title: African-American women who use crack cocaine: a comparison of mothers who live with and have been separated from their children.
abstract: OBJECTIVE
  This study examined factors that influenced caregiver status for African-American mothers who use crack cocaine but are not receiving drug treatment and participated in an HIV prevention study in North Carolina.
  
  
  METHODS
  Caregiver mothers who were living with at least one of their children at intake (n = 257) were compared with non-Caregivers who were separated from all of their children (n = 378). Bivariate analyses and logistic regression were used to compare these mothers at intake on current drug use, risky sex practices, psychological symptoms, victimization, and aggression.
  
  
  RESULTS
  Compared with Caregiver mothers, non-Caregivers reported higher frequencies of drug use, risky sex practices, psychological distress, and victimization experiences. Caregiver mothers were more likely than non-Caregiver mothers to have health insurance, but were less likely to have received drug treatment. Logistic regression found that non-Caregiver mothers were significantly more likely than Caregiver mothers to be older, to have been physically abused as children, to trade sex more frequently, to be homeless, and to have no health insurance. Recent crack use, psychological symptoms, and victimization were not significantly related to caregiver status.
  
  
  CONCLUSIONS
  Findings that socio-environmental factors were more strongly associated with caregiver status than crack use underscore the importance of contextual issues such as housing, victimization history, and resources in serving maternal crack users. Community outreach and interventions that engage mothers who use drugs and live with their children may be more effective strategies than formal office-based services to link mothers who use crack and their children to needed drug treatment and family and child services.
authors.affiliation: RTI International, Substance Abuse Treatment Evaluations and Interventions, 3040 Cornwallis Road, Research Triangle Park, NC 27709, USA.
authors.forename: Wendy K K
authors.initials: WK
authors.lastname: Lam
authors.forename: Wendee
authors.initials: W
authors.lastname: Wechsberg
authors.forename: William
authors.initials: W
authors.lastname: Zule
mesh_terms: D001741:Black or African American; D002648:Child; D002649:Child Abuse / Q000208:ethnology; D019970:Cocaine-Related Disorders / Q000453:epidemiology / Q000208:ethnology* / Q000523:psychology; D016578:Crack Cocaine; D003710:Demography; D005260:Female; D006801:Humans; D009034:Mother-Child Relations; D009035:Mothers / Q000523:psychology* / Q000706:statistics & numerical data; D012309:Risk-Taking; D012725:Sexual Behavior / Q000523:psychology; D011795:Surveys and Questionnaires
chemical_list: D016578:Crack Cocaine