Alcohol Use Among Pregnant Ugandan Women of Mixed HIV Status is Associated with Social Environment and Food Insecurity Shalean Collins1, Barnabas Natamba2, Angela Arbach3, Elizabeth Widen4, Pooja Desai2, Hijab Khan2, Jeffrey K Griffiths5 and Sera L Young2. 1Public Health, Tulane University, New Orleans, LA, United States; 2Nutritional Sciences, Cornell University, Ithaca, NY, United States; 3Internal Medicine, NYU Medical Center, New York, NY, United States;4Epidemiology, Columbia University, New York, NY, United States and 5Public Health & Community Medicine, Tufts University, Boston, MA, United States. Antenatal alcohol use (AAU) is associated with poor health outcomes in maternal-infant dyads. However, AAU prevalence and risk factors are poorly understood, particularly in low-income settings. Therefore we studied correlates of any AAU among pregnant women receiving antenatal care in Gulu, Uganda. Characteristics of pregnant women enrolled in a cohort study (n=403, 33% HIV+) were assessed at multiple levels of the social-ecological model (SEM). AAU was reported by 20.1% of participants. Beer (10.1%) and kweete (sorgum-millet brew) (9.2%) were the most frequently consumed alcohols (Figure 1). Excessive drinking was rare; mean alcohol units consumed/month was 4.4 in those who drank. In multivariate logistic models, social environment, (partner drinking 30 days/month, [Odds Ratio (OR) 2.17, p=0.03] or friends drinking 1-29 days/month [OR 3.59, p

Table 1. Bivariate and multivariate logistic models of any alcohol use during pregnancy among 403 pregnant Ugandans of mixed HIV status Characteristic

Unadjusted OR p-value Adjusted OR p-value

Maternal Characteristics

Maternal Age (y) 1.05 (1.00-1.10)

0.01 1.06 (1.01-1.12)

0.01

HIV-positive 0.68 (0.39-1.18)

0.17 0.60 (0.32-1.12)

0.11

Depression score1 1.00 (0.98-1.02)

0.70

Maternal education level Primary Secondary >Secondary

ref 1.04 (0.61-1.78) 2.26 (1.01-5.03)

0.17 0.04

ref 1.05 (0.58-1.90) 1.03 (0.39-2.68)

0.86 0.94

Maternal Nutrition Food insecurity score2 0.95(0.91-1.00)

0.05 0.93 (0.88-0.99)

0.02

Dietary diversity score3

1.17 (1.02-1.35)

0.02

Household and Interpersonal Characteristics Partner drinks (days/month) Never 1-29 30

ref 1.43 (0.79-2.56) 1.87 (1.00-3.50)

0.04 0.22

ref 1.05(0.55-1.99) 2.17(1.06-4.44)

0.86 0.03

Friends drink (days/month) Never 1-29 30

ref 2.99 (1.65-5.42) 2.00 (0.74-5.36)

Years displaced to IDP camp None 1-4 5-10 >10

ref 0.90 (0.18-4.57) 1.00 (0.18-5.28) 1.00 (0.20-4.91)

0.90 1.00 0.99

1Depression score (0-56) Center for Epidemiologic Studies Depression Scale (CES-D) 2Individually-Focused Food Insecurity Access Scale (IFIAS); Natamba et al., 2014 3Dietary diversity (0-26), FAO HDDS Scale; FAO 2011 4Domestic violence: sexual and physical violence within the past year 5Asset score (0-12) based on possession of 12 household items of value