title: 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.
abstract: 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.
  
  
  
  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 (≥50ng/ml), a biomarker of alcohol intake. Sociodemographics data was collected. Correlates of self-reported unhealthy alcohol use and PEth positive were determined.
  
  
  
  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.
  
  
  
  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.
authors.affiliation: Department of Population Health Sciences, School of Nursing and Health Professions, University of San Francisco, 2130 Fulton St., San Francisco, CA 94117, United States. Electronic address: mcouture@usfca.edu.
authors.forename: Marie-Claude
authors.initials: MC
authors.lastname: Couture
authors.affiliation: University of New Mexico Health Sciences Center, Dept. of Internal Medicine MSC 10 5550, 1 University of New Mexico, Albuquerque, NM 87131, United States.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Page
authors.affiliation: National Center for HIV, AIDS, Dermatology and STDs, #245H, Street 6A, Phum Kean Khlang, Sangkat Prekleap Russey Keo, Phnom Penh, Cambodia; University of Health Sciences-Cambodia, #73 Monivong Boulevard, Srah Chak, Phnom Penh, Cambodia.
authors.forename: Neth
authors.initials: N
authors.lastname: Sansothy
authors.affiliation: Global Health Sciences/Prevention and Public Health Group, University of California San Francisco, Mission Hall, 550 16th St., Third Fl., Box 1224, San Francisco, CA 94158, United States.
authors.forename: Ellen
authors.initials: E
authors.lastname: Stein
authors.affiliation: National Center for HIV, AIDS, Dermatology and STDs, #245H, Street 6A, Phum Kean Khlang, Sangkat Prekleap Russey Keo, Phnom Penh, Cambodia.
authors.forename: Mean Chhi
authors.initials: MC
authors.lastname: Vun
authors.affiliation: Department of Medicine, University of California San Francisco, Mission Hall, 550 16th St., Third Fl., Box 1224, San Francisco, CA 94158, United States.
authors.forename: Judith A
authors.initials: JA
authors.lastname: Hahn
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000097:blood / Q000453:epidemiology*; D015415:Biomarkers / Q000097:blood; D002160:Cambodia / Q000453:epidemiology; D003430:Cross-Sectional Studies; D059788:Dried Blood Spot Testing; D005260:Female; D020404:Glycerophospholipids / Q000097:blood*; D006801:Humans; D008297:Male; D010361:Patients / Q000523:psychology*; D015995:Prevalence; D057566:Self Report; D012727:Sex Characteristics; D060386:Sex Workers / Q000523:psychology*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D020404:Glycerophospholipids; C051521:phosphatidylethanol
keywords: Biomarker; Female sex workers; HIV risk; Male clients; Phosphatidylethanol; Unhealthy alcohol use