3rd Conference on Retroviruses and Opportunistic Infections Washington, DC - January 28-February 1, 1996

Conf Retroviruses Opportunistic Infect 1996 Jan 28-Feb 1; 3rd:58 (abstract no. 29)

Rodriguez E, Mofenson L, Chang B, Rich K, Fowler MG, Smeriglio V, Landesman S, Fox H, Diaz C, Green K, Hansen C
National Institutes of Health, Bethesda, MD

OBJECTIVE: To evaluate the relationship of drug use with maternal HIV culture positivity at delivery and perinatal HIV transmission among mother-infant pairs enrolled in five sites in the WITS cohort.

METHODS: Drug use during pregnancy was assessed by self-report and urine toxicology; univariate analyses and multivariate logistic regression were used to evaluate the association of "hard drug" (cocaine, heroin/opiate, methadone and injection drug) use prenatally or at delivery with a positive maternal delivery culture and perinatal transmission.

RESULTS: 42% of 530 women used hard drugs during pregnancy. Maternal prenatal hard drug use was significantly associated with maternal HIV culture positivity at delivery (OR=1.91, P=0.004). In addition, maternal hard drug use was associated with an increased risk for perinatal HIV transmission (OR l.89, p 0.003), with a similar trend for cocaine use alone. The association between drug use and transmission remained significant even after adjusting for positive maternal HIV culture at delivery, CD4+ lymphocytes and gestational age. Adjusting for duration of rupture of membranes (DROM), perinatal transmission was significantly higher among women using drugs during pregnancy who had DROM for greater than 4 hours, but not among those who had DROM less than or equal to 4 hours.

CONCLUSIONS: The prevalence of hard drug use during pregnancy in HIV positive women in this study was shown to be high. Such drug use was associated with an increased risk for maternal HIV culture positivity at delivery and for perinatal HIV transmission. Substance abuse treatment and counseling for pregnant HIV infected women may help reduce these risks.

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Copyright © 1996 - Foundation for Retrovirology and Human Health . Reproduction of this abstract (other than one copy for personal reference) must be cleared through the Foundation for Retrovirology and Human Health.