SUBSTANCE ABUSE
&
HIV DISEASE
Janet L. Mitchell, M.D., M.P.H., F.A.C.O.G.
Consultant on Women’s Health
Addiction, Research & Treatment Corporation
Brooklyn, NY
• Epidemiology
• HIV care
EPIDEMIOLOGY
AIDS Cases by Age and Sex
Reported 1981-1999, United States
40,000
35,000
Male N=609,326
Number of Cases
30,000
Female N=124,045
25,000
20,000
15,000
10,000
5,000
0
0 10 20 30 40 50 60 70 80 90
Age at Diagnosis
AIDS Cases in Adult/Adolescent Men,
Reported
July 1998 - June 1999, and Estimated AIDS
incidence,* Diagnosed July 1998 – June 1999
Risk Exposure
by Risk Exposure United States Men who have
sex with men
Injection drug
45% use (IDU)
53%
MSM/IDU
than elective c/sections
Current Standard of Care for
Pregnant Women in Developed Countries
Combination Anti-retroviral Therapy
(should include AZT if appropriate)
Perinatal Transmission Rates
• Zidovudine/ ACTG 076
• Combination therapy/HAART
• Nevirapine
• Elective c/section
Safety and Toxicity of Individual
Antiretroviral Agents in Pregnancy
www.hivatis.org/guidelines/adult/text/
pregnancy1.html
Antiretroviral Pregnancy Registry
1410 Commonwealth Drive
Wilmington, NC 28403
telephone (800) 258-4263
fax (800) 800-1052
CDC WEBSITE:
http://www.cdc.gov/hiv/graphics.htm