Phosphatidylethanol confirmed alcohol use among ART-naive HIV-infected persons who denied consumption in rural Uganda
Phosphatidylethanol confirmed alcohol use among ART-naive HIV-infected persons who denied consumption in rural Uganda
复制标题
DOI：
10.1080/09540121.2017.1290209
复制
发表时间：
2017-01-01
影响因子：
1.7
通讯作者：
Hahn, Judith A.
中科院分区：
文献类型：
--
作者：
Muyindike, Winnie R.;Lloyd-Travaglini, Christine;Hahn, Judith A.
艾滋病毒感染者饮酒情况的少报可能会对临床护理产生不利影响。这项研究使用酒精生物标记物检查了在临床和研究环境中否认饮酒的患者少报饮酒量的相关因素。我们在乌干达姆巴拉拉医院艾滋病毒诊所招募了未接受过抗逆转录病毒疗法的艾滋病毒感染成年人。我们对饮酒、人口统计、灵性和宗教指数 (SRI)、健康和功能状态进行了基线访谈；检测呼气酒精含量，并采集血液中的磷脂酰乙醇 (PEth)，这是酒精使用的敏感且特异的生物标志物。我们确定了向诊所咨询师否认饮酒的参与者（第 1 组，n=104）和在研究访谈中否认饮酒的参与者（第 2 组，n=198）的 PEth 状态。阳性 PEth 定义为 8 ng/ml。使用多重逻辑回归模型来检查 PEth 阳性测试是否因人口统计、识字率、灵性、社会期望的报告和身体健康状况而变化。结果显示，在第 1 组的 104 名参与者中，28.8% 的 PEth 呈阳性。对于那些报告先前不健康饮酒的人，PEth 呈阳性的几率较高（调整后优势比 (AOR)：4.7，95% 置信区间 (CI)：1.8、12.5）。没有其他因素具有统计显着性。在第 2 组的 198 名参与者中，13.1% 的 PEth 呈阳性。与新教徒相比，那些报告过去不健康饮酒的参与者（AOR：4.6，95％CI：1.8，12.2）和天主教徒（AOR：3.8，95％CI：1.3，11.0）的PEth阳性几率较高，而识字参与者的PEth阳性几率较低（AOR：0.3，95％CI：0.1，0.8）。我们得出的结论是，艾滋病毒诊所工作人员的饮酒情况漏报情况严重，但在进行呼气酒精和 PEth 检测的研究环境中漏报率较低。一份关于过去不健康饮酒的报告可能会凸显否认者目前的饮酒情况。乌干达的艾滋病毒护理机构需要制定改善酒精自我报告的策略。
Under-reporting of alcohol use by HIV-infected patients could adversely impact clinical care. This study examined factors associated with under-reporting of alcohol consumption by patients who denied alcohol use in clinical and research settings using an alcohol biomarker. We enrolled ART-naive, HIV-infected adults at Mbarara Hospital HIV clinic in Uganda. We conducted baseline interviews on alcohol use, demographics, Spirituality and Religiosity Index (SRI), health and functional status; and tested for breath alcohol content and collected blood for phosphatidylethanol (PEth), a sensitive and specific biomarker of alcohol use. We determined PEth status among participants who denied alcohol consumption to clinic counselors (Group 1, n=104), and those who denied alcohol use on their research interview (Group 2, n=198). A positive PEth was defined as 8ng/ml. Multiple logistic regression models were used to examine whether testing PEth-positive varied by demographics, literacy, spirituality, socially desirable reporting and physical health status. Results showed that, among the 104 participants in Group 1, 28.8% were PEth-positive. The odds of being PEth-positive were higher for those reporting prior unhealthy drinking (adjusted odds ratio (AOR): 4.7, 95% confidence interval (CI): 1.8, 12.5). No other factors were statistically significant. Among the 198 participants in Group 2, 13.1% were PEth-positive. The odds of being PEth-positive were higher for those reporting past unhealthy drinking (AOR: 4.6, 95% CI: 1.8, 12.2), the Catholics (AOR: 3.8, 95% CI: 1.3, 11.0) compared to Protestants and lower for the literate participants (AOR: 0.3, 95% CI: 0.1, 0.8). We concluded that under-reporting of alcohol use to HIV clinic staff was substantial, but it was lower in a research setting that conducted testing for breath alcohol and PEth. A report of past unhealthy drinking may highlight current alcohol use among deniers. Strategies to improve alcohol self-report are needed within HIV care settings in Uganda.