Objective: To determine the effect of HIV infection on pregnancy and birth rates and assess the potentially confounding effect of illicit drug use.
Design: A retrospective record review of matched cohorts examining pregnancy outcomes for HIV-positive women and two HIV-negative comparison groups (one matched by drug use).
Methods: Ninety HIV-positive women who gave birth in a US city between 1989 and 1993 were matched to HIV-negative women by race, age, parity and date of index birth (group 1, N = 180) and also by the type of illicit drug used (group 2, N = 90). Data were abstracted on tubal ligations and pregnancies occurring before April 1996.
Results: A total of 63% of HIV-positive women used cocaine during the index pregnancy and 26% also used opiates. HIV-positive women had fewer tubal ligations than group 1 (38.9% versus 51.1%, P = 0.058), but there was no difference when matching included drug use (38.9% in group 2). HIV infection was associated with a decrease in the number of pregnancies; this decrease was most marked when matching included drug use (18.0 versus 32.1 pregnancies per 100 woman-years,P < 0.01). There were no significant differences in spontaneous or therapeutic terminations. Poisson regression analysis demonstrated that HIV infection and older age were associated with fewer pregnancies, and cocaine use with an increased pregnancy rate.
Conclusion: This study confirms that HIV infection is associated with a decrease in the number of pregnancies, but also illustrates the confounding effects of illicit drug use among women in the United States.
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http://dx.doi.org/10.1097/00002030-200202150-00020 | DOI Listing |
JAMA Health Forum
January 2025
Department of Health Policy and Management, University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania.
Importance: 2021 Advance child tax credit (ACTC) monthly payments were associated with reduced US child poverty rates; however, policymakers have expressed concerns that permanent adoption would increase parental substance use.
Objective: To assess whether 2021 ACTC monthly payments were temporally associated with changes in substance use among parents compared with adults without children.
Design, Setting, And Participants: The primary sample included adults aged 18 to 64 years who responded to the National Survey on Drug Use and Health in 2021.
J Addict Med
January 2025
From the Boonshoft School of Medicine, Wright State University, Dayton, OH (KL, SS, TNC); Ohio State University, Columbus, OH (SH, NM, TP); and RTI International, Research Triangle Park, NC (BR).
Objectives: Stigma is known to be a major barrier to treatment for people who use drugs (PWUD). This study uses the Stigma and Health Discrimination Framework to analyze how different forms of stigma shape experiences in the wake of an overdose incident, and perceptions of the efficacy and utility of postoverdose interventions among a sample of PWUD in Dayton, Ohio-a location with a high overdose rate.
Methods: Interviews were conducted with 23 individuals who self-reported past-month illicit opioid, crack/cocaine, or methamphetamine use who had experienced or witnessed a drug overdose in the past 6 months.
Tunis Med
December 2024
Pneumology Department, Gabès University Hospital, Faculty of Medicine of Sfax, Gabès, Tunisia.
Introduction: Information on the use of tobacco and other illicit substances by young people is an essential element for the implementation of appropriate preventive measures.
Aim: To estimate the prevalence of smoking, alcohol and drug use among high school students in the city of Gabes.
Methods: Cross-sectional survey carried out in 2022 in 5 schools in the city of Gabes, southern Tunisia, by a self-administered questionnaire.
BMC Glob Public Health
January 2025
Division of General Internal Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, 80045 CO, USA.
Background: In the USA, many states, including Colorado, have increased criminal penalties for illicit opioid possession, which may alter overdose risk. We aimed to evaluate the relationship between Colorado's increased drug-related criminal legal penalties, risk of overdose, and substance use patterns.
Methods: We used concept mapping - a mixed-methods approach used to develop a conceptual understanding of an issue from a community lens - to engage with people with living and/or lived experience with the criminal legal system, substance use, and/or overdose, their loved ones, and service providers.
Trials
January 2025
Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway.
Background: There is a lack of knowledge on effective treatment methods for comorbid benzodiazepine dependence in populations undergoing opioid agonist treatment (OAT). Tapering and discontinuation of benzodiazepines has long been considered the standard treatment, even though there is limited evidence for this practice. There is also limited research on benzodiazepine agonist treatment; however, peer and clinical experiences indicate that such approaches may be beneficial for a subgroup of the patients with long-lasting benzodiazepine dependence not responding to other treatment approaches.
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