4093.0: Tuesday, October 23, 2001 - Board 2

Abstract #20153

Reproductive health services for low income women who use illicit drugs: Barriers to use of preventive and needed health services

Lee A. Crandall1, Lisa R. Metsch, PhD2, Clyde B. McCoy, PhD2, Hayley B. Tobias, BA3, and Dale D. Chitwood, PhD4. (1) Epidemiology and Public Health, University of Miami, PO Box 016069, Miami, FL 33101, (305) 243-3021, lcrandal@med.miami.edu, (2) Department of Epidemiology and Public Health, University of Miami, 1801 NW 9th Ave (D-93), Miami, FL 33136, (3) University of Miami Dept of Epidemiology and Public Health, PO Box 016069, Miami, FL 33101, (4) Sociology Research Center, University of Miami, 5665 Ponce de Leon Blvd, Coral Gables, FL 33146

Reproductive services have become a focus for drug testing, possibly discouraging health services utilization among women using illicit drugs. Consequently, we studied reproductive health service needs and utilization among a multi-ethnic population of 528 women ages 18-44 in Miami-Florida using interviews from a stratified, network-referred (snowball) street (i.e., non-treatment) sample of chronic drug users and socially and ethnically similar persons who were not chronic drug users. Subjects included 94 injection drug users (IDUs), 233 other chronic drug users (ODU), and 201 non-drug users (NDUs). A minority of women reported that they had a regular source of health care, but NDUs were significantly more likely to report a regular source of care. About 2/3 of women reported experiencing reproductive health problems (other than pregnancy) in the 12 months preceding their interview, with about 18% of IDUs and ODUs reporting that these problems remained untreated versus 10% of NDUs (p< .01). More NDUs (21%) reported pregnancies in the past 12 months than IDUs (5%) or ODUs 12%). When the data for the two drug using groups were combined, the 31 pregnant chronic drug users (CDU) were much less likely to have received prenatal care than NDUs (36% vs. 83%, p<.001), and reported more miscarriages (26% of CDUs vs. 9% of NDUs). Logistic regression analysis showed a strong and robust negative effect of being a drug user on receipt of prenatal care when usual source of care and third party coverage were controlled.

Learning Objectives: Participants will more clearly understand barriers to reproductive health services for women who use drugs. Participants will be able to recognize the impact of drug use relative to poverty and insurance status as a barrier to services. Participants will appreciate the effect of drug testing and reporting to authorities as barriers to services.

Keywords: Drug Abuse, Reproductive Health Research

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: none
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.

The 129th Annual Meeting of APHA