Tattooing among Iranian prisoners: results of the two national biobehavioral surveillance surveys in 2015-2016<sup>,</sup>

Jafari, Saeede; Moradi, Ghobad; Zareie, Bushra; Gouya, Mohammad Mehdi; Zavareh, Fatemeh Azimian; Ghaderi, Ebrahim

doi:10.1016/j.abd.2019.11.006

Saeede Jafari

Student Research Committee, Kurdistan University of Medical Sciences, Sanandaj, Iran

http://orcid.org/0000-0002-5357-9250

Ghobad Moradi

Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran

http://orcid.org/0000-0003-2612-6528

Bushra Zareie

Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran

http://orcid.org/0000-0002-8307-4835

Mohammad Mehdi Gouya

Iranian Center for Communicable Diseases Control, Ministry of Health & Medical Education, Tehran, Iran

http://orcid.org/0000-0002-0288-8790

Fatemeh Azimian Zavareh

Iranian Center for Communicable Diseases Control, Ministry of Health & Medical Education, Tehran, Iran

http://orcid.org/0000-0002-8001-3084

Ebrahim Ghaderi ^** Corresponding author. E-mail:ebrahimghaderi@yahoo.com (E. Ghaderi).

Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran

http://orcid.org/0000-0002-2303-1657

* Corresponding author. E-mail:ebrahimghaderi@yahoo.com (E. Ghaderi).

Author's contributions

Saeede Jafari: Statistic analysis; approval of the final version of the manuscript; elaboration and writing of the manuscript; obtaining, analysis, and interpretation of the data.

Ghobad Moradi: Approval of the final version of the manuscript; conception and planning of the study; obtaining, analysis, and interpretation of the data; effective participation in research orientation; intellectual participation in the propaedeutic and/or therapeutic conduct of the studied cases; critical review of the literature; critical review of the manuscript.

Bushra Zareie: Statistic analysis; approval of the final version of the manuscript; elaboration and writing of the manuscript; obtaining, analysis, and interpretation of the data.

Mohammad Mehdi Gouya: Approval of the final version of the manuscript; conception and planning of the study; effective participation in research orientation; intellectual participation in the propaedeutic and/or therapeutic conduct of the studied cases; critical review of the literature; critical review of the manuscript.

Fatemeh Azimian Zavareh: Approval of the final version of the manuscript; conception and planning of the study; effective participation in research orientation; intellectual participation in the propaedeutic and/or therapeutic conduct of the studied cases; critical review of the literature; critical review of the manuscript.

Ebrahim Ghaderi: Statistic analysis; approval of the final version of the manuscript; conception and planning of the study; obtaining, analysis, and interpretation of the data; effective participation in research orientation; critical review of the manuscript.

Conflicts of interest

None declared.

Variables (n)	Tattooing in lifetime n (%)^a a weighted prevalence. (95%CI)	p-Value	Tattooing in prison n (%)^a a weighted prevalence. (95%CI)	p-Value
Age (mean ± SD)	33.9 ± 8.3		34.3 ± 8.0

Gender
Female (369)	164 (43.6) (37.6-49.8)	<0.001	24 (16.9) (13.1-21.6)	0.767
Male (11,617)	5327 (44.7) (41.2-48.2)		1615 (31.5) (27.9-35.4)

Age (year)
<35 (5952)	3184 (50.7) (47.1-54.2)	0.005	861 (29.1) (25.6-32.8)	<0.001
≥35 (5995)	2288 (38.4) (34.6-42.4)		772 (33.8) (29.1-38.8)

Marital status
Single (4111)	2271 (53.1) (49.2-56.9)	0.842	651 (30.9) (25.6-36.7)	<0.001
Divorced/widow (1120)	527 (45.9) (37.5-54.5)		183 (33.1) (25.1-42.3)
Married (6746)	2691 (40.1) (36.9-43.4)		805 (30.9) (27.7-34.4)

Educational level
Illiterate - primary school (4107)	1996 (47.6) (42.9-52.2)	0.273	619 (33.0) (27.5-39.1)	<0.001
Junior high school - diploma (7018)	3330 (45.7) (42.4-49.1)		988 (30.2) (25.8-35.0)
University (855)	163 (19.4) (14.6-25.5)		33 (22.9) (15.9-31.8)

Job status
No income (816)	378 (45) (41.8-48.2)	0.544	118 (32.5) (25.1-40.8)	0.665
Income (10,021)	4564 (44.2) (40.4-48.2)		1360 (30.3) (26.6-34.2)

History of imprisonment
No (5278)	1798 (32.9) (29.4-36.6)	<0.001	329 (18.8) (14.7-23.8)	<0.001
Yes (6624)	3662 (54.1) (50.2-58)		1299 (37.1) (32.6-41.9)

Number of incarcerations
1-2 (4003)	1975 (48.9) (44.8-53)	<0.001	604 (32.6) (27.7-38.0)	<0.001
3-4 (1494)	925 (59.9) (54.3-65.1)		358 (40.1) (33.7-46.9)
≥5 (1058)	732 (67.6) (61-73.6)		331 (47.7) (41.4-54.2)

Prison term in the last 10 years
≤5 (3859)	2011 (51.6) (47.5-55.8)	<0.001	629 (34.1) (29.2-39.3)	<0.001
>5 (885)	588 (64.1) (57.6-70.2)		295 (50.7) (43.1-58.3)

History of drug use during lifetime
No (3216)	857 (25.1) (21.2-29.4)	<0.001	163 (20.2) (15.8-25.4)	<0.001
Yes (8745)	4629 (51.6) (48.3-54.9)		1477 (33.0) (29.0-37.2)

History of drug injection during lifetime
No (7216)	3603 (48.8) (45-52.6)	0.009	1025 (30.1) (24.9-35.8)	<0.001
Yes (1387)	972 (69) (64.6-73)		433 (44.5) (37.0-52.3)

History of piercing during lifetime
No (6684)	2700 (39.1) (35-43.3)	0.902	813 (30.9) (26.0-36.2)	<0.001
Yes (5233)	2777 (52.3) (48.5-56.1)		823 (31.2) (26.7-36.1)

History of piercing in prison
No (4513)	2340 (50.8) (47.4-54.3)	<0.001	624 (27.9) (23.1-33.3)	<0.001
Yes (642)	404 (63.4) (57-69.3)		193 (48.8) (39.8-57.9)

History of extramarital sex during lifetime
No (4347)	1546 (36.2) (32.3-40.2)	0.009	429 (27.1) (22.9-31.7)	<0.001
Yes (6220)	3344 (51.7) (47.5-55.9)		1084 (33.9) (29.6-38.5)

Number of heterosexual/homosexual partners during lifetime
1 (1104)	519 (44) (40-48)	0.629	153 (31.2) (25.7-37.2)	<0.001
2-3 (3060)	1551 (51.6) (46.5-56.7)		515 (35.1) (30.0-40.5)
>3 (1579)	977 (61.2) (57.5-64.9)		336 (34.5) (24.9-45.6)

Condom use in extramarital sex
Never (1185)	701 (57.7) (53.9-61.4)	0.241	227 (33.2) (24.9-42.7)	0.113
Sometime (3655)	1948 (52.1) (46.6-57.5)		656 (35.4) (30.5-40.5)
Always (1282)	652 (48.9) (45.2-52.6)		188 (28.8) (21.7-37.1)

History of STI in the last year
No (11,273)	5092 (44) (40.7-47.5)	0.531	1539 (31.3) (27.6-35.3)	<0.001
Yes (677)	384 (56.7) (52.9-60.4)		100 (29.0) (22.6-36.3)

Variables	p-Value	AOR (95% CI)	p-Value	OR (95% CI)
Age (year)
≥35		1		1
<35	<0.001	1.62 (1.39-1.89)	<0.001	1.64 (1.38-1.96)

Marital status
Married		1		1
Divorced/widow	0.098	1.21 (0.96-1.52)	0.132	1.26 (0.93-1.72)
Single	0.001	1.31 (1.12-1.52)	<0.001	1.69 (1.45-1.95)

Educational level
University		1		1
Junior high school - diploma	<0.001	2.63 (2.05-3.37)	<0.001	3.49 (2.60-4.67)
Illiterate - primary school	<0.001	3.27 (2.45-4.35)	<0.001	3.75 (2.61-5.40)

History of imprisonment ^a a The variables of the history of imprisonment (OR = 2.41, 95% CI: 2.13-2.72), the number of incarceration (OR = 1.49, 95% CI: 1.35-1.65) and prison term (OR = 1.67, 95% CI: 1.40-1.99), had a correlation with each other. The variable of history of imprisonment was entered into multivariate logistic regression model because of it's higher significant OR.
No		1		1
Yes	<0.001	1.77 (1.51-2.08)	<0.001	2.41 (2.13-2.72)

History of drug use during lifetime ^b b The variables of the history of drug use (OR = 3.18, 95% CI: 2.70-3.75), and the history of drug injection (OR = 2.33, 95% CI: 1.96-2.76) had a correlation with each other. The variable of history of drug use was entered into multivariate logistic regression model because of its higher significance OR.
No		1		1
Yes	<0.001	2.48 (2.10-2.92)	<0.001	3.18 (2.70-3.75)

History of piercing during lifetime ^c c The variables of the history of piercing during lifetime (OR = 1.71, 95% CI: 1.40-2.09), and the history of piercing in prison (OR = 1.67, 95% CI: 1.37-2.04), had a correlation with each other. The variable of the history of piercing during lifetime was entered into multivariate logistic regression model because of it's higher significant OR.
No		1		1
Yes	<0.001	1.55 (1.30-1.84)	<0.001	1.71 (1.40-2.09)

History of extramarital sex during lifetime ^d d The variables of the history of extramarital sex during lifetime (OR = 1.89, 95% CI: 1.56-2.29), the number of heterosexual/homosexual partners during the lifetime (OR = 1.41, 95% CI: 1.28-1.55), and the condom usage (OR = 1.18, 95% CI: 1.07-1.30) had a correlation with each other. The variable of the history of extramarital sex was entered into multivariate logistic regression model because of it's higher significant OR.
No		1		1
Yes	0.001	1.31 (1.12-1.54)	<0.001	1.89 (1.56-2.29)

History of STI in the last year
No		1		1
Yes	0.005	1.26 (1.07-1.47)	<0.001	1.66 (1.42-1.95)

Variables	p-Value	AOR (95% CI)	p-Value	OR (95% CI)
Gender
Female		1		1
Male	0.268	1.64 (0.67-4.04)	<0.001	2.27 (1.57-3.28)

Age (year)
<35		1		1
≥35	0.200	1.21 (0.90-1.62)	0.005	1.24 (1.07-1.44)

History of imprisonment ^a a The variables of the history of imprisonment (OR = 2.54, 95% CI: 1.87-3.46), the number of incarceration (OR = 1.37, 95% CI: 1.22-1.55) and prison term (OR = 1.99, 95% CI: 1.46-2.70), had a correlation with each other. The variable of history of imprisonment was entered into multivariate logistic regression model because of it's higher significant OR.
No		1		1
Yes	<0.001	2.09 (1.63-2.69)	<0.001	2.54 (1.87-3.46)

History of drug use during lifetime ^b b The variables of the history of drug use (OR = 1.95, 95% CI: 1.53-2.48), and the history of drug injection (OR = 1.87, 95% CI: 1.18-2.96) had a correlation with each other. The variable of history of drug use was entered into multivariate logistic regression model because of it's higher significant OR.
No		1		1
Yes	0.019	1.79 (1.11-2.88)	<0.001	1.95 (1.53-2.48)

History of piercing in prison
No		1		1
Yes	<0.001	2.44 (1.56-3.80)	<0.001	2.47 (1.60-3.79)

History of extramarital sex during lifetime
No		1		1
Yes	0.005	1.51 (1.14-1.98)	0.009	1.38 (1.09-1.75)

[1] * Corresponding author. E-mail:ebrahimghaderi@yahoo.com (E. Ghaderi).

Brasil

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Abstract

Background:

Objective:

Methods:

Results:

Study limitations:

Conclusion: