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Korean Journal of Epidemiology 2017;e2017049.
DOI: https://doi.org/10.4178/epih.e2017049    [Accepted] Published online November 5, 2017.
Decomposing Economic Disparities in Risky Sexual Behaviors among People Who Inject Drugs in Tehran: Blinder-Oaxaca Decomposition Analysis
Mehdi Noroozi1  , Hamid Sharifi2  , Alireza Noroozi3,4  , Fatemah Rezaei5  , Mohammad Rafi Bazrafshan6  , Bahram Armoon7 
1Social Determinants of Health Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
2HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
3Psychiatrist, Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran
4Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
5Department of Social Medicine, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
6Department of Nursing, School of Nursing, Larestan University of Medical Sciences, Larestan, Iran
7Student Research Committee, School of Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Correspondence  Bahram Armoon ,Tel: 09104973781, Fax: 0212242043, Email: bahramarmun@gmail.com
Submitted: September 18, 2017  Accepted after revision: November 5, 2017
Abstract
Objectives:
To our knowledge, no study yet has assessed systematically the role of economic status on risky sexual behavior among people who inject drugs(PWID) in Iran. In this study,we used a Blinder–Oaxaca (BO)decomposition to explore the relative contributions of inequality in unprotected sex and to decompose it to its determinants among PWID in Tehran.
Method:
Behavioral surveys among PWID were conducted in Tehran the capital city of Iran from November 2016 to April 2017. We employed a cross-sectional design and snowball sampling methodology. We constructed the asset index (weighted by the first PCA factor) using socioeconomic data and then divided the variable into three tertiles. we used Blinder– Oaxaca (BO) method to decompose the economic inequality in unprotected sex.
Results:
Out of the 520 recruited individuals, 20 persons had missing data on variables used to define the economic status and so were excluded form analysis. in terms of increasing the likelihood of the unprotected sex, compared to high economic subgroup (OR = 2.7), which led to an increase of the low–high disparity by 5.5 pp (i.e., the largest “share” of 21.4% ). The “share” of the constant term indicates that out of the unadjusted total low–high disparity in unprotected sex, 52% was still unexplained by observable characteristics included in the regression model. In terms of unprotected sex, the difference between high- and low-economic groups was 25%.
Conclusion:
Increasing NSP coverage and HIV knowledge might be essential to efforts to eliminate inequalities in HIV risk behaviors among PWID.
Keywords: Risky Sexual; Blinder-Oaxaca; Economic; Decomposing
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