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Baseline data on covariates, alcohol consumption, ART adherence, and viral load were collected from 608 WLWH on ART living in the Western Cape, South Africa. We defined three consumption patterns: no\/light drinking (drinking\u2009\u2264\u20091\/week and\u2009\u2264\u20094 drinks\/occasion), occasional heavy episodic drinking (HED) (drinking\u2009&gt;\u20091 and\u2009\u2264\u20092\/week and\u2009\u2265\u20095 drinks\/occasion) and frequent HED (drinking\u2009\u2265\u20093 times\/week and\u2009\u2265\u20095 drinks\/occasion). In multivariable analyses, occasional HED (OR\u20093.07, 95% CI 1.78\u20135.30) and frequent HED (OR\u20097.11, 95% CI 4.24\u201311.92) were associated with suboptimal adherence. Frequent HED was associated with viral non-suppression (OR\u20092.08, 95% CI 1.30\u20133.28). Suboptimal adherence partially mediated the relationship between frequent HED and viral non-suppression. Findings suggest a direct relationship between frequency of HED and viral suppression. Given the mediating effects of adherence on this relationship, alcohol interventions should be tailored to frequency of HED while also addressing adherence.<\/jats:p>","DOI":"10.1007\/s10461-021-03263-3","type":"journal-article","created":{"date-parts":[[2021,4,19]],"date-time":"2021-04-19T14:14:52Z","timestamp":1618841692000},"page":"3758-3769","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":38,"title":["Associations Between Patterns of Alcohol Use and Viral Load Suppression Amongst Women Living with HIV in South Africa"],"prefix":"10.1007","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0235-6716","authenticated-orcid":false,"given":"B.","family":"Myers","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Lombard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. 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