Substance Use and Drug Treatment Among Reproductive-Age Women With and Without HIV in the Southern United States

Abstract

Background. Women with human immunodeficiency virus (HIV; WWH) and with substance use (SU) have poorer HIV-related outcomes. We characterized SU and treatment across reproductive life stages among Study of Treatment And Reproductive Outcomes (STAR) participants. Methods. The STAR is a prospective cohort of WWH and women without HIV (WWoH) across 6 Southern US sites. We analyzed baseline participant data (2021–2024) on self-reported past-year SU (nonmedical drug use, hazardous alcohol use, tobacco use, and nonmedical cannabis use), as well as drug and alcohol use treatment. We assessed SU and treatment by HIV and pregnancy status. Results. Among 891 women (526 WWH and 362 WWoH), 12% (9% of WWH and 15% WWoH; P = .02) reported past-year drug use; 15%, hazardous alcohol use (11% and 20%, respectively; P