This work was funded by National Institutes of Health R01 MH054907 (DRB), K24AA022586 (JAH), R01AA018631 (JAH), P30 AI027763, R01 MH054907, and U01 CA066529 (JM). FB is supported by the IAS-NIDA fellowship program and JEH is supported by the NIH (K23MH 087228).
Antiretroviral therapy, HIV infections -- Treatment -- Uganda, AIDS (Disease) -- Patients -- Alcohol use
Background: Alcohol consumption among HIV-infected patients may accelerate HIV disease progression or reduce antiretroviral therapy adherence. Self-reported alcohol use is frequently under-reported due to social desirability and recall bias. The aim of this study was to compare self-reported alcohol consumption to phosphatidylethanol (PEth), a biomarker of alcohol consumption, and to estimate the correlation between multiple measures of self-reported alcohol consumption with PEth.
Methods: The Uganda AIDS Rural Treatment Outcomes (UARTO) cohort is located in southwestern Uganda and follows patients on ART to measure treatment outcomes. Patients complete standardized questionnaires quarterly including questions on demographics, health status and alcohol consumption. Baseline dried blood spots (DBS) were collected and retrieved to measure PEth. Results: One hundred fifty samples were tested, and 56 (37.3%) were PEth positive (>8 ng/mL). Of those, 51.7% did not report alcohol use in the past month. Men were more likely to under-report compared to women, OR 2.9, 95% CI51.26, 6.65) and those in the higher economic asset categories were less likely to underreport compared to those in the lowest category (OR50.41 95% CI: 0.17, 0.94). Among self-reported drinkers (n531), PEth was highly correlated with the total number of drinking days in the last 30 (Spearman R50.73, p,0.001).
Conclusions: Approximately half of HIV infected patients initiating ART and consuming alcohol under-report their use of alcohol. Given the high prevalence, clinicians should assess all patients for alcohol use with more attention to males and those in lower economic asset categories who deny alcohol use. Among those reporting current drinking, self-reported drinking days is a useful quantitative measure.
Bajunirwe F, Haberer JE, Boum Y II, Hunt P, Mocello R, et al. (2014) Comparison of Self-Reported Alcohol Consumption to Phosphatidylethanol Measurement among HIVInfected Patients Initiating Antiretroviral Treatment in Southwestern Uganda. PLoS ONE 9(12): e113152. doi:10.1371/journal.pone.0113152