Sexual and Reproductive Health Needs of HIV-Positive People in Tehran, Iran: A Mixed-Method Descriptive Study

Document Type : Original Article


1 School of Public Health and Institute of Public Health Research, Tehran University of Medical Sciences, Tehran, Iran

2 Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran

3 Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran

4 Obstetrics and Gynecologist, Shahid Beheshti Hospital, Isfahan University of Medical Sciences, Isfahan, Iran

5 Department of Midwifery and Reproductive Health, Nursing and Midwifery School, Shahid Beheshti University of Medical Sciences, Tehran, Iran

6 Department of Maternal and Child Health, Nursing and Midwifery School, Tehran University of Medical Sciences, Tehran, Iran

7 Regional Support Team for the Middle East and North Africa (RST-MENA), Cairo, Egypt

8 Iranian Research Center for HIV and AIDS, Tehran University of Medical Sciences, Tehran, Iran

9 Centre for Infectious Disease Control, Ministry of Health and Medical Education, Tehran, Iran


People Living with HIV (PLHIV) are highly stigmatized and consequently hard-to-access by researchers and importantly, public health outreach in Iran, possibly due to the existing socio-cultural situation in this country. The present study aimed to evaluate the sexual and reproductive health needs of PLHIV in Tehran, the capital of Iran.
As a mixed-method descriptive study, this project was conducted in 2012 in Tehran, Iran. In this study, we evaluated and discussed socio-demographic characteristics, family and social support, sexual behaviors, fertility desires and needs, PMTCT services, contraceptive methods, unintended pregnancy and safe abortion, and Pap smear tests among 400 participants referring to the behavioral disorders consulting centers.
Of the sample 240 (60%) were male and 160 (40%) were female. About 50% of women and 40% of men were 25-34 years old. More than 60% of men and 96% of women were married, while more than 50% of the participants had HIV-positive spouses at the time of study. According to the results, fertility desire was observed among more than 30% of female and 40% of male participants. Results of the in-depth interviews indicate that the participants are not satisfied with most of the existing services offered to address their sexual and reproductive health needs.
Despite the availability of services, most of sexual and reproductive health needs of the PLHIV are overlooked by the health system in Iran. Paying attention to sexual and reproductive health needs of PLHIV in Iran not only protects their right to live long and healthy lives, but also may prevent the transmission of HIV from the patients to others within the community.


Main Subjects


    1. Baryamutuma R, Baingana F. Sexual, reproductive health needs and rights of young people with perinatally Acquired HIV in Uganda. African Health Sciences 2011; 11: 211-8. 
    2. United Nations Program on HIV/AIDS (UNAIDS). AIDS by the number [internet].  [cited 2014]. Available from:      unaidspublication/2013/JC2571_AIDS_by_the_numbers_en.pdf
    3. United Nations Program on HIV/AIDS (UNAIDS). UNAIDS report on the global AIDS epidemic 2013.   [cited 2014]. Available from:      2013/gr2013/UNAIDS_Global_Report_2013_en.pdf
    4. Samji H, Cescon A, Hogg RS, Modur SP, Althoff KN, Buchacz K, et al. Closing the gap: increases in life expectancy among treated HIV-positive individuals in the United States and Canada. PLoS One 2013; 8: e81355.  doi: 10.1371/journal.pone.0081355
    5. Pearson CR, Cassels S, Kurth AE, Montoya P, Micek MA, Gloyd SS. Change in sexual activity 12 months after ART initiation among HIV-positive Mozambicans. AIDS Behav 2011; 15: 778-87.  doi: 10.1007/s10461-010-9852-3
    6. Dessie Y, Deresa M. Sexual practices of HIV-positive individuals attending antiretroviral treatment (ART) in Addis Ababa public hospitals: findings from in-depth interview. Pan Afr Med J 2012; 13: 80. 
    7. health Imo. Evaluation of the HIV positive patients and ART in young adults and adults.  2014. Available from:      _evaluation_final_930530_196629.pdf
    8. United Nations Program on HIV/AIDS (UNAIDS). Islamic Republic of Iran.   [2014]. Available from:            countries/islamicrepublicofiran/
    9. UN General Assembly Special Sessions (UNGASS). Islamic Republic of Iran AIDS Progress Report.  2014. Available from:      countryprogressreports/2014countries/IRN_narrative_report_2014_en.pdf
    10. United Nations Program on HIV/AIDS (UNAIDS). The Gap Report 2014. Available from:      documents/unaidspublication/2014/UNAIDS_Gap_report_en.pdf
    11. Ahmadi K, Rezazade M, Nafarie M, Moazen B, Yarmohmmadi Vasel M, Assari S. Unprotected Sex with Injecting Drug Users among Iranian Female Sex Workers: Unhide HIV Risk Study. AIDS Res Treat 2012; 2012: 651070.  doi: 10.1155/2012/651070
    12. Mirabi P, Vasel MY, Moazen B, Sehat M, Rezazadeh M, Ahmadi K. Unprotected anal Intercourse among Iranian Intra-Venous Drug Users. Front Public Health 2013; 1: 34.  doi: 10.3389/fpubh.2013.00034
    13. Sajadi L, Mirzazadeh A, Navadeh S, Osooli M, Khajehkazemi R, Gouya MM, et al. HIV prevalence and related risk behaviours among female sex workers in Iran: results of the national biobehavioural survey, 2010. Sexually Transmitted Infections 2013; 89: iii37-40.  doi: 10.1136/sextrans-2013-051028
    14. Zadeh AO, SeyedAlinaghi S, Hassanzad FF, Hajizadeh M, Mohamadi S, Emamzadeh-Fard S, et al. Prevalence of HIV infection and the correlates among homeless in Tehran, Iran. Asian Pac J Trop Biomed 2014; 4: 65-8.  doi: 10.1016/s2221-1691(14)60210-0
    15. Mohammadi-Moein HR, Maracy MR, Tayeri K. Life expectancy after HIV diagnosis based on data from the counseling center for behavioral diseases. J Res Med Sci 2013; 18: 1040-5. 
    16. Rezaei-Soufi L, Davoodi P, Abdolsamadi HR, Jazaeri M, Malekzadeh H. Dental caries prevalence in human immunodeficiency virus infected patients receiving highly active anti-retroviral therapy in kermanshah, iran. Cell J 2014; 16: 73-8. 
    17. Abdollahi A, Mohraz M, Rasoulinejad M, Shariati M, Kheirandish P, Abdollahi M, et al. Retinitis due to opportunistic infections in Iranian HIV infected patients. Acta Med Iran 2013; 51: 711-4. 
    18. Alavi SM, Jamshidian R, Salmanzadeh S. Comparative study on toxoplasma serology among HIV positive and HIV negative illicit drug users in Ahvaz, Iran. Caspian J Intern Med 2013; 4: 781-4. 
    19. Arbabi M, Fakhrieh Z, Delavari M, Abdoli A. Prevalence of Trichomonas vaginalis infection in Kashan city, Iran (2012-2013). Iran J Reprod Med 2014; 12: 507-12. 
    20. Farnam F, Janghorbani M, Raisi F, Merghati-Khoei E. Compare the effectiveness of PLISSIT and sexual health models on women's sexual problems in Tehran, Iran: a randomized controlled trial. J Sex Med 2014; 11: 2679-89.  doi: 10.1111/jsm.12659
    21. Hajiaghababaei M, Javidan AN, Saberi H, Khoei EM, Khalifa DA, Koenig HG, et al. Female sexual dysfunction in patients with spinal cord injury: a study from Iran. Spinal Cord 2014; 52: 646-9.  doi: 10.1038/sc.2014.99
    22. Jafari F, Noori R, Moazen B, Khoddami-Vishteh H-R, Narenjiha H, Mirabi P. Perceived sexual satisfaction among women with drug-dependent husbands in Iran. Journal of Substance Use 2014; 19: 416-20.  doi: 10.3109/14659891.2013.840685
    23. Kahler CW, Wray TB, Pantalone DW, Kruis RD, Mastroleo NR, Monti PM, et al. Daily Associations Between Alcohol Use and Unprotected Anal Sex Among Heavy Drinking HIV-Positive Men Who Have Sex with Men. AIDS Behav 2014.  doi: 10.1007/s10461-014-0896-7
    24. Wilson PA, Stadler G, Boone MR, Bolger N. Fluctuations in depression and well-being are associated with sexual risk episodes among HIV-positive men. Health Psychol 2014; 33: 681-5.  doi: 10.1037/a0035405
    25. Blashill AJ, Wilson JM, O'Cleirigh CM, Mayer KH, Safren SA. Examining the correspondence between relationship identity and actual sexual risk behavior among HIV-positive men who have sex with men. Arch Sex Behav 2014; 43: 129-37.  doi: 10.1007/s10508-013-0209-7
    26. Fields EL, Bogart LM, Galvan FH, Wagner GJ, Klein DJ, Schuster MA. Association of discrimination-related trauma with sexual risk among HIV-positive African American men who have sex with men. Am J Public Health 2013; 103: 875-80.  doi: 10.2105/ajph.2012.300951
    27. Read JS, Newell MK. Efficacy and safety of cesarean delivery for prevention of mother-to-child transmission of HIV-1. Cochrane Database Syst Rev 2005: CD005479.  doi: 10.1002/14651858.cd005479
    28. Office of the High Commissioner for Human Rights (OHCHR). HIV/AIDS and human rights. Available from:
    29. United Nations Program on HIV/AIDS (UNAIDS). Islamic republic of Iran NCPI report. Available from:       Iran%2C%20Islamic%20RepublicofNCPI2012.pdf
    30. Mantell JE, Smit JA, Stein ZA. The right to choose parenthood among HIV-infected women and men. J Public Health Policy 2009; 30: 367-78.  doi: 10.1057/jphp.2009.35
    31. Moodley J, Cooper D, Mantell JE, Stern E. Health care provider perspectives on pregnancy and parenting in HIV-positive individuals in South Africa. BMC Health Serv Res 2014; 14: 384.  doi: 10.1186/1472-6963-14-384