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 exam ine associations between drug use, health, risk behavior, and sexually tran smitted diseases (STD). Design: A longitudinal cohort study of 260 women with confirmed HN-positive serostatus. Methods: Each participant contributed a self-report interview, a clinical e xamination, laboratory testing of cultures for Trichomonas vaginalis, Chlam ydia trachomatis, Neisseria gonorrhoeae, and urinalysis for the presence of metabolites of cocaine and opiates, Data were examined on 140 women at I-y ear follow-up. Women were defined as drug users if they reported crack, coc aine, or heroin use in the 6 months before the interview or if they had a p ositive toxicologic test result for cocaine or opiates. Results. 34% of those in the sample were classified as positive for drug us e. Drug use was associated with the number of sexual partners, age at first intercourse, prevalence of STDs, and lower quality of life. STDs were pres ent 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 f ollow-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 behavi ors that place them at risk for STDs, to have elevated STD prevalence, and to have lower perceived health across several indices. Identification of dr ug use and treatment for it need to be a central component of HIV care for women.