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SUMMARY
Substance abuse history and treatment needs were assessed in 308 women at a comprehensive HIV program in St. Louis. We found that 229 (74%) women had a history of substance abuse and 38 (12%) had a history of injection drug use. Only 25 (44%) of 57 women requiring substance abuse treatment at enrollment had received treatment. Adherence with quarterly medical follow-up was associated with highly active antiretroviral therapy (HAART) prescription in 1997 and 1998, but not with need for substance abuse treatment. However, women needing substance abuse treatment were less likely to have been prescribed HAART in 1998. We recommend that providers of medical services to women with HIV conduct formal assessments of substance abuse behaviors among their patients and ensure that treatment needs are adequately addressed within the framework of care. Further examination of the use of HAART in women who are active substance abusers is needed.