Peer-reviewedCC BY 4.0AIDS and Behavior
Self-reported and Point-of-Care Biomarkers of Substance Use Measures Among Older Adults with HIV from Low- and Middle-Income Countries
Abstract
Measuring alcohol and other drug (AOD) use remains challenging in HIV care in low-and middle-income countries, where self-report and point-of-care (POC) urine biomarkers capture different time windows. Among 2,059 people with HIV aged 40 years or older across eight IeDEA clinics (2020 to 2022), we examined what self-reported AOD use (AUDIT, ASSIST) and POC urine tests (uEtG for alcohol; 5-panel drug screen) each capture. Self-report identified more use than urine testing (unhealthy alcohol 19.7% versus uEtG-positive 12.2%), consistent with its longer recall window. Higher self-reported alcohol intensity was associated with uEtG positivity in a graded pattern, more strongly among women. Urine-positive but self-report-negative results, more common among men, suggested under-reporting. Self-report and biomarkers answer different measurement questions: self-report for longer-term burden and screening, biomarkers for recent use and corroboration. Combining both, including longer-window biomarkers, can strengthen AOD measurement among older PWH in LMICs.
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BibTeX
@article{lancaster2026selfreported,
title = {{Self-reported and Point-of-Care Biomarkers of Substance Use Measures Among Older Adults with HIV from Low- and Middle-Income Countries}},
author = {Kathryn E Lancaster and Melissa A Stockton and Judith A Hahn and Thida Chanyachukul and Ivan Marbaniang and Dhanushi Rupasinghe and Hai Thi Thanh Nguyen and Edith Kwobah and Helen Byakwaga and Aggrey Semeere and Suzanne Goodrich and Patrizia Carrieri and Gad Murenzi and Hugo Perazzo and Brenda Crabtree Ramírez and Jessica Mejía and Andreas D Haas and Ardele Mandiriri and Albert Minga and Marie Plaisy and Antoine Jaquet and Angela M Parcesepe and Rohidas T Borse and Vidya Mave and Smita Nimkar and Thach Ngoc Pham and Dung Thi Hoai Nguyen and Dung Thi Nguyen and Jeremy L Ross and Kathy Petoumenos and Rodrigo Moreira and Sandra W Cardoso and Valdilea G Veloso and Beatriz Grinsztejn and Paola Alarcón-Murra and Alvaro López-Iñiguez and Jessica Mejía-Castrejón and Sharon Ortiz-Valdespino and Jessica Castilho and Karu Jayathilake and Gallican Kubwimana and Benjamin Muhoza and Jocelyne Ingabire and Jean Paul Mivumbi and Fabiola Mabano and Faustina Kanyabwisha and Obed Tuyishime and Diane Ryumugabe and Verene Mukankurunziza and Marie Gertrude Bahire Rutwaza and Francoise Musabyimana and Fabienne Shumbusho and Marie Grace Ingabire and Giovanni Alleluia Ndabakuranye and Josephine Gasana and Anthere Murangwa and Bonheur Uwakijijwe and Olive Uwamahoro and Kathryn Anastos and Marcel Yotebieng},
journal = {AIDS and Behavior},
year = {2026},
month = sep,
doi = {10.1007/s10461-026-05270-8},
url = {https://u-bordeaux.hal.science/hal-05744256v1},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Self-reported and Point-of-Care Biomarkers of Substance Use Measures Among Older Adults with HIV from Low- and Middle-Income Countries
AU - Kathryn E Lancaster
AU - Melissa A Stockton
AU - Judith A Hahn
AU - Thida Chanyachukul
AU - Ivan Marbaniang
AU - Dhanushi Rupasinghe
AU - Hai Thi Thanh Nguyen
AU - Edith Kwobah
AU - Helen Byakwaga
AU - Aggrey Semeere
AU - Suzanne Goodrich
AU - Patrizia Carrieri
AU - Gad Murenzi
AU - Hugo Perazzo
AU - Brenda Crabtree Ramírez
AU - Jessica Mejía
AU - Andreas D Haas
AU - Ardele Mandiriri
AU - Albert Minga
AU - Marie Plaisy
AU - Antoine Jaquet
AU - Angela M Parcesepe
AU - Rohidas T Borse
AU - Vidya Mave
AU - Smita Nimkar
AU - Thach Ngoc Pham
AU - Dung Thi Hoai Nguyen
AU - Dung Thi Nguyen
AU - Jeremy L Ross
AU - Kathy Petoumenos
AU - Rodrigo Moreira
AU - Sandra W Cardoso
AU - Valdilea G Veloso
AU - Beatriz Grinsztejn
AU - Paola Alarcón-Murra
AU - Alvaro López-Iñiguez
AU - Jessica Mejía-Castrejón
AU - Sharon Ortiz-Valdespino
AU - Jessica Castilho
AU - Karu Jayathilake
AU - Gallican Kubwimana
AU - Benjamin Muhoza
AU - Jocelyne Ingabire
AU - Jean Paul Mivumbi
AU - Fabiola Mabano
AU - Faustina Kanyabwisha
AU - Obed Tuyishime
AU - Diane Ryumugabe
AU - Verene Mukankurunziza
AU - Marie Gertrude Bahire Rutwaza
AU - Francoise Musabyimana
AU - Fabienne Shumbusho
AU - Marie Grace Ingabire
AU - Giovanni Alleluia Ndabakuranye
AU - Josephine Gasana
AU - Anthere Murangwa
AU - Bonheur Uwakijijwe
AU - Olive Uwamahoro
AU - Kathryn Anastos
AU - Marcel Yotebieng
PY - 2026
DA - 2026/09/03
JO - AIDS and Behavior
DO - 10.1007/s10461-026-05270-8
UR - https://u-bordeaux.hal.science/hal-05744256v1
AB - Measuring alcohol and other drug (AOD) use remains challenging in HIV care in low-and middle-income countries, where self-report and point-of-care (POC) urine biomarkers capture different time windows. Among 2,059 people with HIV aged 40 years or older across eight IeDEA clinics (2020 to 2022), we examined what self-reported AOD use (AUDIT, ASSIST) and POC urine tests (uEtG for alcohol; 5-panel drug screen) each capture. Self-report identified more use than urine testing (unhealthy alcohol 19.7% versus uEtG-positive 12.2%), consistent with its longer recall window. Higher self-reported alcohol intensity was associated with uEtG positivity in a graded pattern, more strongly among women. Urine-positive but self-report-negative results, more common among men, suggested under-reporting. Self-report and biomarkers answer different measurement questions: self-report for longer-term burden and screening, biomarkers for recent use and corroboration. Combining both, including longer-window biomarkers, can strengthen AOD measurement among older PWH in LMICs.
SN - 1090-7165
SN - 1573-3254
ER -