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Using data from patients with HIV (PWH) entering a clinical trial, we asked whether TLFB could predict PEth\u00a0&gt;\u00a020\u00a0ng\/ml and assessed the magnitude of association between TLFB and PEth level.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We defined unhealthy alcohol use as any alcohol use in the presence of liver disease, at\u2010risk drinking, or alcohol use disorder. Self\u2010reported alcohol use obtained from TLFB interview was assessed as mean number of drinks\/day and number of heavy drinking days over the past 21\u00a0days. Dried blood spot samples for PEth were collected at the interview. We used logistic regression to predict PEth\u00a0&gt;\u00a020\u00a0ng\/ml and Spearman correlation to quantify the association with PEth, both as a function of TLFB.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 282 individuals (99% men) in the analytic sample, approximately two\u2010thirds (69%) of individuals had PEth\u00a0&gt;\u00a020\u00a0ng\/ml. The proportion with PEth\u00a0&gt;\u00a020\u00a0ng\/ml increased with increasing levels of self\u2010reported alcohol use; of the 190 patients with either at\u2010risk drinking or alcohol use disorder based on self\u2010report, 82% had PEth\u00a0&gt;\u00a020\u00a0ng\/ml. Discrimination was better with number of drinks per day than heavy drinking days (AUC: 0.80 [95% CI: 0.74 to 0.85] vs. 0.74 [95% CI: 0.68 to 0.80]). The number of drinks per day and PEth were significantly and positively correlated across all levels of alcohol use (Spearman\u2019s <jats:italic>R<\/jats:italic> ranged from 0.29 to 0.56, all <jats:italic>p<\/jats:italic> values\u00a0&lt;\u00a00.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In this sample of PWH entering a clinical trial, mean numbers of drinks per day discriminated individuals with evidence of significant alcohol use by PEth. PEth complements self\u2010report to improve identification of self\u2010reported unhealthy alcohol use among PWH.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acer.14435","type":"journal-article","created":{"date-parts":[[2020,8,28]],"date-time":"2020-08-28T13:51:17Z","timestamp":1598622677000},"page":"2053-2063","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Validating Self\u2010Reported Unhealthy Alcohol Use With Phosphatidylethanol (PEth) Among Patients With HIV"],"prefix":"10.1111","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6263-1076","authenticated-orcid":false,"given":"Oghenowede","family":"Eyawo","sequence":"first","affiliation":[{"name":"School of Global Health, Faculty of Health, York University Toronto ON Canada"},{"name":"Veterans Aging Cohort Study Coordinating Center (OE, ACJ, KM, JPT) West Haven VA Healthcare System West Haven Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanhong","family":"Deng","sequence":"additional","affiliation":[{"name":"Yale Center for Analytic Sciences (YD, JD) Yale University School of Public Health New Haven Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Dziura","sequence":"additional","affiliation":[{"name":"Yale Center for Analytic Sciences (YD, JD) Yale University School of Public Health New Haven Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0139-5502","authenticated-orcid":false,"given":"Amy C.","family":"Justice","sequence":"additional","affiliation":[{"name":"Veterans Aging Cohort Study Coordinating Center (OE, ACJ, KM, JPT) West Haven VA Healthcare System West Haven Connecticut"},{"name":"Yale School of Medicine (ACJ, JPT, PGO, DAF, EJE) New Haven Connecticut"},{"name":"Center for Interdisciplinary Research on AIDS (ACJ, NBH, DAF, EJE) Yale School of Public Health New Haven Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen","family":"McGinnis","sequence":"additional","affiliation":[{"name":"Veterans Aging Cohort Study Coordinating Center (OE, ACJ, KM, JPT) West Haven VA Healthcare System West Haven Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janet P.","family":"Tate","sequence":"additional","affiliation":[{"name":"Veterans Aging Cohort Study Coordinating Center (OE, ACJ, KM, JPT) West Haven VA Healthcare System West Haven Connecticut"},{"name":"Yale School of Medicine (ACJ, JPT, PGO, DAF, EJE) New Haven Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria C.","family":"Rodriguez\u2010Barradas","sequence":"additional","affiliation":[{"name":"Michael E DeBakey Veterans Affairs Medical Center (MCR\u2010B) Baylor College of Medicine Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan B.","family":"Hansen","sequence":"additional","affiliation":[{"name":"Center for Interdisciplinary Research on AIDS (ACJ, NBH, DAF, EJE) Yale School of Public Health New Haven Connecticut"},{"name":"College of Public Health (NBH) University of Georgia Athens Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5470-102X","authenticated-orcid":false,"given":"Stephen A.","family":"Maisto","sequence":"additional","affiliation":[{"name":"Department of Psychology (SAM) Syracuse University Syracuse New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent C.","family":"Marconi","sequence":"additional","affiliation":[{"name":"Atlanta Veterans Affairs Medical Center (VCM) Emory University School of Medicine Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick G.","family":"O\u2019Connor","sequence":"additional","affiliation":[{"name":"Yale School of Medicine (ACJ, JPT, PGO, DAF, EJE) New Haven Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kendall","family":"Bryant","sequence":"additional","affiliation":[{"name":"National Institute on Alcohol Abuse and Alcoholism HIV\/AIDS Program (KB) Bethesda Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4006-010X","authenticated-orcid":false,"given":"David A.","family":"Fiellin","sequence":"additional","affiliation":[{"name":"Yale School of Medicine (ACJ, JPT, PGO, DAF, EJE) New Haven Connecticut"},{"name":"Center for Interdisciplinary Research on AIDS (ACJ, NBH, DAF, EJE) Yale School of Public Health New Haven Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9375-0489","authenticated-orcid":false,"given":"E. 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