Introduction: Substance abusing women are one of the highest risk groups for HIV for three reasons: a) contact with HIV through the exchange of needles with other substance users with HIV; b) contact through participation in sex work; or c) contact with a male sex partner who has HIV. In treating substance abusing women with HIV, it is important to determine how specific patterns of substance abuse may be related to general self-perceptions of symptom problems and psvchological well being.

Project Description: This paper discusses results from a sample of more than 60 substance abusing women with HIV who are being treated in an outpatient clinic in Detroit. Of the current sample, 93.4% are African Americans, 0.0% are Latinas, 3.3% are Caucasians, and 3.3% are of unknown ethnicity. Within 2-4 weeks after admission into the program, women receive a detailed needs assessment that includes a brief interview about current and past drug use. They also are administered an 8-item short version of the Center for Epidemiological Studies Depression Scale (CES-D), and the Rand Institute Short Form 21 (SF-21) of the Medical Outcomes Study Index of Health-related Functioning. Women also receive the Andrews and Withey General Well Being Scale.

Results: While lifetime patterns of marijuana use were unrelated to the functioning measures, women with a history of cocaine use (crack or intranasal) had lower levels of physical functioning and social role appropriate functioning on the SF-21. Heroin users had lower levels of role functioning, cognitive functioning, and pain tolerance, and much worse perceptions of their current health status than those women who had not used heroin. Amphetamine users had worse current cognitive functioning than those who had not used this drug. All significant correlations ranged from 0.32 to 0.49 (in absolute value) and were significant at the 0.05 level or lower using two-tailed tests. Partial correlation methods also were used to demonstrate that all correlations were largely unaffected by controlling for age.

Implications: The program in which these women participate is designed to help the women stop using drugs and break down barriers to receiving needed medical treatments for their HIV-related problems. While one goal of the program is to help the women enter a residential drug-free substance abuse treatment modality, they may participate in this outpatient program even if they continue to use substances.