CDC Encourages Contraception for Heavy Drinking Women 
By Karla Gale 

NEW YORK (Reuters Health) - Researchers at the US Centers for Disease Control and Prevention (news - web sites) reached out to women at risk for alcohol-exposed pregnancies in a recent trial project, helping them choose effective contraception until they gain control over their alcohol abuse. 

Dr. Louise Floyd, CDC's chief of fetal alcohol syndrome prevention in Atlanta, Georgia, describes the program, termed Project CHOICES, as a ``client-centered motivational intervention.'' 
Investigators focused on populations such as incarcerated women, women in alcohol- and drug-treatment recovery programs, and women attending university-based obstetrics and gynecology clinics. Floyd told Reuters Health that ``these places are where we are most likely to find women ages 18 to 44 who are sexually active, drinking at risk levels and are not effectively contracepting.'' 

Floyd continued, ``We know from research that has been done with respect to reducing alcohol use that, depending on the level of addiction, recovery rates may vary significantly. Some of the women we would be targeting with this intervention would not be able to achieve the reductions in their alcohol use that we are targeting. Others might achieve them for the short term, but then relapse.'' 

What is novel in Project CHOICES, Floyd said, is a combined approach to reduce high-risk drinking along with a component ''focusing on getting (women) to engage in effective contraception until they are sure they can get their risk drinking under control.'' 

One aspect of the intervention is informing the client of the consequences of becoming pregnant while she is drinking at risk levels. These would include effects on the woman herself, such as infertility or spontaneous abortion. The consequences for the children of women who use alcohol, including fetal alcohol syndrome and birth defects, are also presented. 

``Secondly, we want to convey a more personalized message,'' Floyd added, ``so we do a fairly extensive assessment of her drinking habits, looking at frequency, amount, and pattern of her alcohol abuse. Then we give her feedback in terms of how she compares with women in her age group overall in terms of drinking patterns. 

``As you might expect, many of the women who are risk-drinking really do not see themselves drinking at rates of alcohol that are higher than most women their age. That's because their circle of friends drink similarly.'' 

The next step, Floyd explained, is to discuss the reasons why the women are not using contraception, then helping them to choose an effective method that they can use as prescribed. 
The researchers will work with associates in Virginia, Texas, and Florida in conducting a 3-year clinical trial using the materials and methods established in the early trial.