Department of Community Health Systems, University of California, San Francisco, San Francisco, California, United States of America.
Department of Medicine, University of California, San Francisco, San Francisco, California, United States of America.
PLoS One. 2024 Oct 4;19(10):e0308867. doi: 10.1371/journal.pone.0308867. eCollection 2024.
The objective of this study was to identify the prevalence and correlates of phosphatidylethanol (PEth) levels suggestive of unhealthy alcohol use among women living with and without HIV who self-reported no or low-risk drinking. We analyzed data from a cross-sectional study among women enrolled in the San Francisco Bay Area site of the Women's Interagency HIV Study (WIHS). Between October 2017 and March 2018, PEth was tested from dried blood spots in 192 women enrolled in the San Francisco site of the WIHS. Using multivariable logistic regression, we identified the correlates of PEth levels suggestive of unhealthy alcohol use (>50 ng/ml) among the 168 women who reported no or low-risk drinking (<7 drinks per week) in the past six months, while controlling for age in years and race/ethnicity. Among the 168 women in the analysis sample, the median age was 55; 51% identified as Black/African American, 47% were living with HIV and 28% had PEth levels ≥50 ng/ml which are suggestive of unhealthy alcohol use. Factors independently associated with PEth levels ≥50 ng/ml in adjusted models were: identifying as Black/African American (adjusted odds ratio [aOR] = 8.34, 95% CI = 2.06-33.72), having an alanine transaminase to aspartate aminotransferase ratio > 1 (aOR = 3.10, 95% CI = 1.18-8.13), higher high-density lipoprotein levels (aOR = 1.31 per 10 mg/dL increase, 95% CI = 1.01-1.70), and consuming a greater number of drinks per week in the past six months (aOR = 1.40, 95% CI = 1.10-1.78). Nearly a third of women in this study had PEth levels suggestive of unhealthy alcohol use and potentially under-reported their use. To optimize alcohol related health care, there is a need to consider approaches to improve ascertainment of unhealthy alcohol use, especially among Black/African American women and those living with liver disease, so that interventions can be initiated.
本研究的目的是确定在自我报告无或低风险饮酒的 HIV 感染者和非 HIV 感染者中，磷脂酰乙醇（PEth）水平提示不健康饮酒的流行率及其相关因素。我们分析了参加旧金山湾区妇女机构艾滋病毒研究（WIHS）的女性的横断面研究数据。在 2017 年 10 月至 2018 年 3 月期间，对参加 WIHS 旧金山站的 192 名女性的干血斑进行了 PEth 检测。通过多变量逻辑回归，我们确定了在过去六个月内报告无或低风险饮酒（每周<7 杯）的 168 名女性中，PEth 水平提示不健康饮酒（>50ng/ml）的相关因素，同时控制了年龄和种族/族裔。在分析样本中的 168 名女性中，中位数年龄为 55 岁；51%的女性为黑人/非裔美国人，47%的女性为 HIV 感染者，28%的女性 PEth 水平≥50ng/ml，提示不健康饮酒。在调整模型中，与 PEth 水平≥50ng/ml 独立相关的因素为：黑人/非裔美国人（调整优势比[aOR]=8.34，95%可信区间[CI]=2.06-33.72）、丙氨酸氨基转移酶与天冬氨酸氨基转移酶比值>1（aOR=3.10，95%CI=1.18-8.13）、高密度脂蛋白水平较高（aOR=每增加 10mg/dL 增加 1.31，95%CI=1.01-1.70）和过去六个月每周饮酒量增加（aOR=1.40，95%CI=1.10-1.78）。本研究中近三分之一的女性 PEth 水平提示不健康饮酒，且可能存在饮酒量报告不足的情况。为了优化与酒精相关的医疗保健，需要考虑改进不健康饮酒评估的方法，特别是在黑人/非裔美国女性和患有肝脏疾病的人群中，以便能够及时干预。
