Why Has HIV/AIDS Prevalence Increased in Iran?

To the Editor—AIDS is a syndrome caused by the human immunodeficiency virus (HIV). AIDS occurs in late-stage HIV infection, when a person's CD4 cell count drops below 200 cells/μL of blood and the body can no longer defend itself. Although there is currently no cure for AIDS, with early diagnosis and effective antiretroviral treatment and support, people can have a long, normal, healthy life with HIV. The most common way to transmit HIV is by having sex without a condom. HIV can also be transmitted through infected drug-taking equipment (blood transmission) or from mother to child, but not by sweat, saliva, or urine [1]. Black Americans make up only 12% of the US population but account for 41% of all HIV-infected persons. The Centers for Disease Control and Prevention (CDC) reported that the mortality rates of HIV-infected black Americans decreased by 28% between 2008 and 2012. According to new data released from the World Health Organization (WHO) and the United Nations Children's Fund, the number of babies born with HIV in Latin America and the Caribbean diminished by 78% during 2001–2013. The National HIV/AIDS Strategy has decreased the rates of HIV prevalence and transmission in the United States from 2010 to 2015 by 11% and 17%, respectively. According to a new report by the CDC, the average number of transmissions per 100 people living with HIV (transmission rate) fell from 3.16 to 2.61 in the United States over the last 5 years.

In Iran, unlike the US, HIV is most commonly transmitted among injecting drug users [2]. Based on the statistics analysis, it is estimated that more than 20 thousand of Iranian people are infected with HIV [2]. The most important reason is that due to sociocultural facts, AIDS in Iran is considered a negative phenomenon; HIV-infected people in Iran have not been seen in an accepted manner and thus hide their disease from others, increasing the transmission possibility of HIV. Failure to expand diagnostic, prevention, and care services would result in underachievement on decreasing the number of HIV-infected Iranian people. Furthermore, Iranians who are living with HIV are often unaware of their status. HIV testing uptake and linkage to care are critical to reduce new HIV infections and increase people's awareness of their HIV status [2]. Face-to-face interaction and social networking strategies have been found to be a more impressive and cost-effective method of engaging people in HIV testing, but due to sociocultural facts, Iranians ignore this method [3]. Another problem is the number of checkups for HIV that Iranian pregnant women undergo during pregnancy. WHO recommends 4 or more checkups for HIV. Rural and poor Iranian pregnant women often do not receive even one checkup. Therefore the prevalence of HIV/AIDS has increased in Iran.

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Potential conflict of interest. Both authors: No reported conflicts. Both authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.