ISSUES OF WOMEN DUALLY DIAGNOSED WITH HIV INFECTION AND SUBSTANCE USE PROBLEMS IN THE CAROLINAS

Abstract

A growing number of women are being dually diagnosed with HIV infection and substance use problems. Forty-two percent of all women diagnosed with AIDS have been infected through injection drug use. Many more women with HIV are exposed to nonintravenous drugs that potentially affect their quality of life and illness experience. This study sought to identify from the perspective of women factors that most influenced their ability to obtain treatment for their HIV infection and control their substance use. A focus group approach was used for data collection. Twenty-five HIV-infected women participated in one of four focus groups. Women were asked to identify and discuss their concerns and needs related to HIV/AIDS and substance use. Twenty-four women were African-American; one was white. All the women reside in South Carolina or North Carolina. Each focus group session was audiotaped and transcribed. Content analysis, following Krippendorff's (1980) methodology, was used to analyze the data. Five themes emerged: 1) AIDS as a life-altering event; 2) spirituality; 3) mental health issues; 4) barriers to health care services; and 5) environmental influences. It was concluded that the coexistence of HIV and substance abuse adds to the complexity of women's treatment needs. For these women, an HIV diagnosis can serve to alter their lives either positively or negatively. Dually diagnosed women have needs that require integration of physical and interventions. These women may benefit from services of psychiatric or mental health nurse who have the skills necessary to address the psychosocial issues women face as well as provide treatment. Additionally, drug treatment services to be expanded and made more comprehensive. Drug programs need to be developed specifically for and these services need to be made accessible to women with substance abuse problems. Further, drug programs need to provide comprehensive services can appropriately integrate the treatment of HIV and substance abuse.