Alcohol use among HIV-positive women of childbearing age, United States, 2013-2014

Abstract

More than one-quarter of the adults living with diagnosed HIV infection in the US are women. Binge drinking (i.e., ≥4 alcoholic drinks per occasion for women) is associated with poor HIV treatment compliance, HIV incidence, and unplanned pregnancy. However, little is known about the prevalence of binge drinking among women of childbearing age who are living with HIV (WLWH) and health risk behaviours among those who binge drink. Using the 2013-2014 data cycles of Medical Monitoring Project, we assessed the weighted prevalence of drinking patterns by socio-demographic, clinical and reproductive characteristics of 946 WLWH. Logistic regression was used to calculate unadjusted and adjusted prevalence ratios and 95% confidence intervals. Overall, 39% of WLWH reported current drinking and 10% reported binge drinking. Compared to non-drinkers, binge drinkers were less likely to adhere to antiretroviral therapy (ART) or be virally suppressed. In multivariate analyses, binge drinking among WLWH was associated with smoking, drug use, and reduced ART adherence compared to non-drinkers, increasing the likelihood of negative clinical outcomes. WLWH may benefit from a comprehensive approach to reducing binge drinking including alcohol screening and brief interventions and evidence-based policy strategies that could potentially improve adherence to HIV treatment.

Keywords: HIV; alcohol consumption; binge drinking; pregnancy; women.

Figure 1.

a. Prevalence of Clinical Characteristics among HIV-positive Women of Childbearing Age in Care, Stratified by Drinking Status – Medical Monitoring Project, 2013–2014. b. Prevalence of Health Risk Behaviors among HIV-positive Women of Childbearing Age in Care, Stratified by Drinking Status – Medical Monitoring Project, 2013–2014.Abbreviations: ART = Antiretroviral therapy; PR = Unadjusted Prevalence Ratio.Weighted percentages are the prevalence of the behaviour within the drinking pattern category.Time period: In the past 12 months, unless otherwise noted. All measures are self-reported unless otherwise noted.Non-drinkers were defined as women who did not report drinking any alcohol in the past 30 days.Current/non-binge drinkers were defined as women who reported consuming ≥1 drink in the past 30 days and did not report consuming ≥4 drinks in a sitting.Binge drinkers were defined as women who reported consuming ≥4 drinks during at least one sitting in the past 30 days.Drug use includes non-injection and injection use for non-medical reasons.ART adherent was defined as patients who self-report that they are currently taking ART and were 100% dose adherent in the past 3 days. A patient is defined as 100% adherent if they took their ART doses or set of pills/spoonfuls/injections of ART medications as prescribed by a health care provider in the last 3 days. Otherwise, they were considered as not adherent.Recent viral suppression is defined as the most recent viral load in the past 12 months prior to the interview as undetectable or <200 copies/ml. This information is based on data as recorded by medical record abstraction during the past 12 months prior to interview.