Open AccessSexual Risk among Pregnant Women at Risk of HIV Infection in Cape Town, South Africa: What Does Alcohol Have to Do with It?
Author(s) -
Amanda P. Miller,
Steven Shoptaw,
Rufaro Mvududu,
Nyiko Mashele,
Thomas J. Coates,
LindaGail Bekker,
Zaynab Essack,
Candice Groenewald,
Zaino Petersen,
Pamina M. Gorbach,
Landon Myer,
D. A. Davey
Publication year - 2022
Publication title -
aids and behavior
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.994
H-Index - 106
eISSN - 1573-3254
pISSN - 1090-7165
DOI - 10.1007/s10461-022-03742-1
Subject(s) - serostatus , medicine , alcohol use disorders identification test , pregnancy , psychological intervention , population , environmental health , health psychology , public health , breastfeeding , demography , psychiatry , family medicine , poison control , human immunodeficiency virus (hiv) , pediatrics , injury prevention , viral load , nursing , biology , sociology , genetics
This study examines baseline associations between alcohol use and HIV sexual risk among a cohort of HIV-uninfected pregnant women (n = 1201) residing in a high HIV burdened community in Cape Town, South Africa. Alcohol use was measured using a modified version of the Alcohol Use Disorder Identification Test (AUDIT). HIV sexual risk was measured through a composite variable of four risk factors: diagnosis with a STI, self-report of > 1 recent sex partners, partner HIV serostatus (unknown or HIV+) and condomless sex at last sex. Any past year alcohol use prior to pregnancy was reported by half of participants (50%); 6.0% reported alcohol use during pregnancy. Alcohol use prior to pregnancy was associated with increased odds of being at high risk of HIV (aOR = 1.33, 95% CI 1.05-1.68, for 2 risks and aOR = 1.47, 95% CI 0.95-2.27 for 3 risks). In addition to reducing alcohol use, several other strategies to address HIV sexual risk were identified. Evidence-based interventions to address alcohol use and other HIV sexual risk behaviors during pregnancy in South Africa are desperately needed. Qualitative work exploring individual and community level drivers of alcohol use among pregnant and breastfeeding women in this setting could support development of a culturally tailored intervention to address these issues in this population.