216 Substance use during pregnancy and postpartum among women with perinatally-acquired HIV

Abstract

Substance use during and after pregnancy may be a critical determinant of health for women living with HIV (WLHIV), but little is known about substance use patterns among pregnant and postpartum women living with perinatally-acquired HIV (WLPHIV). We sought to estimate prevalence of marijuana, alcohol, and opioid use during pregnancy and postpartum among WLHIV and determine associations between mode of HIV acquisition (perinatally- vs. non-perinatally acquired HIV) and substance use. We analyzed data on marijuana, alcohol, and opioid use from the Surveillance Monitoring for ART Toxicities study of the Pediatric HIV/AIDS Cohort Study, which has been enrolling pregnant WLHIV at 22 US sites since 2007. Included in the analysis were participants enrolled from 2007-2019 who were born after 1982 and had self-reported substance use data available in pregnancy, 1-year postpartum, or both. Prevalence of any marijuana, alcohol, opioid, and concomitant alcohol and marijuana use was compared by WLPHIV status, separately for pregnancy and postpartum. Multivariable log binomial regression models were fit using generalized estimating equations to estimate the relative risk of each substance use outcome by PHIV status, adjusting for race/ethnicity, age, and delivery year. A total of 1547 pregnancies of 1159 WLHIV had available data in pregnancy (N=1538) or postpartum (N=925); 19% (N=298) were among WLPHIV. WLPHIV were younger and more often identified as Hispanic. During pregnancy, no significant differences in substance use were observed by PHIV status (Table 1). Substance use was more common postpartum, with little difference in postpartum marijuana use by PHIV status (Table 2). However, the adjusted RR (aRR) for postpartum alcohol use was increased for WLPHIV (aRR 1.23, 95% CI 1.03-1.48). Although use of substances during and after pregnancy was frequent, there were no major differences in substance use based on mode of HIV acquisition. However, the high prevalence of substance use among all WLHIV, particularly postpartum alcohol and marijuana use, warrants further attention.View Large Image Figure ViewerDownload Hi-res image Download (PPT)