title: Utility of Brief Versions of the Alcohol Use Disorders Identification Test (AUDIT) to Identify Excessive Drinking Among Patients in HIV Care in South Africa.
abstract: In sub-Saharan Africa, large proportions of patients who are on antiretroviral therapy (ART) engage in excessive alcohol use, which may lead to adverse health consequences and may go undetected. Consequently, health care workers need brief screening tools to be able to routinely identify and manage excessive alcohol use among their patients. Various brief versions of the valid and reliable 10-item Alcohol Use Disorders Identification Test (AUDIT) (i.e., the AUDIT-C, AUDIT-3, AUDIT-QF, AUDIT-PC, AUDIT-4, and m-FAST) may potentially replace the full AUDIT in busy HIV care settings. This study aims to assess the utility of these six brief versions of the AUDIT relative to the full AUDIT for identifying excessive alcohol use among patients in HIV care settings in South Africa.
  
  
  
  Participants were 188 (95 women) patients from three ART clinics within district hospitals in the City of Tshwane Metropolitan Municipality who reported past-12-month alcohol use. Performance of each brief AUDIT measure for identifying excessive alcohol use was evaluated against that of the full AUDIT (with a cutoff score of ≥6 for women and ≥8 for men) as the gold standard. We used receiver-operating characteristic (ROC) analysis.
  
  
  
  Most brief AUDIT measures had an area under the receiver operating curve (AUROC) above .90 when compared with the full AUDIT (five of six for women and three of six for men). The AUDIT-PC, AUDIT-4, and m-FAST had the highest AUROCs, whereas the three brief measures comprising only consumption items had low specificities at the most optimal cutoff levels.
  
  
  
  Various brief versions of the AUDIT may be appropriate substitutes for the full AUDIT for screening for excessive alcohol use in HIV clinics in sub-Saharan Africa.
authors.affiliation: Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Pretoria, South Africa.|School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.|School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
authors.forename: Neo K
authors.initials: NK
authors.lastname: Morojele
authors.affiliation: Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Pretoria, South Africa.
authors.forename: Sebenzile
authors.initials: S
authors.lastname: Nkosi
authors.affiliation: Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Pretoria, South Africa.
authors.forename: Connie T
authors.initials: CT
authors.lastname: Kekwaletswe
authors.affiliation: Centre for Addiction and Mental Health, Toronto, Ontario, Canada.|Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.|Center for Health, Intervention, and Prevention, University of Connecticut, Storrs, Connecticut.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Shuper
authors.affiliation: Biostatistics Unit, South African Medical Research Council, Pretoria, South Africa.|Division of Epidemiology and Biostatistics, University of the Witwatersrand, Johannesburg, South Africa.|School of Mathematics, Statistics and Computer Science, College of Agriculture, Engineering and Science, University of KwaZulu-Natal, Pietermaritzburg, South Africa.
authors.forename: Samuel O
authors.initials: SO
authors.lastname: Manda
authors.affiliation: Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Cape Town, South Africa.|Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
authors.forename: Bronwyn
authors.initials: B
authors.lastname: Myers
authors.affiliation: Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Cape Town, South Africa.|Department of Psychiatry, University of Stellenbosch, Cape Town, South Africa.
authors.forename: Charles D H
authors.initials: CD
authors.lastname: Parry
mesh_terms: D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000523:psychology*; D019973:Alcohol-Related Disorders / Q000150:complications / Q000175:diagnosis*; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000523:psychology*; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data*; D012372:ROC Curve; D012680:Sensitivity and Specificity; D013019:South Africa; D055815:Young Adult