Recent Alcohol Use Is Associated With Increased Pre-exposure Prophylaxis (PrEP) Continuation and Adherence Among Pregnant and Postpartum Women in South Africa.

Autor:	Miller AP; Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA., Shoptaw S; Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA.; Department of Psychiatry, University of Cape Town, Cape Town, South Africa., Moucheraud C; Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, CA., Mvududu R; Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Observatory, South Africa., Essack Z; Center for Community-Based Research, Human Sciences Research Council, South Africa., Gorbach PM; Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA., Myer L; Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Observatory, South Africa., Davey DLJ; Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA.; Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Observatory, South Africa.; Division of Infectious Diseases, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA; and.; The Desmond Tutu HIV Center, Institute for Infectious Disease and Molecular Medicine, Faculty of Health Science, University of Cape Town, Cape Town, South Africa.
Jazyk:	angličtina
Zdroj:	Journal of acquired immune deficiency syndromes (1999) [J Acquir Immune Defic Syndr] 2023 Mar 01; Vol. 92 (3), pp. 204-211.
DOI:	10.1097/QAI.0000000000003133
Abstrakt:	Background: South African women experience high levels of alcohol use and HIV infection during the perinatal period. Oral pre-exposure prophylaxis (PrEP) is highly effective at reducing HIV risk. We examined associations between alcohol use and PrEP use during pregnancy and postpartum. Methods: The PrEP in Pregnant and Postpartum women study is a prospective observational cohort of 1200 HIV-negative pregnant women enrolled at first antenatal care visit and followed through 12 months' postpartum in Cape Town, South Africa. The analytic sample comprised pregnant women who initiated PrEP at baseline and were not censored from study follow-up before 3-month follow-up. We examined associations between any or hazardous alcohol use (Alcohol Use Disorders Identification Test-Consumption score ≥3) in the year before pregnancy and PrEP continuation and adherence during pregnancy (self-report of missing <2 doses in past 7 days and biomarker-confirmed with tenofovir diphosphate in dried blood spots). Results: Of 943 women on PrEP (median age of 26 years), 50% reported alcohol use before pregnancy, and 33% reported hazardous use. At 3-month follow-up, 58% of women were still using PrEP; 41% reported recent adherence, and 23% were biomarker-confirmed adherent. In multivariable models, hazardous alcohol use was associated with increased odds of continuing PrEP [adjusted odds ratio (aOR) = 1.54, 95% confidence interval (CI): 1.16-2.06], self-reported PrEP adherence (aOR = 1.41, 95% CI: 1.07-1.87), and biomarker-confirmed PrEP adherence (aOR = 1.35 95% CI: 0.98, 1.87). Associations were similar in models of any alcohol use and PrEP continuation/adherence. Conclusions: Pregnant and postpartum women who reported recent alcohol use had increased odds of continuing to take PrEP, indicating that higher risk women may continue on oral PrEP. Competing Interests: The authors have no conflicts of interest to disclose. (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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