{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T09:30:04Z","timestamp":1787131804353,"version":"build-2736575974"},"reference-count":30,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T00:00:00Z","timestamp":1773619200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Research Vice-chancellor of Shiraz University of Medical Sciences","award":["97-01-04-17410"],"award-info":[{"award-number":["97-01-04-17410"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["AIDS Research and Human Retroviruses"],"published-print":{"date-parts":[[2026,4,1]]},"abstract":"<jats:p>Accurate estimation of the sizes of most-at-risk populations (MARPs) for HIV infection is critical for effective intervention planning, resource allocation, and service coverage assessment. This study aimed to estimate the population sizes of female sex workers (FSWs), people who inject drugs (PWIDs), and men who have sex with men (MSM) in the 18\u201345-year-old population of Shiraz, Iran, using the network scale-up (NSU) method. A cross-sectional study was conducted involving 768 purposively selected individuals aged 18\u201345 years residing in Shiraz for at least 5 years. Data were collected through a self-administered questionnaire, utilizing 16 reference groups with known frequencies to estimate average social network size. The prevalence of MARPs was then estimated and adjusted using established correction factors. The average active social network size was 203 contacts (103 males and 100 females). Adjusted size estimations indicated the highest prevalence among FSW at 2,181 per 100,000 (95% confidence interval [CI]: 1,979\u20132,375), followed by PWID at 561 per 100,000 (95% CI: 488\u2013633) and MSM at 418 per 100,000 (95% CI: 272\u2013563). Age distribution analyses revealed the greatest PWID prevalence in the 35\u201339 age group, FSW in 30\u201334, and MSM in 25\u201329. The estimated sizes of these populations substantially exceeded current harm-reduction program coverage in the region. Application of the NSU method revealed significant gaps between the actual sizes of high-risk populations and those reached by existing interventions in Shiraz. Targeted expansion of prevention, testing, and treatment programs, alongside initiatives to combat stigma and improve outreach, is urgently needed to control HIV transmission among these hidden and vulnerable groups.<\/jats:p>","DOI":"10.1177\/08892229261432847","type":"journal-article","created":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T04:18:33Z","timestamp":1773721113000},"page":"139-145","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Estimating the Size of Most-at-Risk Populations for HIV\/AIDS Using the Generalized Network Scale-Up Method: A Study in Shiraz, IranIran"],"prefix":"10.1177","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8607-8436","authenticated-orcid":false,"given":"Ahmad","family":"Maghsoudi","sequence":"first","affiliation":[{"name":"Social Determinants of Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran."},{"name":"Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad Reza","family":"Baneshi","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Center for Longitudinal and Life Course Research, School of Public Health, University of Queensland, Herston, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jafar","family":"Hassanzadeh","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Health, Institute of Health, Research Center for Health Sciences, Shiraz University of Medical Sciences, Shiraz, Iran."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,3,16]]},"reference":[{"issue":"1","key":"e_1_3_3_2_2","first-page":"98","article-title":"Counseling and harm reduction centers for vulnerable women to HIV\/AIDS in Iran","volume":"42","author":"Fahimfar N","year":"2013","unstructured":"Fahimfar N, , Sedaghat A, , Hatami H, , Kamali K, , Gooya M. Counseling and harm reduction centers for vulnerable women to HIV\/AIDS in Iran. Iran J Public Health, 2013; 42(Supple1):98\u2013104.","journal-title":"Iran J Public Health"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-017-1803-9"},{"key":"e_1_3_3_4_2","doi-asserted-by":"crossref","unstructured":"Khodadost M Ghalehkhani N Hajebi A et al. Hot spot mapping and size estimation of illicit drug users in Iran: A pilot study. 2021; doi: 10.21203\/rs.3.rs-141437\/v1","DOI":"10.21203\/rs.3.rs-141437\/v1"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2011.09.002"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0182755"},{"key":"e_1_3_3_7_2","doi-asserted-by":"crossref","first-page":"S39","DOI":"10.4103\/ijph.IJPH_46_20","article-title":"Size estimation of high-risk groups for HIV infection in India based on data from national integrated bio-behavioral surveillance and targeted interventions","volume":"64","author":"Arumugam E","year":"2020","unstructured":"Arumugam E, , Kangusamy B, , Sahu D, , Adhikary R, , Kumar P, , Aridoss S. Size estimation of high-risk groups for HIV infection in India based on data from national integrated bio-behavioral surveillance and targeted interventions. 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Applying current methods in size estimation for high risk groups in the context of concentrated epidemics: Lessons learned. jHASE-J HIV AIDS Surveill Epidemiol, 2010; 2(1).","journal-title":"jHASE-J HIV AIDS Surveill Epidemiol"},{"issue":"1","key":"e_1_3_3_11_2","first-page":"21","article-title":"Size estimation of most-at-risk groups of HIV\/AIDS using network scale-up in Tabriz, Iran","volume":"3","author":"JafariKhounigh A","year":"2014","unstructured":"JafariKhounigh A, , Haghdoost AA, , SalariLak S, et al. Size estimation of most-at-risk groups of HIV\/AIDS using network scale-up in Tabriz, Iran. 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