Predictors and risk-taking consequences of drug use among HIV-infected women.
OBJECTIVE
To determine rates of drug use among women with HIV, and to examine associations between drug use, health, risk behavior, and sexually transmitted diseases (STD).


METHODS
A longitudinal cohort study of 260 women with confirmed HIV-positive serostatus.


METHODS
Each participant contributed a self-report interview, a clinical examination, laboratory testing of cultures for Trichomonas vaginalis, Chlamydia trachomatis, Neisseria gonorrhoeae, and urinalysis for the presence of metabolites of cocaine and opiates. Data were examined on 140 women at 1-year follow-up. Women were defined as drug users if they reported crack, cocaine, or heroin use in the 6 months before the interview or if they had a positive toxicologic test result for cocaine or opiates.


RESULTS
34% of those in the sample were classified as positive for drug use. Drug use was associated with the number of sexual partners, age at first intercourse, prevalence of STDs, and lower quality of life. STDs were present at baseline in 33.7% and 15.5% of drug users and nonusers, respectively. Drug use among this population was also associated at both baseline and follow-up with the likelihood of having a Karnofsky score below 80, and with overall perceived general health.


CONCLUSIONS
Drug users in this cohort were more likely to engage in behaviors that place them at risk for STDs, to have elevated STD prevalence, and to have lower perceived health across several indices. Identification of drug use and treatment for it need to be a central component of HIV care for women.
Novotná
L
L
State University of New York, School of Public Health at Albany, USA.
Wilson
T E
TE
Minkoff
H L
HL
McNutt
L A
LA
DeHovitz
J A
JA
Ehrlich
I
I
Des Jarlais
D C
DC
D000328:Adult; D005260:Female; D015658:HIV Infections / Q000276:immunology / Q000503:physiopathology / Q000523:psychology; D006801:Humans; D008137:Longitudinal Studies; D011237:Predictive Value of Tests; D011788:Quality of Life; D012309:Risk-Taking; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases; D019966:Substance-Related Disorders