The predictors and patterns of alcohol use in HIV positive women during their postpartum period, and how these impact viral load.

Mazubane, Thandeka

The predictors and patterns of alcohol use in HIV positive women during their postpartum period, and how these impact viral load.

Thesis / Dissertation

2023

Abstract

Introduction Although alcohol use among HIV-positive pregnant women in South Africa has been extensively researched, few studies have attempted to understand the longitudinal patterns and predictors of alcohol use when HIV-positive status intersects with the postpartum period. We examined the patterns of alcohol consumption during the postpartum period among HIV-positive women from Gugulethu, Cape Town; explored predictors associated with any alcohol consumption; and lastly, examined the association between alcohol use and HIV viral load. Methods Participants were recruited at the Gugulethu Community Health Centre while receiving prevention of mother to child transmission (PMTCT) services, obstetric, or postnatal care. The Alcohol Use Disorder Identification Test (AUDIT) screening tool was used to assess the alcohol use of eligible women. Participants were also assessed for hazardous alcohol use using the AUDIT-C scoring system during the analysis. The factors associated with patterns of alcohol use were then investigated using multiple logic regression and Generalised Mixed Effect Models. Using Generalised Mixed Effect Models, we also investigated the relationship between alcohol consumption and HIV viral load. Results Among 360 women (median age: 33 years), 10–28% reported alcohol use during the 24-month postpartum period, with alcohol use characterised by hazardous, binge drinking, and risky/dependency behaviour and associated with single relationship status and depression, whereas strong social support and patient-provider relationship was protective against risky/dependent alcohol use. We also found an association between hazardous, risky/dependent alcohol use and viral load, where hazardous drinkers and risky/dependent were 3 and 5 times more likely to have a suboptimal (>1000 copies/ml) viral load, respectively. Conclusion These unique data sheds light on the trajectories of alcohol use during the postpartum period in this vulnerable population, emphasizing the critical support and attention needed by this population and the strong focus public health needs to put on screening and interventions at a primary care level.

Keywords

Public Health and Family Medicine

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