Kay A. Armstrong, MS¹, Erica Gollub, DrPH², Tamara Y. Boney, MS², Antonella Lavelanet, BA², Katina Mackey, BA², Delinda Mercer, PhD³, David Metzger, PhD², and Sumedha Chhatre, PhD². (1) Public Health Consultant, 645 Harper Ave, Drexel Hill, PA 19026, 610-622-6480, armstrong@wharton.upenn.edu, (2) Center for Studies of Addiction, University of Pennsylvania, 3535 Market St, Philadelphia, PA 19104, (3) Consultant, 3409 16th Avenue, Scottsbluff, NE 69361

Background: Historically family planning, STD and HIV services are separate. 198 high risk women in need of multiple services participated in an HIV/STD risk reduction study. Primary goals were to reduce: 1) unprotected vaginal and anal sex acts, and 2) STD incidence. Methods: Eligibility criteria were: injecting, snorting or smoking cocaine/crack/heroin or speedball > 12 times and at least 30% unprotected vaginal/anal sex acts in the last 3 months. STD tests, personal interviews and audio CASI surveys were conducted at baseline, 6 and 12 months. Results: At baseline, women were age 18-61 (mean, 39.6), predominantly Black (66%), unemployed (93%), had < 12 years of education (78%), and > 1 pregnancy (94%, range: 0-23); Many (49%) tested positive for > 1 STD. In the past 3 months, most had multiple partners (median 4), sex for money (80%) and used condoms (37%) although not consistently (60% believed they were not at risk). Few women used Norplant/Depo Provera (4%), the Pill (.5%), Cervical Cap (.5%) or IUD (.5%). Most fertile women (89%) did not plan to become pregnant next year. Recent health care services were sparse despite most having health insurance (69%, primarily Medicaid); more women were tested for HIV (37%) than received gynecological services (29%), treatment for STDs (6%), or family planning/contraceptive counseling (4%). Hospitals (22%) were used more than community health clinics (13%) or drop-in clinics(5%). Conclusions: Few drug using women used family planning services including STD treatment. Integration of HIV/STD and family planning prevention and treatment services is suggested.

Learning Objectives:

• Learn about the kinds and extent of prevention services that high risk drug using women access.
• Attendees will be encouraged to assess, advocate and/or initiate the integration of family planning, STD and HIV/AIDS prevention services.

Keywords: Reproductive Health, Service Integration

Presenting author's disclosure statement:
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.