High prevalence of unhealthy alcohol use and comparison of self-reported alcohol consumption to phosphatidylethanol among women engaged in sex work and their male clients in Cambodia. (1st August 2016)

• Record Type: Journal Article
• Authors: Couture, Marie-Claude; Page, Kimberly; Sansothy, Neth; Stein, Ellen; Vun, Mean Chhi; Hahn, Judith A.
• Is Part Of: Drug and alcohol dependence. Volume 165(2016)
• Page Start: 29
• Page End: 37
• Publication Date: 2016-08-01
• Subjects: Unhealthy alcohol use -- Biomarker -- Phosphatidylethanol -- Female sex workers -- Male clients -- HIV risk; Drug abuse -- Periodicals; Alcoholism -- Periodicals; 616.86
• DOI: 10.1016/j.drugalcdep.2016.05.011
• Languages: English
• ISSNs: 0376-8716

Abstract

Highlights: Unhealthy alcohol use is prevalent in Cambodian sex work settings. Unhealthy alcohol use is higher in women working in entertainment establishments. Self-reported unhealthy alcohol use is accurately reported by female sex workers. Male clients are more likely to under-report unhealthy alcohol consumption. Unhealthy alcohol use should be integrated into HIV prevention interventions. Abstract: Background: In Cambodia, most of the female sex workers (FSW) work in venues where unhealthy alcohol use is ubiquitous and potentially contributing to the HIV epidemic. However, no accurate data exists. We compare self-reported unhealthy alcohol consumption to a biomarker of alcohol intake in Cambodian FSW and male clients, and determine factors associated with unhealthy alcohol use. Methods: A cross-sectional study was conducted among FSW (n = 100) and male clients (n = 100) in entertainment and sex work venues in Cambodia. Self-reported unhealthy alcohol use (AUDIT-C) was compared to phosphatidylethanol (PEth) positive (≥50 ng/ml), a biomarker of alcohol intake. Sociodemographics data was collected. Correlates of self-reported unhealthy alcohol use and PEth positive were determined. Results: The prevalence of PEth positive in FSW was 60.0%. Self-reported unhealthy alcohol consumption was reported by 85.0% of the women. Almost all women (95.0%) testing PEth positive also reported unhealthy alcohol use. Prevalence of unhealthy alcohol consumption (self-report and PEth positive) was higher in FSW working in entertainment establishments compared to other sex work venues ( p < 0.01). Among male clients, 47.0% reported unhealthy alcohol consumption and 42.0% had a PEth positive. However, only 57.1% of male clients with PEth positive reported unhealthy alcohol use. Conclusions: Unhealthy alcohol consumption is prevalent in Cambodian sex work settings. Self-reported unhealthy alcohol use is well reported by FSW, but less by male clients. These findings highlight the urgency of using accurate measures of unhealthy alcohol consumption and integrating this health issue into HIV prevention interventions.