Cited by 97Substance Abuse Treatment and OutcomesHIV, Drug Use, Sexual RiskHIV/AIDS Research and Interventions

Declining and rebounding unhealthy alcohol consumption during the first year of HIV care in rural Uganda, using phosphatidylethanol to augment self‐report

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Hahn, Judith A., Emenyonu, Nneka I., Fatch, Robin, Muyindike, Winnie R., Kekiibina, Allen, Carrico, Adam W., Woolf‐King, Sarah, Shiboski, Stephen·2016·Addiction

Abstract

Aims: We examined whether unhealthy alcohol consumption, which negatively impacts HIV outcomes, changes after HIV care entry overall and by several factors. We also compared using phosphatidylethanol (PEth, an alcohol biomarker) to augment self‐report to using self‐report alone. Design: A prospective 1‐year observational cohort study with quarterly visits. Setting: Large rural HIV clinic in Mbarara, Uganda. Participants: A total of 208 adults (89 women and 119 men) entering HIV care, reporting any prior year alcohol consumption. Measurements: Unhealthy drinking was PEth+ (≥ 50 ng/ml) or Alcohol Use Disorders Identification Test–Consumption+ (AUDIT‐C+, over 3 months, women ≥ 3; men ≥ 4). We calculated adjusted odds ratios (AOR) for unhealthy drinking per month since baseline, and interactions of month since baseline with perceived health, number of HIV symptoms, antiretroviral therapy (ART), gender and self‐reported prior unhealthy alcohol use. Findings: The majority of participants (64%) were unhealthy drinkers (PEth+ or AUDIT‐C+) at baseline. There was no significant trend in unhealthy drinking overall [per‐month AOR: 1.01; 95% confidence interval (CI) = 0.94–1.07], while the per‐month AORs were 0.91 (95% CI = 0.83–1.00) and 1.11 (95% CI = 1.01–1.22) when participants were not yet on ART and on ART, respectively (interaction P ‐value < 0.01). In contrast, 44% were AUDIT‐C+; the per‐month AORs for being AUDIT‐C+ were 0.89 (95% CI = 0.85–0.95) overall, and 0.84 (95% CI = 0.78–0.91) and 0.97 (95% CI = 0.89–1.05) when participants were not on and were on ART, respectively. Conclusions: Unhealthy alcohol use among Ugandan adults entering HIV care declines prior to the start of anti‐retroviral therapy but rebounds with time. Augmenting self‐reported alcohol use with biomarkers increases the ability of current alcohol use measurements to detect unhealthy alcohol use.

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  1. [41]Hahn JA Fatch R Kabami J Self-Report of Alcohol Use Increases When Specimens for Alcohol Biomarkers Are Collected in Persons With HIV in Uganda J Acquir Immune Defic Syndr 2012 61 4 e63 e64 23138732 PMC3495104
  2. [42]Bajunirwe F Haberer J Boum Y Comparison of self-reported alcohol consumption to phosphatidylethanol measurement among HIV infected patients initiating antiretroviral treatment in south western Uganda Submitted 2014 PMC4249861 25436894

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Authors
Hahn, J. A., Emenyonu, N. I., Fatch, R., Muyindike, W. R., Kekiibina, A., Carrico, A. W., Woolf‐King, S., & Shiboski, S.
Affiliations
  • University of California, San Francisco (US)
  • Mbarara University of Science and Technology (UG)
  • Mbarara University of Sciences and Technology Faculty of Medicine Mbarara Uganda
Corresponding author
Hahn, Judith A.
Venue
Addiction
Publisher
Wiley
Published
2015-11-05
Volume
111
Issue
2
Pages
272-279
ISSN
  • 0965-2140 (ISSN-L)
  • 1360-0443
OpenAlex
W1909348998
Cited by
97
References
39
Citations by year
2026: 4 · 2025: 4 · 2024: 7 · 2023: 25 · 2022: 13 · 2021: 9 · 2020: 6 · 2019: 6 · 2018: 4 · 2017: 10 · 2016: 9
FWCI
6.02
Type
journal article
Language
en
Open access
Locations
  • Addiction (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
Funders
US National Institutes of Health, (R01AA018631, U01AA020776, K24AA022586, K01AA021671, P30DK026743)
Topics
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
  • Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
Keywords
phosphatidylethanol, alcohol biomarkers, AUDIT-C, antiretroviral therapy, alcohol consumption trends, health perception, HIV symptoms, Uganda, Mbarara, gender differences in drinking, HIV outcomes, Alcohol Use Disorders Identification Test
MeSH terms
Adult, Alcohol Drinking, Ambulatory Care, Breath Tests, Female, Humans, Male, Risk-Taking, Rural Health, Uganda, Biomarkers, HIV Infections, Glycerophospholipids, Self Report

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