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Crack Cocaine Use and Adherence to Antiretroviral Treatment Among HIV-Infected Black Women

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Abstract

Since the appearance of crack cocaine in the 1980s, unprecedented numbers of women have become addicted. A disproportionate number of female crack users are Black and poor. We analyzed interview data of HIV-infected women ≥ 18 years of age reported to 12 health departments between July 1997 and December 2000 to ascertain if Black women reported crack use more than other HIV-infected women and to examine the relationship between crack use and antiretroviral treatment (ART) adherence among Black women. Of 1655 HIV-infected women, 585 (35%) were nonusers of drugs, 694 (42%) were users of other drugs and 376 (23%) were crack users. Of the 1196 (72%) Black women, 306 (26%) were crack users. We used logistic regression to examine the effect of crack use on adherence to ART, controlling for age and education among Black women. In multivariate analysis, crack users and users of other drugs were less likely than non-users to take their ART medicines exactly as prescribed (odds ratio [OR] = 0.37; 95% confidence interval [CI] = 0.24–0.56), OR = 0.47; 95% CI = 0.36–0.68), respectively. HIV-infected Black women substance users, especially crack cocaine users, may require sustained treatment and counseling to help them reduce substance use and adhere to ART.

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Authors and Affiliations

  1. Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities/Fetal Alcohol Syndrome Prevention Team, 1600 Clifton Rd., Mailstop E-86, Atlanta, GA, 30333

    Tanya Telfair Sharpe

  2. NCHSTP/Division of HIV/AIDS Prevention, USA

    Lisa M. Lee, Allyn K. Nakashima & Patricia L. Fleming

  3. Division of Reproductive Health, Surveillance Unit/ITSSB, USA

    Laurie D. Elam-Evans

Authors
  1. Tanya Telfair Sharpe
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  2. Lisa M. Lee
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  3. Allyn K. Nakashima
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  4. Laurie D. Elam-Evans
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  5. Patricia L. Fleming
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Correspondence to Tanya Telfair Sharpe.

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Sharpe, T.T., Lee, L.M., Nakashima, A.K. et al. Crack Cocaine Use and Adherence to Antiretroviral Treatment Among HIV-Infected Black Women. Journal of Community Health 29, 117–127 (2004). https://doi.org/10.1023/B:JOHE.0000016716.99847.9b

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  • DOI: https://doi.org/10.1023/B:JOHE.0000016716.99847.9b

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