, it has been found that HIV patients did not have adequate information about their disease. Conclusion: Defects in the consultation process for the patients with HIV infection in the hospital were concluded. The quantity of consulting services for patients was in low level; therefore it is essential to improve consulting services for health promotion of the HIV patients.

HIV & AIDS Review, 2019

Introduction: The third wave of human immunodeficiency virus (HIV) is rising due to high-risk sex... more Introduction: The third wave of human immunodeficiency virus (HIV) is rising due to high-risk sexual behaviours in Iran. In spite of launching programs to combat HIV in Iran, condom use frequency has not yet reached the optimal level, especially in high-risk groups. The aim of this study was to assess the sexual protection behaviours and awareness among HIV-positive women. Material and methods: This descriptive study was performed on 100 HIV-positive women who referred to the Voluntary and Counselling Centre (VCT) in Tehran and were recruited using a purposive sampling method. Data collection was carried out using HIV/acquired immunodeficiency syndrome (AIDS) awareness and sexual protection behaviour questionnaires. Results: Condom use was practiced only by 22.2% in all their vaginal and anal sexual intercourse during the three months, and 77.8% of the women never used condoms or failed to use them continuously. Their sexual partners were HIV-positive in 71% of cases. The mean ± SD of awareness score about HIV/AIDS was 7.60 ± 3.31, indicating average awareness of the subjects in the study. A total of 49.1% of the participants stated that their sexual partners' reluctance was the most important reason for non-use of condoms, while women were not willing to use condoms in 18.2% of cases. Conclusions: The results of the present study indicated poor sexual protection behaviours in HIV-positive women. As a result, gender-based harm reduction programs to promote safe sexual behaviour, awareness level, and negotiation power for condom use in HIV-positive women is more important than ever.

Content Analysis of Teleconsultation Enquiries in Positive Health Club, Imam Khomeini Hospital, Tehran, Iran

Journal of Therapy and Management in HIV Infection, 2019

HIV & AIDS Review, 2019

Introduction: Health seeking behavior (HSB) is a highly important concept for assessment of healt... more Introduction: Health seeking behavior (HSB) is a highly important concept for assessment of health access and services. This study was performed to evaluate the validity and reliability of the Persian version of the Questionnaire of Health Seeking Behavior of women living with human immunodeficiency virus (HIV). Material and methods: After obtaining permission from the questionnaire author we started our study in April 2018. We used the forward-backward method according to World Health Organization guidelines. In the first stage, qualitative assessment for assessing face and content validity was done by using 10 experts' and 10 HIV-positive women's ideas during panel and quantitative assessment was done using the content validity ratio (CVR) and content validity index (CVI). Reliability assessment was done among 80 HIV women by Cronbach's α. We conducted a pre-test among 10 HIV-positive women to discover any possible problems or issues. Results: Internal reliability, and construct validity of the questionnaire were determined among expert and HIV-positive women participants. Overall internal reliability (Cronbach's α = 0.81) was high. SPSS 16 was used to analyze data, using analytical statistical methods including the χ 2 test. After considering the quality of validity and the content of comments, the values of all the items, such as the CVI 0.93 and CVR 0.97, were obtained. Conclusions: The results represented the validity and reliability of the Persian version of the questionnaire to estimate the HSB, and it is possible to use it as an assessment tool.

Evaluation of Acquired HIV Drug Resistance among People Living with HIV Who Have Taken Antiretroviral Therapy for 9–15 Months in 14 Triangular Clinics in Iran, 2015–2016

Intervirology, 2018

Aims: The aim of this study was to evaluate drug resistance patterns among Iranian people living ... more Aims: The aim of this study was to evaluate drug resistance patterns among Iranian people living with HIV who have taken antiretroviral therapy for 9–15 months. Methods: A cross-sectional study was conducted between December 2015 and May 2016. Two hundred fifty-two blood samples were collected from all eligible HIV-infected patients at fourteen healthcare settings, located in major provinces in Iran. The samples were examined for presence of drug resistance strains and viral load level. Moreover, a phylogenetic tree, using neighbor joining, was constructed and HIV subtypes were determined. Results: The most common subtypes were CRF35-AD (47.6%) and A1 (42.8%), followed by 45_CPX (4.8%) and C (4.8%). The resistance to non-nucleoside reverse transcriptase inhibitors (NNRTIs), nucleoside reverse transcriptase inhibitors (NRTIs), and protease inhibitors was reported as 19.2, 19.2, and 10.3%, respectively. M184I/V mutation was the most frequent (31.6%) mutation among NRTI-based regimens....

An Estimation of HIV/AIDS’s Cost in the Voluntary Counseling and Testing Center of Imam Khomeini Hospital in 2010-2011

Journal of Therapy and Management in HIV Infection, 2018

Drugs Side Effects in Pregnant Women Infected with HIV Referred to Imam Khomeini Hospital, Voluntary Counseling and Testing Center Tehran, Iran 2009 – 2013

Journal of Therapy and Management in HIV Infection, 2018

Acta medica Iranica, 2017

There are limited documents about HIV patients switched to second-line antiretroviral therapy (AR... more There are limited documents about HIV patients switched to second-line antiretroviral therapy (ART) in resource-limited countries. We aimed to assess the efficacy of second-line ART for HIV patients following first-line ART failure. This was a cohort study of HIV/AIDS patients with first-line ART treatment failure switched to second-line ART between January 2004 and March 2014, who followed for at least 12 months after switching. Fifty of studied patients (85%) were treated with regimens containing lopinavir/ritonavir (Kaletra) and nine of them (15%) treated with other regimes. Seven patients were experienced opportunistic infections in accordance with stage III and IV WHO classification. In this way, 11.8% of patients had aclinicalfailure, and 37 of them (62%) had immunological responses. Weight gain was evident in these patients, and there was a significant correlation between theincrease in CD4 and weight gain (P=0.007). Only 13 patients achieved HIV viral load testing that 6 of ...

Iranian journal of allergy, asthma, and immunology, 2016

Vaccines against the HIV-1 virus offers the best hope for eliminating HIV-associated mortality. R... more Vaccines against the HIV-1 virus offers the best hope for eliminating HIV-associated mortality. Recombinant adenovector type 5 (rAd5) vaccine is a potential candidate for preventive vaccine strategies. In this study, we evaluated the rAd5 prime/protein boost strategy in a murine model. We used rAd5 harboring single HIV-1 genes. These genes, including gag (p24) and exon1 of tat, were amplified from HIV-1 (clade A) RNA using nested PCR. Recombinant vectors were constructed, purified and then injected at 1012 viral particles into four groups, each comprising five mice. The groups were each assigned to receive one of rAd5 prime/protein boost Gag, Tat with and without recombinant granulocyte-macrophage colony-stimulating factor (rGM-CSF), and rAd5 with and without genes. The humoral responses were evaluated using ELISA and cellular immune responses checked by cell proliferation and ELISpot assays (IL-2, IL-4 and IFN-γ). It was shown that compared with the rAd5 injection alone, the rAd5 p...

Global Journal of Health Science, 2015

Background: The application of family planning methods to people with HIV not only prevents unwan... more Background: The application of family planning methods to people with HIV not only prevents unwanted pregnancy, but also leads to a reduction in the possibility of transmission of the virus from the patient to the sexual partner and the fetus. In order to prevent the spread of HIV and enhance reproductive rights, it is necessary to inform women with HIV of the contraception methods. Objective: The aim of this study was to explore experiences of HIV positive women about contraception use. Method: This qualitative study was conducted on 18 women with HIV who were at reproductive age and had referred the Center for clients with Risky Behavior in Imam Khomeini Hospital. Data were analyzed using the conventional content analysis method in MAXQDA 10. Results: The following two themes were derived from descriptions of the use of contraception methods by women with HIV: 1) Contraception is the forgotten component of reproductive health services; 2) inconsistent condom use. Each theme also contained three sub-themes. Conclusion: Results of investigations showed that Risky Behavior consultation Centers mostly stress the use of condom for husband/sexual partners without HIV. In addition, since health care practitioners play an important role in provision of reproductive health services, their lack of knowledge and cooperation considerably contribute to the spread of the disease and violation of patient rights.

World Journal of AIDS, 2014

Background: This study was undertaken to address the controversy regarding immunologic response t... more Background: This study was undertaken to address the controversy regarding immunologic response to combination antiretroviral therapy (cART) among older patients. Methods: In a crosssectional study all patients attending the HIV Clinic at Imam Khomeini Hospital (Tehran) from 2010 to 2011 were evaluated. Immunologic response was investigated using consecutive CD4+ T-cell counts in a one-year interval and outcomes were analyzed for older (>=50 yrs) and younger (<50 yrs) patients using SPSS version 16.0. Results: A total of 714 patients were actively enrolled in the clinic while 24 were 50 years or older, and had initiated ART; a similar random group of younger patients was selected as the control. Hepatitis C was the most prevalent co-infection in both groups. Patients with no serologic evidence of hepatitis B and C had significantly higher CD4+ T-cell counts than HIV/HBV co-infected patients after 12 months (p = 0.04). The average increased CD4+ T-cell counts in 6, 9, and 12 months of cART initiation were lower among older patients but the difference was not significant (50.75 vs. 123.08; p = 0.37, 132.87 vs. 710.58; p = 0.25, 271.27 vs. 500; p = 0.65). Conclusion: About 11% of the registered HIV-positive patients at our clinic were 50 years or older while their immunologic response to cART showed to be different. Specific needs of older HIV infected patients are highly recommended to be addressed in future treatment and care programs.