Correlates of high phosphatidylethanol (PEth) levels and their concordance with self‐reported heavy alcohol consumption among men who have sex with men who binge drink alcohol. (8th July 2022)

• Record Type: Journal Article
• Authors: McLaughlin, Matthew F.; Jain, Jennifer P.; Ikeda, Janet; Walker, John E.; Coffin, Phillip; Santos, Glenn‐Milo
• Is Part Of: Alcoholism. Volume 46:Number 8(2022)
• Page Start: 1565
• Page End: 1579
• Publication Date: 2022-07-08
• Subjects: alcohol biomarkers -- binge drinking -- heavy drinking -- men who have sex with men -- phosphatidylethanol; Alcoholism -- Periodicals; Alcoholism -- Periodicals; Alcoolisme; Electronic journals; Périodique électronique (Descripteur de forme); Ressource Internet (Descripteur de forme); 616.861005
• DOI: 10.1111/acer.14891
• Languages: English
• ISSNs: 0145-6008

Abstract

Abstract: Background: Heavy alcohol use, including binge drinking, is associated with high morbidity and mortality among men who have sex with men (MSM). Self‐reported alcohol measures may lead to inaccurate estimates due to recall and social desirability biases. Objective alcohol biomarkers like phosphatidylethanol (PEth) can be used to corroborate self‐report and could help to inform treatment approaches and research strategies for alcohol using MSM. Methods: From 2015 to 2020, alcohol using MSM ≥18 years were enrolled in a randomized controlled trial evaluating the efficacy of naltrexone in reducing binge drinking. Using this trial's baseline data, we applied multivariable logistic regression to identify the correlates of high PEth levels (i.e., ≥87 ng/ml) and concordance between PEth levels and self‐reported heavy drinking. Results: Of 118 MSM, 64% had PEth levels ≥87 ng/ml and 72% had PEth levels that were concordant with self‐reported heavy alcohol use. Factors significantly associated in separate models with elevated PEth levels were income ≥$60, 000 (adjusted odds ratio [aOR] = 4.09; 95% CI = 1.13 to 14.82), being employed (aOR = 4.04; 95% CI = 1.45 to 11.32), episodic cannabis use (aOR = 4.63; 95% CI = 1.27 to 16.92), and any alcohol/substance use prior to or during anal intercourse (aOR = 2.52; 95% CI = 1.08 to 5.90). Living with HIV was associated with significantly lower odds of elevated PEth levels (aOR = 0.23; 95% CI = 0.09 to 0.61). Factors associated with significantly higher concordance between PEth levels and self‐reported heavy alcohol use included at least weekly use of poppers (aOR = 6.41; 95% CI = 1.27 to 32.28) and polysubstance use (aOR = 2.53; 95% CI = 1.02 to 6.27). Living with HIV was associated with lower odds of concordance (aOR = 0.36; 95% CI = 0.14 to 0.97). Conclusions: PEth may enhance the detection of heavy drinking among MSM, including the identification of subpopulations that may benefit from targeted alcohol reduction interventions. However, PEth values for MSM living with HIV showed modest concordance with self‐reported alcohol use and may need to be supplemented with additional biomarkers or evaluated against a different cutoff. Abstract : Binge drinking contributes significantly to morbidity among men who have sex with men (MSM). Phosphatidylethanol (PEth) is a promising biomarker to objectively identify drinking thresholds. Among binge‐drinking MSM, high PEth levels (≥87 ng/ml) were associated with high income, marijuana use, being employed, alcohol/substance use before sex, and living without HIV. People living with HIV (PLWH) had lower odds of concordant self‐report and PEth levels. Our findings support PEth as a reliable tool to identify heavy drinking and corroborate evidence of reduced PEth sensitivity for PLWH.