Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #119051

Katherine Theall, Tulane University School of Public Health and Tropical Medicine, 1440 Canal St., SL-18, New Orleans, LA 70112, (504) 495-1647, ccrimmins@asph.org

Objective: To examine the association between alcohol consumption and HIV-1 vaginal shedding. Methods: HIV 1- infected women attending a large urban HIV primary care clinic in New Orleans, Louisiana between June 2002 and October 2004, who underwent a gynecological exam and were > 18 years of age were included. Subjects underwent clinical exams and were interviewed using a computer-assisted survey at baseline, one and three months. Results: Women (N=187) were mostly African American (86.4%), median age of 38 (range 19-61), on antiretroviral therapy (ARV) (56.7%) and had a median CD4 of 404 copies/ěL and plasma viral load of 3196 copies/mL at baseline. Self-reported adherence to ARV on the prior day was 89.6%. Overall period prevalence of vaginal shedding (> 50 copies/swab) was 24.5%, with a baseline prevalence of 27.3%. At baseline, 30% reported any alcohol consumption, 32.6% were weekly drinkers, 25.5% were binge drinkers, and 10.0% were heavy drinkers. Prevalence of various consumption patterns was similar over the course of follow-up. Recent heavier alcohol consumption and binge drinking were both strongly and positively associated with vaginal shedding, but only among women on ARV. After adjusting for plasma viral load, immunosupression, and ARV adherence, recent heavy alcohol consumption (> 2 drinks yesterday) was significantly associated with vaginal shedding (adjusted POR=2.29, 95% CI=1.18, 14.43). Plasma viral loads were not different between heavy alcohol consumers and those who were light consumers or abstinent. Conclusions: Recent and heavier binge alcohol consumption may increase expression of HIV-1 RNA in vaginal fluids of women on ARV.

Learning Objectives:

• 1 - summarize recent research on genital HIV shedding among women
• 2 - learn about the mechanisms behind genital shedding, factors associated with increased shedding, and the role of alcohol consumption

Keywords: Alcohol, HIV/AIDS

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.