The developmental effects of HIV and alcohol: a comparison of gestational outcomes among babies from South African commu
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AIDS Research and Therapy Open Access
RESEARCH
The developmental effects of HIV and alcohol: a comparison of gestational outcomes among babies from South African communities with high prevalence of HIV and alcohol use Kirsten A. M. Donald1*, Anne Fernandez2, Kasey Claborn2,3,4, Caroline Kuo2,5,6, Nastassja Koen6, Heather Zar1,7 and Dan J. Stein6,8
Abstract Background: There is growing evidence of the negative impact of alcohol on morbidity and mortality of individuals living with HIV but limited evidence of in utero effects of HIV and alcohol on exposure on infants. Methods: We conducted a population-based birth cohort study (N = 667 mother-infant dyads) in South Africa to investigate whether maternal alcohol use and HIV affected gestational outcomes. Descriptive data analysis was conducted for all variables using frequency distributions, measures of central tendency, and estimates of variance. Hierarchical multiple regression was conducted to determine whether maternal alcohol use, maternal HIV status and other risk factors (socioeconomic status, smoking, depression) predicted infant outcomes. Results: Our results showed severity of recent alcohol use and lifetime alcohol use predicted low birth weight. Similarly lifetime alcohol use predicted shorter infant length, smaller head length, smaller head circumference, and early gestational age. However, HIV status was not a significant predictor of gestational outcomes. Conclusions: The unexpected finding that maternal HIV status did not predict any of the gestational outcomes may be due to high rates of ART usage among HIV-infected mothers. The potentially negative effects of HIV on gestational outcomes may have been attenuated by improved maternal health due to high coverage of antiretroviral treatment in South Africa. Interventions are needed to reduce alcohol consumption among pregnant mothers and to support healthy growth and psychosocial development of infants. Keywords: Gestational outcomes, Alcohol, HIV, South Africa, Pregnancy Background Alcohol use, including hazardous and harmful levels, remains a serious health problem among individuals living with HIV globally and in South Africa specifically. In South Africa, the country with the largest number *Correspondence: [email protected] 1 Department of Paediatrics and Child Health, Institute of Child Health Building, Red Cross War Memorial Children’s Hospital, 5th Floor, Klipfontein Road, Rondebosch, Cape Town 7700, South Africa Full list of author information is available at the end of the article
of people living with HIV (PLWH) globally [1], alcohol consumption is among the highest in the world [2]. A national survey documented that 9% of the population engage in risky or hazardous drinking [3–5]. Even more concerning is a high proportion of individuals living with HIV struggle with alcohol abuse and dependence. While national estimates are unavailable, local studies in communities with high prevalence of HIV show rates of recent alcohol use as high as 51% as well as concerning levels of depen
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