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Are female drug users receiving reproductive health care services

Kay A. Armstrong, MS1, Erica Gollub, DrPH2, Tamara Y. Boney, MS2, Antonella Lavelanet, BA2, Katina Mackey, BA2, Delinda Mercer, PhD3, David Metzger, PhD2, and Sumedha Chhatre, PhD2. (1) Public Health Consultant, 645 Harper Ave, Drexel Hill, PA 19026, 610-622-6480, armstrong@wharton.upenn.edu, (2) Center for Studies of Addiction, University of Pennsylvania, 3535 Market St, Philadelphia, PA 19104, (3) Consultant, 3409 16th Avenue, Scottsbluff, NE 69361

Background: Historically family planning, STD and HIV services are separate. 198 high risk women in need of multiple services participated in an HIV/STD risk reduction study. Primary goals were to reduce: 1) unprotected vaginal and anal sex acts, and 2) STD incidence. Methods: Eligibility criteria were: injecting, snorting or smoking cocaine/crack/heroin or speedball > 12 times and at least 30% unprotected vaginal/anal sex acts in the last 3 months. STD tests, personal interviews and audio CASI surveys were conducted at baseline, 6 and 12 months. Results: At baseline, women were age 18-61 (mean, 39.6), predominantly Black (66%), unemployed (93%), had < 12 years of education (78%), and > 1 pregnancy (94%, range: 0-23); Many (49%) tested positive for > 1 STD. In the past 3 months, most had multiple partners (median 4), sex for money (80%) and used condoms (37%) although not consistently (60% believed they were not at risk). Few women used Norplant/Depo Provera (4%), the Pill (.5%), Cervical Cap (.5%) or IUD (.5%). Most fertile women (89%) did not plan to become pregnant next year. Recent health care services were sparse despite most having health insurance (69%, primarily Medicaid); more women were tested for HIV (37%) than received gynecological services (29%), treatment for STDs (6%), or family planning/contraceptive counseling (4%). Hospitals (22%) were used more than community health clinics (13%) or drop-in clinics(5%). Conclusions: Few drug using women used family planning services including STD treatment. Integration of HIV/STD and family planning prevention and treatment services is suggested.

Learning Objectives:

Keywords: Reproductive Health, Service Integration

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Integrating Family Planning and HIV/STI Prevention: U.S. and International Perspectives

The 132nd Annual Meeting (November 6-10, 2004) of APHA