Phosphatidylethanol (PEth) as a Biomarker of Alcohol Consumption in HIV-Infected Young Russian Women: Comparison to Self-Report Assessments of Alcohol Use

Abstract

Background Alcohol use is particularly deleterious for HIV-infected individuals and thus accurate assessment of alcohol consumption is crucial in this population. Phosphatidylethanol (PEth) provides an objective assessment of drinking and can be compared to self-reported alcohol assessments to detect underreporting. The purpose of this study was to identify underreporting and its potential predictors in an HIV-infected sample of young Russian women. Methods The current study examined the concordance between a quantitative measure of PEth and self-reported recent alcohol consumption in a prospective sample of HIV-infected young women (N = 204) receiving medical care in Saint Petersburg, Russia. Results At baseline, 53% of participants who denied drinking in the prior 30 days tested positive for PEth (i.e., underreporters), although this rate decreased significantly at a three-month follow-up assessment. Further exploration did not identify consistent predictors of underreporting status. Quantitative PEth levels showed, at best, modest overlap to self-reported alcohol consumption among those reporting alcohol use (e.g., Spearman’s r = .27 between PEth and total drinks past-30 days at baseline). Conclusions Objective measures of alcohol consumption demonstrate modest overlap with self-report measures of use in HIV-infected young Russian women. Incorporating objective and quantifiable biological markers are essential for valid assessments of alcohol use.

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“…Self‐reported alcohol consumption can be biased (Devaux and Sassi, ; Stockwell et al., ). However, measurement of PEth as a biomarker of recent alcohol consumption correlated well with the self‐reported consumption estimates, and PEth is considered a valid measure to protect against consumption underestimation (Bajunirwe et al., ; Littlefield et al., ; Schröck et al., ; Stewart et al., ). Further assessments of the full cohort as the study progresses will add validity to these consumption estimates via repeat measurements.…”

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“…Our results must be interpreted in light of study limitations, including the use of a cross-sectional design, which limits our ability to interpret the directionality of findings. Further, the rates of unhealthy alcohol use and underreporting may differ significantly by community and across distinct demographic groups; this is reflected in other work evaluating PEth in diverse samples, including HIV-infected young women in Russia [ 50 ], young people who inject drugs in the US [ 51 ], and veterans living with HIV and/or hepatitis C [ 52 ]. As such, these findings may not generalize to other populations.…”

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“…Notably, only about 50% of participants had a positive PEth biomarker at enrollment, which suggests that some women could have exaggerated their drinking behavior at baseline to enroll in a research study that paid cash incentives to participants. While PEth is clearly associated with drinking behavior in women at the aggregate level (Wang et al., ), some other studies have reported inconsistent results for PEth versus self‐reported drinking in women (Littlefield et al., ; Papas et al., ). It remains unclear how sensitive or specific a PEth result is for an individual woman, or how its test characteristics may vary according to the time between the last drinking episode and the PEth assessment (Moore et al., ).…”