fardad doroudi

 HIV/AIDS-related stigma and discrimination are among the main barriers to controlling the HIV epidemic. Discriminatory behavior in healthcare settings deprives people of accessing high-quality health services.

 This study presents the design, development, and pilot study of a novel web-based application (“REDXIR”), which is designed based on behavioral and gamification principles and aims to eliminate HIV/AIDS-related discriminatory behavior among health professions students. REDXIR storyline is set in an imaginary world where the students' journey is like a 10-level game, in which each level consists of several missions with a certain amount of score. The participants have to accomplish the mission to reach the minimum amount of score to pass each level. Finally, each becomes an individual who has not only the knowledge but also the competency to educate and advocate appropriately in the field.

 The pilot was done in six medical sciences universities in Tehran, Iran. The feasibility of the instructional design, specifically gamification strategies in the field of HIV education, and the executive functions to run the program on a bigger scale were evaluated. In total, 241 students were included and performed 1952 missions. The program evaluation showed a mean satisfaction score of 4.16 (from 1, the lowest, to 5, the highest) and participants considered their learning practical and gamification method appropriate for HIV education.

 A meaningful gamification design for an online medical education program could be a suitable, functional, and applicable learning model to reduce HIV/AIDS stigma and discrimination among health professions students.

Although the HIV pandemic is witnessing a decline in the number of new infections in most regions of the world, the Middle East and North Africa (MENA) has a rapidly growing HIV problem. While generating HIV data has been consistently increasing since 2005, MENA’s contribution to the global HIV literature is just over 1% and the existing evidence often falls behind the academic standards. Several factors could be at play that contribute to the limited quantity and quality of HIV data in MENA. This editorial tries to explore and explain the barriers to collecting high-quality HIV data and generating precise estimates in MENA. These barriers include a number of logistic and socio-political challenges faced by researchers, public health officials, and policy-makers. Looking at successful regional HIV programs, we explore examples were policies have shifted and lessons could be learned in developing appropriate responses to HIV across the region.

Main technique to control acquired immunodeficiency syndrome (HIV) infection is the effective preventive programs among high-risk groups. Modeling is one of the effective methods where there is inadequate data. We used the modes of transmission (MOT) model to predict the transmission of HIV infection in Iran. We systematically searched published and grey literature to find values for the input parameters of MOT in 2010. The data were discussed by experts before being fed into the model. Using the Monte Carlo simulation, we computed the 95% confidence interval (CI) for the outputs of the MOT. The MOT estimates that 9136 new HIV infections would have occurred in Iran in 2010 (95% CI: 6831, 11757). About 56% (95% CI: 47.7%, 61.6%) of new infections were among intravenous drug users (IDUs) and 12% (95% CI: 9.5%, 15%) among their sexual partners. The major routes of direct and indirect HIV transmission in Iran are unsafe injection (68%) and unprotected sexual contact (34% unprotected heterosexual and 10% homosexual) respectively. If current coverage for safe injection among IDUs increases from 80% to 95%, new HIV infections in this group would decrease around 75%. IDUs remain at highest risk of HIV infection in Iran, so the preventive program coverage for IDUs and their spouses needs to be increased. As the sexual transmission of HIV contributes increasingly to the pool of new infections, serious measures such as harm reduction program are required to reduce sexual transmission of HIV among the relevant key populations.