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Epidemiol Health System J. 2026;13(1): 16-21.
doi: 10.34172/ehsj.26367
  Abstract View: 2
  PDF Download: 2

Original Article

Estimating the Prevalence of People Injecting Drugs at Ages 18-45 in Shiraz, Iran: The Use of a Network Scale-Up Approach

Ahmad Maghsoudi 1,2 ORCID logo, Mohammad Reza Baneshi 3 ORCID logo, Jafar Hassanzadeh 4* ORCID logo

1 Social Determinants of Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences. Kerman, Iran
2 Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
3 Center for Longitudinal and Life Course Research, Faculty of Medicine, School of Public Health, University of Queensland, Queensland, Australia
4 Department of Epidemiology, School of Health, Institute of Health, Research Center for Health Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
*Corresponding Author: Jafar Hassanzadeh, Email: jhassanzadeh.sums@gmail.com

Abstract

Background and aims: Accurate estimation of populations at heightened risk for Human Immunodeficiency Virus (HIV) infection is essential for effective healthcare intervention planning and resource allocation. This study employed the network scale-up method to estimate the prevalence of People Who Inject Drugs (PWIDs) aged 18-45 in Shiraz, Iran.

Methods: A purposive sampling approach was used to recruit 768 individuals aged 18-45, who were interviewed using a self-administered questionnaire. The average social network size was estimated using 16 reference groups with known population frequencies. Post-correction factors were applied to adjust for transmission and relative network-size errors. Data were analyzed using SPSS version 25.

Results: The mean reported social network size was 203 individuals. The crude estimate of PWIDs in the target age group was 1,812, while the adjusted estimate was 4,857 (95% UI: 4,231-5,483). The prevalence of PWIDs was estimated at 561 (95% UI: 488-633) per 100,000 individuals, with the highest prevalence observed among those aged 35-39 years.

Conclusion: The estimated number of PWIDs significantly exceeds the current number of individuals receiving support from harm-reduction services. To effectively combat the spread of HIV, enhancing access to prevention and treatment services for this population is crucial.


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Submitted: 17 Feb 2025
Revision: 06 Jan 2026
Accepted: 07 Jan 2026
ePublished: 29 Jun 2026
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