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Background: The study was conducted to compare rates of sexually transmitted diseases (STD) and side effects in a cohort of high-risk women who received either an intrauterine device (IUD) or depo-medroxyprogesterone acetate (DMPA). Methods: We performed a retrospective chart review study of women seeking contraception at an innercity resident obstetrics/gynecology clinic. We compared 194 women with IUDs vs. 191 women receiving DMPA. Mean age was 31.9 years, with 75.1% and 69.2% being nonwhite and single, respectively. More white women received the IUD (34.5% vs. 15.0%, p < 0.001), and significantly more single women received DMPA (85.2% vs. 53.9%, p < 0.001). Results: After controlling for potentially confounding variables, DMPA women were significantly more likely to have a subsequent STD, although this effect disappeared when interaction terms were added to the model. Overall, duration of contraception use and being black were the best predictors of subsequent STD infection. Women who received IUDs were more likely to report side effects but less likely to discontinue use of their birth control (18.8% vs. 67.0%, p < 0.001). Conclusions: Although sexual risk factors may have influenced provider prescribing practices in selecting IUD or DMPA, overall rates of STDs and discontinuation rates for IUDs were equivalent or superior to rates for DMPA. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To assess hepatitis C virus (HCV) serostatus, risk factors, and desire for education about HCV among methadone maintenance treatment (MMT) patients. METHODS: We surveyed 200 MMT patients and reviewed charts for 276 patients. RESULTS: The self-report HCV seroprevalence was 34%, adjusted to 52%. The chart review HCV seroprevalence was 70%. Most participants had risk factors for contracting or spreading HCV. CONCLUSIONS: There is discrepancy in HCV seroprevalence by self-report versus serum test results among MMT patients. Some HCV+ MMT patients engage in high-risk behaviors for HCV transmission and may not disclose HCV+ status. MMT patients want HCV education. [ABSTRACT FROM AUTHOR]

Nine hundred and sixty-nine impaired physicians (125 women and 844 men) enrolled in one of four state physician health programs were evaluated with comprehensive psychosocial, psychiatric and substance abuse/dependence profiles. When compared to male impaired physicians at time of entry to physician health programs, the 125 female impaired physicians were younger (39.9 vs. 43.7 years; p < .0001), reported more medical (48.7% vs. 34.4%; OR = 1.81) and psychiatric (76.5% vs. 63.9%; OR = 1.84) problems at intake. They were more likely to report past (51.8% vs. 29.9%; OR = 2.51) or current (11.4% vs. 4.8%; OR = 2.54) suicidal ideation, and more likely to have made a suicide attempt under the influence (20.0% vs. 5.1%; OR = 4.64) or not under the influence (14.0% vs. 1.7%; OR = 9.67) of a substance. Although alcohol was the primary drug of abuse for all physicians studied, women physicians were more likely to abuse sedative hypnotics than men (11.4 vs. 6.4; OR = 1.87). There were no gender differences in employment problems (65.3% vs. 67.5%; ns) or legal problems (15% vs. 21%; OR = .66) due to addiction. These findings suggest different characteristics between male and female impaired physicians which may have implications for identification and treatment of this population. [ABSTRACT FROM AUTHOR]