Alcohol is a major contributor to the global burden of disease. In South Africa, alcohol abuse is hypothesized to correlate with women's HIV status, mental health, and partner relationships over time. All pregnant women in 12 urban, low-income, Cape Town neighborhoods were interviewed at baseline, post-birth, and at 6, 12, 36, and 60 months following delivery with retention rates from 82.5 to 94%. Women were assessed for any alcohol use, problematic drinking, depression, intimate partner violence, and HIV status. Prior to pregnancy discovery and 5 years after giving birth, alcohol use was 25.8 and 24.7%, respectively. Most women decreased their alcohol use during pregnancy. Twenty-one percent reported alcohol use on two or more assessments, and only 15% of the mothers drinking alcohol at 5 years were also drinking at baseline. Mothers with depression had a higher likelihood of drinking alcohol compared to mothers who were not depressed only at baseline and 6 months post-birth. Mothers who experienced IPV had more than twice the likelihood of drinking alcohol compared to non-IPV mothers at all assessments. HIV positive mothers were more likely to drink alcohol compared to mothers without HIV prior to pregnancy discovery and at 5 years post-birth. These longitudinal trends in alcohol use among young women in South Africa represent a large economic, social, and health burden and must be addressed in a comprehensive manner.
Keywords: Alcohol; Depression; Intimate partner violence; Maternal health.