Economic disparity associated with receptive syringe sharing in people who inject drugs in Tehran: Blinder-Oaxaca Decomposition Analysis

Background: The present study aimed to describe the socioeconomic inequality associated with receptive syringe sharing in people who inject drugs (PWID) in Tehran city, the capital of Iran.Methods: This cross-sectional study was conducted in 2016-2017. By snowball sampling, we recruited 520 PWID from street venues and two Drop-in Centers in Tehran. Using principle component analysis, the socioeconomic status (SES) of participants was categorized to low and high. The determinants of inequality in receptive syringe sharing were assessed by the Oaxaca-Blinder decomposition and a logistic regression analysis; Adjusted Odds Ratio (AOR) was reported as the effect size. Result: Median age was 32 years (IQR: 24 tot 38), All of PWID were male, and 64.0% had low SES. The prevalence of receptive sharing was 12.8% in low SES and 22.38% in high SES (p-value=0.01). Receptive syringe sharing was significantly associated with low SES (AOR: 1.97, CI95% 1.78-2.18), low HIV knowledge (AOR: 1.32, 95%CI 1.25-1.41) and access to needle and syringe programs (AOR=0.65, 95%CI 0.60-0.70).Conclusion: Receptive syringe sharing is high, particularly among PWID with low socioeconomic status. In addition to economic status, low access to needle and syringe programs and low HIV knowledge explained a major part of inequalities in receptive syringe sharing among PWID.