RISK FACTORS AND DETERMINANTS OF SEX TRADE BEHAVIOURS AMONG THE MALE HOMELESS POPULATION IN IRAN

Introduction: This study aimed to investigate sex- related behaviours and the risk factors for prostitution and its related variables among homeless men in Tehran. Material and methods: This cross-sectional study was performed on 247 homeless men (18-55 years old) living in temporary shelters in southeast Tehran between 2017 and 2018. Data were collected using a semi-structured interview containing demographic information, medical history and the level of exposure to prostitution. Data analysis was conducted by SPSS-22 using descriptive statistics, correlation analysis and multivariable regressions. Results: Participants had a mean age of 37.5 years. The mean duration of homelessness was 3.7 years. Most participants were single, had primary education and a history of imprisonment. The most common reason for prostitution was poverty especially considering the need to financially support addiction mostly to methamphetamine, heroin and cigarettes. We found a correlation between prostitution and risky sexual acts, substance abuse, psychological and mental health disorders and infection (p < 0.05). Discussion: As has also been shown in other studies, mental health issues and psychoactive substance abuse increase the risk for prostitution. Homelessness is associated with substance abuse and prostitution is a major source of income for homeless individuals. So mental disorders, substance abuse and homelessness form a vicious cycle that exacerbate one another and heighten the risks and prevalence of prostitution. Conclusions: Given the rice in homelessness rate and consequently prostitution, transmission of HIV/AIDS and hepatitis has increased. The provision of housing, job opportunities, social and medical support can protect the homeless from mental health disorders and drug abuse and the chance of risky sexual acts can be reduced.