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The scope of the problem: AIDS is now the sixth leading cause of death among reproductive-age women in the United States and the primary cause of death in young women in major cities. Its incidence is rising more rapidly among women than any other group. The 1987 case definition may have undercounted women with AIDS, which has contributed to underrecognition of the problem. So have the failure of physicians to think of HIV as a woman's problem and underestimation of the importance of heterosexual sex in trasmitting the virus. [ABSTRACT FROM AUTHOR]

We aimed to determine if the trend in substance use in this central core of a large inner-city area confirmed an increase in marijuana use among young women < 22 years of age as childbearing years were beginning or if marijuana use and harder drug use were greatest among women beyond the teens and the early second decade of life and to describe one prenatal care intervention. Statistical reports for the Special Prenatal Clinic, a Harlem clinic for women with a current or past history of substance use, were reviewed from 1985 (the clinic's inception) through March 1996 to determine the trends, patterns, and types of drug use. Findings chronicled the beginning and rise in crack cocaine use, especially after 1986, confirmed an increase in marijuana use by adolescents since 1992, and suggest that the risk for use of hard drugs increases with age, predominantly in the childbearing years. Intervention by the Special Prenatal Clinic aided case-finding, allowed for comprehensive care, offered women opportunities for behavior change, and increased their chances of keeping their babies after delivery. [ABSTRACT FROM AUTHOR]