Depression, Abuse, Relationship Power and Condom Use by Pregnant and Postpartum Women with Substance Abuse History

AIDS Behav. 2016 Feb;20(2):292-303. doi: 10.1007/s10461-015-1176-x.


Substance-abusing pregnant and postpartum women are less likely to maintain consistent condom use and drug and alcohol abstinence, which is particularly concerning in high HIV-prevalence areas. Data from 224 pregnant and postpartum women in substance abuse treatment were analyzed to examine effects of history of substance use, child abuse, and mental health problems on current substance use and condom-use barriers. Mediators were depression, relationship power and social support. Most participants (72.9 %) evidenced current depression. Less social support (-0.17, p < 0.05) and relationship power (-0.48, p < 0.001), and greater depression (-0.16, p < 0.05) predicted more condom-use barriers. History of mental health problems predicted condom-use barriers, mediated by recent depression and relationship power (0.15, p < 0.001). These findings suggest depression and diminished relationship power limit highest-risk women's ability to negotiate condom use and abstain from substance use, increasing their risk of acute HIV infection and vertical transmission.

Keywords: Condom; Depression; HIV; Pregnant; Substance abuse.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Adult Survivors of Child Abuse / psychology*
  • Adult Survivors of Child Abuse / statistics & numerical data
  • Child
  • Condoms / statistics & numerical data*
  • Depression / epidemiology
  • Depression / psychology*
  • Female
  • HIV Infections / epidemiology*
  • Humans
  • Negotiating
  • Postpartum Period
  • Pregnancy
  • Pregnant Women / psychology*
  • Safe Sex
  • Social Support
  • Substance-Related Disorders / psychology
  • Substance-Related Disorders / rehabilitation*