Comparing pregnant and non-pregnant women in South Africa: Drug use, HIV risk and the need for comprehensive services

Background: Cape Town South Africa is challenged with how to best reduce drug use, including a rising methamphetamine epidemic, in childbearing age women. To develop effective women-specific treatments, it is necessary to first examine the presenting issues that pregnant and non-pregnant drug-users face. Methods: Pregnant (n=22) and non-pregnant women (n=288) drug-users were compared on a priori selected baseline variables that encompassed demographic, HIV-risk and comprehensive-service domains. Results: The total sample mean age and years of completed education were 23.3 (SD=4.3) and 9.1 (SD=2.0) respectively. Past-month drug-use differed by pregnancy status only for methamphetamine (local-name “tik”) with a larger proportion of pregnant than non-pregnant women reporting “tik” use (95.5% vs. 68.8%; p=0.008). Other drug use, including alcohol (91%) and marijuana (local-name “dagga”; 70.3%), were reported by the majority of both groups. While over 90% of both groups reported having sex with their main partner in the past-month (mean= 7.7; SD=6.7 times), pregnant women reported fewer times of condom use in the past-month (0.2 vs. 1.78; p=<0.0001). Regarding comprehensive-service assistance, a greater proportion of pregnant than non-pregnant women wanted educational assistance (72.7% vs. 46.5%; p=0.018). The most requested services included employment (89.4%), financial assistance (89.4%), and housing (75.2%). Mental health assistance was least requested (21.9%). Conclusions: These findings suggest that (1) there is an urgent need for treatment to address methamphetamine-use in pregnant women; and (2) there are both common and unique issues that must be addressed when developing and adapting comprehensive treatments for drug-using women which are dependent upon pregnancy status.