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

• Published in: AIDS research and therapy 2017-05, Vol.14 (1), p.28-10, Article 28
• Main Authors: Donald, Kirsten A M, Fernandez, Anne, Claborn, Kasey, Kuo, Caroline, Koen, Nastassja, Zar, Heather, Stein, Dan J
• Format: Article
• Language: English
• Subjects: Acquired immune deficiency syndrome; Age; AIDS; Alcohol; Alcohol Drinking - adverse effects; Alcohol use; Alcoholic beverages; Anti-HIV Agents - therapeutic use; Antiretroviral agents; Antiretroviral therapy; Attenuation; Babies; Birth weight; Childbirth & labor; Circumferences; Communities; Data analysis; Data processing; Estimates; Exposure; Female; Fetal Alcohol Spectrum Disorders - diagnosis; Fetal Growth Retardation - chemically induced; Gestational age; Gestational outcomes; Head; Health; HIV; HIV Infections - drug therapy; Human immunodeficiency virus; Humans; Infant; Infant, Low Birth Weight; Infants; Low-birth-weight; Mental depression; Morbidity; Mortality; Population studies; Pregnancy; Regression analysis; Risk analysis; Risk factors; Smoking; South Africa; Studies; Variance; Womens health
• ISSN: 1742-6405; 1742-6405
• DOI: 10.1186/s12981-017-0153-z

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. 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. 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. 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.