Remote alcohol biomarker monitoring to promote drinking reductions among people with HIV: A proof-of-concept pilot study.

BACKGROUND

Alcohol use contributes to suboptimal HIV care outcomes, yet existing interventions for people with HIV (PWH) have demonstrated limited efficacy, particularly when outcomes are measured objectively with biomarkers. This proof-of-concept pilot investigated the feasibility and acceptability of integrating phosphatidylethanol (PEth) monitoring into behavioral treatment for alcohol use among Veterans with HIV and elevated depressive and/or anxiety symptoms.

METHOD: Participants (N = 20) remotely self-collected dried blood spot (DBS) samples for PEth monitoring and completed a videoconference follow-up session reviewing personalized PEth results in comparison to self-reported alcohol use. Analyses used a mixed-methods approach to synthesize quantitative and qualitative data that assessed feasibility, acceptability, and preferences for a behavioral alcohol intervention. Feasibility and acceptability indicators included PEth sample return and analysis rates, and a PEth monitoring self-report questionnaire.

RESULTS

Feasibility was high as 90% of participants submitted DBS samples with 100% of submitted samples successfully analyzed. Participants reported high satisfaction (M = 7.86, SD = 0.81) with remote DBS procedures and the PEth review session. Participants viewed PEth comparisons as useful (M = 8.33, SD = 1.14), easy to understand (M = 8.78, SD = 0.65), and motivating for reducing alcohol use (M = 6.72, SD = 3.14). Qualitative interviews revealed openness to integrating PEth monitoring into treatment, the importance of client-centered communication when delivering PEth feedback, and support for flexible, telehealth-delivered behavioral interventions.

CONCLUSION

Findings demonstrated the feasibility and acceptability of remote PEth monitoring among PWH with elevated alcohol use and depressive/anxiety symptoms. PEth monitoring may enhance self-awareness and motivation, bolstering behavioral treatment effectiveness for alcohol use among PWH.