Abstract
Despite the effectiveness of pre-exposure prophylaxis (PrEP) in reducing HIV incidence, this intervention is inaccessible in Iran. We examined the interest in using PrEP and associated factors among people who inject drugs (PWID) in 2023 using data from 2,174 PWID. The main outcome was interest in using PrEP, which was divided into three categories: interest in using PrEP under any circumstances, interest in using PrEP if provided for free, and no interest in using PrEP. We found that 37.9% of PWID were interested in using PrEP under any circumstances, 48.3% were interested in using PrEP if provided for free, and 13.8% were not interested in using PrEP. Additionally, only 7.7% of participants reported prior awareness of PrEP. Having high school or more education (adjusted relative risk ratios [ARRR]: 1.92; 95% confidence interval [CI]: 1.42, 2.61), having access to opioid agonist treatment (OAT) in the last six months (ARRR: 1.59; 1.13, 2.25), and having sufficient HIV knowledge (ARRR: 2.87; 2.03, 4.06) were positively associated with interest in using PrEP under any circumstances. Similarly, having high school or more education (ARRR: 1.50; 1.10, 2.04), having access to OAT in the last six months (ARRR: 2.63; 1.88, 3.67), and having sufficient HIV knowledge (ARRR: 4.53; 3.23, 6.37) were associated with interest in using PrEP if provided for free. Health insurance was negatively associated with interest in using PrEP under any circumstances (ARRR: 0.64; 0.47, 0.87) and with interest in using PrEP if provided for free (ARRR: 0.33; 0.23, 0.45). The findings show a strong potential for PrEP acceptance, indicating that addressing financial and logistical barriers to free PrEP access could greatly reduce HIV incidence among PWID in Iran.
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Data availability
All data generated or analyzed during this study are included in this published article.
Abbreviations
- PrEP:
-
Pre-exposure prophylaxis
- WHO:
-
World Health Organization
- PWID:
-
People who inject drugs
- RDS:
-
Respondent-driven sampling
- RRR:
-
Crude relative risk ratios
- ARRR:
-
Adjusted relative risk ratios
- OAT:
-
Opioid agonist treatment
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Funding
This study was supported by the Kerman University of Medical Sciences (Grant number: IR.KMU.REC.1401.216).
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H.Mo: Conducted the formal analysis, contributed to study design, and drafted the original manuscript. S.M., F.T, M.B, N.N, H.Mi., N.S., M.R. & M.Kh.: Contributed to data acquisition, study design, and manuscript review.A.H, A.M., W.M., & M.Ka: Conceptualized the study, contributed to study design and analysis plan, data interpretation, and critically revised the manuscriptH.S: Conceptualized and supervised the study, contributed to study design and data interpretation, and critically revised the manuscript. All authors read and approved the final manuscript.
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The Ethics committee of Kerman University of Medical Sciences approved the study protocol (Ethics code: IR.KMU.REC.1401.443).
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Moameri, H., Mehmandoost, S., Tavakoli, F. et al. Interest in HIV pre-exposure prophylaxis use and associated factors among people who inject drugs in Iran: a nationwide survey in 2023. Sci Rep (2026). https://doi.org/10.1038/s41598-026-36329-0
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DOI: https://doi.org/10.1038/s41598-026-36329-0
