Drug use patterns over time among HIV-seropositive and HIV-seronegative women: The HER study experience

Background: Drug use, particularly among women, is a public health issue given its health effects and its impact on HIV transmission. Becoming HIV seropositive could lead to differing patterns of drug use over time. HIV infection may decrease drug use due to an increased access to health services. Alternatively, increased drug use may occur due to depression associated with being HIV infected, leading to despair, hopelessness, and a lack of motivation to become drug free. Methods: We evaluated the potential association between HIV serostatus and drug use among a cohort of 1310 women who were part of a multicenter collaborative study on the natural history of HIV infection. Eight hundred seventy-one HIV-seropositive women and 439 HIV-seronegative women were enrolled at four sites (New York, Providence, Baltimore, and Detroit). We defined drug use as any heroin or cocaine use reported at the baseline visit (enrollment). Results: Drug use was found to decrease during earlier visits (months 1-24) and remained stable at 20% thereafter (months 30-84). No significant differences in change of drug use were noted by HIV serostatus, using generalized estimating equation-based logistic regression analyses. Conclusions: HIV-seropositive status did not affect drug use patterns over time within our population of high-risk women.