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Effects of Maternal HIV Infection and Alcohol Use in Pregnancy on Birth Outcomes in Uganda

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Abstract

Alcohol use and HIV infection are prevalent in sub-Saharan Africa (sSA), and both are associated with low birth weight. Yet, few studies have evaluated the combined effects of maternal HIV infection and alcohol use on birth outcomes. We analyzed data from a prospective cohort study of HIV-related placental changes in Ugandan women. We defined alcohol use as self-reported alcohol use within the last year, using the AUDIT questionnaire and used linear and logistic regression to measure associations between maternal alcohol use, HIV serostatus, and birth weight. In a subsample, we measured alcohol exposure using phosphatidylethanol (PEth) in neonatal heelstick dried blood spots to confirm maternal alcohol use. Of 352 participants, 176 (50%) were women with HIV (WHIV). Three of 176 (2%) HIVuninfected women and 17/176 (10%) of WHIV self-reported alcohol use (P = 0.002). Maternal HIV infection was associated with lower birth weight (β = −0.12, 95% CI [−0.20, −0.02], P = 0.02), but self-reported alcohol use was not (β = 0.06, 95% CI [−0.15, 0.26], P = 0.54), and the interaction between HIV serostatus and alcohol use was not significant (P = 0.13). Among the PEth subsample, neither HIV status nor PEthconfirmed alcohol use were associated with low birth weight. Maternal HIV infection was associated with lower birth weight, but alcohol use was not, and there was no significant interaction between maternal HIV infection and alcohol use. Alcohol use was more prevalent in WHIV and under-reporting was common. A larger study of the effects of laboratory-confirmed alcohol and HIV exposure on birth outcomes is warranted.

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Funding

This work was supported by the Harvard University Center for AIDS Research National Institutes of Health/National Institute of Allergy and Infectious Diseases [grant number P30AI060354 to LMB] and supported by a KL2/Catalyst Medical Research Investigator Training award from Harvard Catalyst | The Harvard Clinical and Translational Science Center [grant number KL2TR002542 to LMB], and the Charles H. Hood Foundation (to LMB), a career development award from the National Institute of Allergy and Infectious Diseases [grant number K23AI138856 to LMB], midcareer mentoring awards [grant number K24AI141036 to IVB, K24AA022586 to JAH, K24 HL166024 to MJS], the Weissman Family MGH Research Scholar Award (to IVB), and the American Society of Tropical Medicine and Hygiene Burroughs Wellcome Postdoctoral Fellowship in Tropical Infectious Diseases (to LMB).

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Authors and Affiliations

  1. Mbarara University of Science and Technology, P.O.Box 1410, Mbarara, Uganda

    Julian Adong, Nicholas Musinguzi, Joseph Ngonzi & Mark J. Siedner

  2. Department of Medicine, Center for Global Health, Massachusetts General Hospital, Boston, USA

    Jessica E. Haberer, Ingrid V. Bassett, Mark J. Siedner & Lisa M. Bebell

  3. Department of Pathology, Center for Global Health, Massachusetts General Hospital, Boston, USA

    Drucilla J. Roberts

  4. University of California, San Francisco, USA

    Judith A. Hahn

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  1. Julian Adong
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  2. Nicholas Musinguzi
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  4. Jessica E. Haberer
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Correspondence to Julian Adong.

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Adong, J., Musinguzi, N., Ngonzi, J. et al. Effects of Maternal HIV Infection and Alcohol Use in Pregnancy on Birth Outcomes in Uganda. AIDS Behav 28, 805–810 (2024). https://doi.org/10.1007/s10461-023-04181-2

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