Parry Charles D H, Myers Bronwyn, Londani Mukhethwa, Shuper Paul A, Nkosi Sebenzile, Hahn Judith A, Kekwaletswe Connie, Morojele Neo K
Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Cape Town, South Africa.
Department of Psychiatry, University of Stellenbosch, Cape Town, South Africa.
Alcohol Clin Exp Res (Hoboken). 2023 May;47(5):940-950. doi: 10.1111/acer.15062. Epub 2023 Mar 28.
Accurately quantifying alcohol use among persons with HIV (PWH) is important for validly assessing the efficacy of alcohol reduction interventions.
We used data from a randomized controlled trial of an intervention to reduce alcohol use among PWH who were receiving antiretroviral therapy in Tshwane, South Africa. We calculated agreement between self-reported hazardous alcohol use measured by the Alcohol Use Disorders Identification Test (AUDIT; score ≥8) and AUDIT-Consumption (AUDIT-C; score ≥3 for females and ≥4 for males), heavy episodic drinking (HED) in the past 30 days, and heavy drinking in the past 7 days with a gold standard biomarker--phosphatidylethanol (PEth) level (≥50 ng/mL)--among 309 participants. We used multiple logistic regression to assess whether underreporting of hazardous drinking (AUDIT-C vs. PEth) differed by sex, study arm, and assessment time point.
Participants' mean age was 40.6 years, 43% were males, and 48% were in the intervention arm. At 6 months, 51% had PEth ≥50 ng/mL, 38% and 76% had scores indicative of hazardous drinking on the AUDIT and AUDIT-C, respectively, 11% reported past 30-day HED, and 13% reported past 7-day heavy drinking. At 6 months, there was low agreement between AUDIT-C scores and past 7-day heavy drinking relative to PEth ≥50 (sensitivities of 83% and 20% and negative predictive values of 62% and 51%, respectively). Underreporting of hazardous drinking at 6 months was associated with sex (OR = 3.504. 95% CI: 1.080 to 11.364), with odds of underreporting being greater for females.
Steps should be taken to decrease underreporting of alcohol use in clinical trials.
准确量化艾滋病毒感染者（PWH）的酒精使用量对于有效评估减少酒精使用干预措施的效果至关重要。
我们使用了一项随机对照试验的数据，该试验旨在减少南非茨瓦内接受抗逆转录病毒治疗的PWH的酒精使用量。我们计算了通过酒精使用障碍识别测试（AUDIT；得分≥8）和AUDIT-消费版（AUDIT-C；女性得分≥3，男性得分≥4）自我报告的危险酒精使用量、过去30天的重度暴饮（HED）以及过去7天的重度饮酒与309名参与者的金标准生物标志物——磷脂酰乙醇（PEth）水平（≥50 ng/mL）之间的一致性。我们使用多元逻辑回归来评估危险饮酒报告不足（AUDIT-C与PEth对比）是否因性别、研究组和评估时间点而异。
参与者的平均年龄为40.6岁，43%为男性，48%在干预组。在6个月时，51%的人PEth≥50 ng/mL，分别有38%和76%的人在AUDIT和AUDIT-C上的得分表明存在危险饮酒，11%的人报告过去30天有HED，13%的人报告过去7天有重度饮酒。在6个月时，相对于PEth≥50，AUDIT-C得分与过去7天的重度饮酒之间的一致性较低（敏感性分别为83%和20%，阴性预测值分别为62%和51%）。6个月时危险饮酒报告不足与性别有关（OR = 3.504，95% CI：1.080至11.364），女性报告不足的几率更高。
应采取措施减少临床试验中酒精使用报告不足的情况。
