[Use of methadone in obstetric and gynecologic management of drug-dependent females with and without HIV infection].

In the course of obstetrical and gynecological care, 113 women with acute intravenous drug use (IVD) participated in a methadon detoxification. In addition to medical treatment, socio-paedagogical intervention was part of the approach. A total of 212 cycles of methadon detoxification have been administered since patients' relapse during or after detoxication had a chance of readmission. In 45% of the attempts, detoxification could be fully achieved. An investigation of actual drug behaviour of the participating women in October 1990 showed, that 23.9% had abstained from drug consumption for at least 6 months ("drug free"). According to the HIV status and pregnancy 4 groups with comparable age (mean 27.7 years) and duration of drug dependency (mean 7.5 years) were classified. There were remarkable differences in drug behaviour between these groups. Of the HIV-infected women treated during pregnancy, 36% were drug free. Of the HIV-infected women without pregnancy and pregnant women without HIV-infection, comparable proportions (approx. 27% each) were living without drugs. All but one HIV-negative women of the group without pregnancy (3.8%) consumed drugs. In conclusion, pregnancy and subsequent motherhood seems to enhance and stabilize the motivation to quit drug consumption. The significant difference between the HIV-negative and HIV-positive women without pregnancy suggests, that besides pregnancy, the awareness of HIV-infection and of a limited life expectancy has also a positive influence on drug behaviour.