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      Lifetime and past‐month alcohol use and related factors among female sex workers in Iran

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          Abstract

          Objective

          Alcohol use is more common among female sex workers (FSWs). This study assessed the prevalence of lifetime and past‐month alcohol use and related factors among FSWs in Iran.

          Methods

          We conducted a cross‐sectional survey among 1464 women from 8 major cities in Iran. Behavioral data were collected by trained interviewers and conducted face‐to‐face in a private room. Weighted analysis was used to determine the lifetime and past‐month alcohol use prevalence. Univariate and multivariate logistic regression was used to investigate the association between alcohol use and independent variables.

          Results

          The most alcohol used in lifetime and past‐month (weekly, less than once a week, and daily) in FSWs was 52.7% (12.25%, 12.94%, and 1.83%), respectively. In the final model, factors that were independently associated with alcohol use included the 31–40 years (AOR = 2.41, 95% CI: 1.13–5.15), education level of diploma (AOR = 2.43, 95% CI: 1.31–4.51), history of lifetime drug use (AOR = 2.79, 95% CI: 2.01–3.89), history of lifetime group sex (AOR = 2.07, 95% CI: 1.41–3.03), history of intentional abortion (AOR = 1.42, 95% CI: 1.06–1.92), six or more sexual clients in the last month (AOR = 3.25, 95% CI: 1.80–5.87), history of lifetime anal sex (AOR = 2.47, 95% CI: 1.82‐3.35), and FSWs the married, temporarily married, and living with partner were positively associated with lifetime alcohol use.

          Conclusion

          Alcohol use is prevalent among FSWs in Iran. Further prevention programs are needed to address and reduce harms associated with alcohol use among this vulnerable population in Iran. Designing intervention programs, it is suggested to consider other variables affecting alcohol use in FSWs.

          Abstract

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          Most cited references46

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          The global burden of disease attributable to alcohol and drug use in 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016

          Summary Background Alcohol and drug use can have negative consequences on the health, economy, productivity, and social aspects of communities. We aimed to use data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 to calculate global and regional estimates of the prevalence of alcohol, amphetamine, cannabis, cocaine, and opioid dependence, and to estimate global disease burden attributable to alcohol and drug use between 1990 and 2016, and for 195 countries and territories within 21 regions, and within seven super-regions. We also aimed to examine the association between disease burden and Socio-demographic Index (SDI) quintiles. Methods We searched PubMed, EMBASE, and PsycINFO databases for original epidemiological studies on alcohol and drug use published between Jan 1, 1980, and Sept 7, 2016, with out language restrictions, and used DisMod-MR 2.1, a Bayesian meta-regression tool, to estimate population-level prevalence of substance use disorders. We combined these estimates with disability weights to calculate years of life lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs) for 1990–2016. We also used a comparative assessment approach to estimate burden attributable to alcohol and drug use as risk factors for other health outcomes. Findings Globally, alcohol use disorders were the most prevalent of all substance use disorders, with 100·4 million estimated cases in 2016 (age-standardised prevalence 1320·8 cases per 100 000 people, 95% uncertainty interval [95% UI] 1181·2–1468·0). The most common drug use disorders were cannabis dependence (22·1 million cases; age-standardised prevalence 289·7 cases per 100 000 people, 95% UI 248·9–339·1) and opioid dependence (26·8 million cases; age-standardised prevalence 353·0 cases per 100 000 people, 309·9–405·9). Globally, in 2016, 99·2 million DALYs (95% UI 88·3–111·2) and 4·2% of all DALYs (3·7–4·6) were attributable to alcohol use, and 31·8 million DALYs (27·4–36·6) and 1·3% of all DALYs (1·2–1·5) were attributable to drug use as a risk factor. The burden of disease attributable to alcohol and drug use varied substantially across geographical locations, and much of this burden was due to the effect of substance use on other health outcomes. Contrasting patterns were observed for the association between total alcohol and drug-attributable burden and SDI: alcohol-attributable burden was highest in countries with a low SDI and middle-high middle SDI, whereas the burden due to drugs increased with higher S DI level. Interpretation Alcohol and drug use are important contributors to global disease burden. Effective interventions should be scaled up to prevent and reduce substance use disease burden. Funding Bill & Melinda Gates Foundation and Australian National Health and Medical Research Council.
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            Global burden of disease and injury and economic cost attributable to alcohol use and alcohol-use disorders.

            Alcohol consumption has been identified as an important risk factor for chronic disease and injury. In the first paper in this Series, we quantify the burden of mortality and disease attributable to alcohol, both globally and for ten large countries. We assess alcohol exposure and prevalence of alcohol-use disorders on the basis of reviews of published work. After identification of other major disease categories causally linked to alcohol, we estimate attributable fractions by sex, age, and WHO region. Additionally, we compare social costs of alcohol in selected countries. The net effect of alcohol consumption on health is detrimental, with an estimated 3.8% of all global deaths and 4.6% of global disability-adjusted life-years attributable to alcohol. Disease burden is closely related to average volume of alcohol consumption, and, for every unit of exposure, is strongest in poor people and in those who are marginalised from society. The costs associated with alcohol amount to more than 1% of the gross national product in high-income and middle-income countries, with the costs of social harm constituting a major proportion in addition to health costs. Overall, we conclude that alcohol consumption is one of the major avoidable risk factors, and actions to reduce burden and costs associated with alcohol should be urgently increased.
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              The Risks Associated With Alcohol Use and Alcoholism

              Alcohol consumption, particularly heavier drinking, is an important risk factor for many health problems and, thus, is a major contributor to the global burden of disease. In fact, alcohol is a necessary underlying cause for more than 30 conditions and a contributing factor to many more. The most common disease categories that are entirely or partly caused by alcohol consumption include infectious diseases, cancer, diabetes, neuropsychiatric diseases (including alcohol use disorders), cardiovascular disease, liver and pancreas disease, and unintentional and intentional injury. Knowledge of these disease risks has helped in the development of low-risk drinking guidelines. In addition to these disease risks that affect the drinker, alcohol consumption also can affect the health of others and cause social harm both to the drinker and to others, adding to the overall cost associated with alcohol consumption. These findings underscore the need to develop effective prevention efforts to reduce the pain and suffering, and the associated costs, resulting from excessive alcohol use.
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                Author and article information

                Contributors
                Moradi_gh@yahoo.com
                Journal
                Brain Behav
                Brain Behav
                10.1002/(ISSN)2157-9032
                BRB3
                Brain and Behavior
                John Wiley and Sons Inc. (Hoboken )
                2162-3279
                23 October 2023
                December 2023
                : 13
                : 12 ( doiID: 10.1002/brb3.v13.12 )
                : e3288
                Affiliations
                [ 1 ] Department of Epidemiology and Biostatistics Faculty of Medicine, Kurdistan University of Medical Sciences Sanandaj Iran
                [ 2 ] Department of Epidemiology, School of Public Health Hamadan University of Medical Sciences Hamadan Iran
                [ 3 ] Iranian Center for Communicable Disease Control Ministry of Health and Medical Education Tehran Iran
                [ 4 ] School of Public Health and Saftey Shahid Beheshti University of Medical Sciences Tehran Iran
                [ 5 ] Social Determinants of Health Research Center, Research Institute for Health Development Kurdistan University of Medical Sciences Sanandaj Iran
                Author notes
                [*] [* ] Correspondence

                Ghobad Moradi, Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran. Email: Moradi_gh@ 123456yahoo.com

                Author information
                https://orcid.org/0000-0003-3359-774X
                https://orcid.org/0000-0003-2612-6528
                Article
                BRB33288
                10.1002/brb3.3288
                10726872
                37872677
                1b43d050-bcf3-4655-98e5-4d8e35fec6bf
                © 2023 The Authors. Brain and Behavior published by Wiley Periodicals LLC.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 07 August 2023
                : 01 April 2023
                : 06 October 2023
                Page count
                Figures: 2, Tables: 3, Pages: 11, Words: 7431
                Funding
                Funded by: Vice‐Chancellor, Research and Technology of Kurdistan University of Medical Sciences, Sanandaj, Iran
                Categories
                Original Article
                Original Articles
                Custom metadata
                2.0
                December 2023
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.3.6 mode:remove_FC converted:18.12.2023

                Neurosciences
                alcohol,female sex workers,high risk behaviors,iran
                Neurosciences
                alcohol, female sex workers, high risk behaviors, iran

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