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IRAN

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Tehran. Area: 18637 sq.km. Population: 10343965 (persons) HIV/AIDS ... Placed in west health center of Tehran. VCT has been offered from 2002. free of cost ... – PowerPoint PPT presentation

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Title: IRAN


1
IRAN
2
Country information
  • Population 71,368,000
  • Male female ratio 1.031
  • Literate three-fourth ( 72)
  • Unemployed a fourth ( 25) of countrys
    population
  • Life expectancy at birth 70 years
  • Languages Persian
  • Age structure Two- thirds are under
    30 years
  • Half of the population under the
    age 20

3
Capital city
  • Tehran
  • Area 18637 sq.km Population 10343965
    (persons)

4
HIV/AIDS Situation in Iran
  • first case 1986 (a hemophilic 7 years old boy)
  • Nationally, more than two third (66) of all
    reported cases are among injection drug
    users(IDU).
  • 62 between ages of 25-44

5
  • HIV/AIDS - adult prevalence rate
  • low less than 0.1
  • Estimated HIV Infected 20,000
  • Notified HIV/AIDS Cases (1986-2002) 4424
  • 95.5 of cases are male

6
Consultant clinic
  • Placed in west health center of Tehran
  • VCT has been offered from 2002
  • free of cost
  • Anonymously
  • voluntary post-test
  • pre-test and counseling

7
People who attend value
  • The anonymity
  • convenience of the site
  • PLWHA support groups
  • Free of cost services
  • Being welcomed by healthcare personnel
  • Youth-friendliness of VCT services
  • Being placed within a primary-health-care clinic

8
Factors with a negative impact on the decision
to attend VCT included
  • The perception that one would not be able to cope
    with a positive test result and would be too
    disturbed to continue normal life or would commit
    suicide
  • The belief that being HIV-positive is equivalent
    to having AIDS and being near death
  • The belief that one would die sooner if ones
    HIV-positive status were confirmed
  • The belief that one is not vulnerable to HIV
    infection despite risky sexual behavior
  • Fear of rejection by family and friends, and of
    discrimination and stigmatization

9
Other Problems
  • Number of VCT service is small
  • Stigma around HIV is still high
  • Community must be prepared to accept and use such
    services
  • Testing is not performed in the clinics and test
    results came back from the laboratory a week or
    more after testing
  • Still more men than women are seen, reflecting
  • Referral system is weak

10
  • Encouraging behavior change is further
    complicated by a lack of services and widespread
    poverty through most of the client
  • Not all doctors, nurses and health workers were
    knowledgeable about HIV/AIDS
  • VCT interventions are costly and require
    infrastructure support and trained personnel that
    may be unsustainable, nor can such
    labor-intensive techniques achieve broad
    population coverage

11
Suggestion
  • Train HIV-positive people to speak publicly about
    their HIV status
  • A more efficient approach is to find cases in
    settings where PLWHA are concentrated
  • Establish the feasibility and acceptability of
    rapid on-site testing
  • Access to partner and pre-marital counseling and
    testing for young couples

12
More suggestion for providing youth friendly
services
  • a. Clear national policies to address the minimum
    age of VCT service use without parental consent.
  • b. Youth-oriented advertisement and promotion of
    services
  • c. Youth-friendly counseling and referral to
    other health and psychosocial support services
  • d. access to particularly vulnerable young people
    (out-of-school and street children).
  • e. Peer education The young HIV-positive
    outreach educators
  • f. Young people who test positive need help in
    coping with their status, including disclosure to
    their families and sexual partner/s.

13
And still more suggestion
  • Identify and effectively target relevant
    audiences
  • Collect qualitative data on psychosocial and
    cultural factors influencing attitudes and
    behavior in target populations, and identify key
    themes and behavior change goals
  • The referral systems between clinic, community
    and district hospitals need to be strengthened
  • Integration of VCT services in HIV/AIDS/STI/TB
    care and referral ensure continuity of care
  • Not limiting some services (STI, TB or MMT) to
    specific days of the week by different doctors
    and different nurses
  • Counselors need mental support because they have
    the difficult task of counseling and are under
    extreme emotional pressure This meant that
    patients who attended the HIV clinic dont had to
    come back on another day if they were on TB
    treatment, or STI or drug use .

14
And some more
  • Technical and financial support is needed to
    improve quality and coverage of VCT services
  • Training and support to religious leaders and
    Islamic health professionals so that they can
    effectively support AIDS prevention and education
    activities in their communities in ways that are
    consistent with Islamic teachings.
  • Expansion of prevention and care services to
    rural areas and under-served low socio-economic
    neighborhoods in urban areas, and for young
    people in both urban and rural areas.
  • Expanded community based care linking clinical
    services with home-based care.
  • Establish protocols to evaluate impact and
    provide feedback for programmatic activities.
  • Disseminate lessons learned upon project
    completion.
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