Combining Multiple Measures of Alcohol Use Helps Clarify Risky Drinking in People with HIV

Researchers and clinicians can better understand the health risks facing people with HIV through comprehensive measures of alcohol use, including objective biomarkers, according to a new study in Alcoholism: Clinical and Experimental Research. Frequent or heavy alcohol use in people with HIV can affect HIV disease progression and comorbidities. Alcohol use disorder is a barrier to effectively managing HIV and contributes in multiple ways to poor health outcomes. These effects are not well understood, however, owing in part to the limitations of self-report tools (questionnaires) for measuring alcohol use. Researchers at Louisiana State University and Tulane University correlated self-reported alcohol use, measured by multiple questionnaires, with a biomarker of alcohol consumption in people with HIV. This study explores the implications of this multi-faceted approach for understanding the alcohol use of people with HIV and the related risk factors.

Investigators examined alcohol use in 365 adults (black and white, men and women) with HIV who were enrolled in the New Orleans Alcohol Use in HIV (NOAH) Study. The data came from multiple sources and involved trained interviewers. The sources included four validated self-report alcohol use questionnaires, and blood levels of phosphatidylethanol (PEth), a biomarker showing recent alcohol consumption including heavy drinking. The researchers used these data to sort participants into seven categories based on alcohol use. The analysis included correlations between alcohol use and sex, age, smoking status, viral load, and other variables.

Comparing biomarker PEth measurements with self-reported measures of alcohol confirmed the high frequency of alcohol use among participants, and the association between low alcohol use and better controlled HIV. This study also highlighted the higher prevalence of heavy drinking among men than women, and among smokers compared to nonsmokers. The analysis showed that self-reported alcohol measures correlated with the biological marker PEth. The strength of the correlations varied, and the questionnaires did not fully capture the alcohol use that showed in PEth indicators. Most correlations were weaker among men, and among frequent and heavy drinkers. Combining data from multiple self-report instruments led to many participants who using single instruments would have been considered infrequent drinkers to be reclassified as frequent or heavy drinkers.

The study highlights the importance of comprehensive assessments of alcohol use, including multiple self-report questionnaires administered by trained staff and the addition of biomarkers, to better understand the risks affecting people with HIV.

Comprehensive Assessment of Alcohol Consumption in People Living with HIV (PLWH): the New Orleans Alcohol Use in HIV (NOAH) Study. T.F. Ferguson, K.P. Theall, M. Brashear, V. Maffei, A. Beauchamp, R. Siggins, L. Simon, D. Mercante, S. Nelson, D.A. Welsh, P.E. Molina (pages xxx)

ACER-19-4185.R2

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