The association between alcohol exposure and mortality persisted after adjusting for age, sex, race, HIV status, HCV and viral suppression in Cox models. First, using only AUDIT-C alcohol characterization, individuals self-reporting abstinence had higher mortality (adjusted hazard ratio [aHR] 1.45, 95% CI: 1.10, 1.92) compared to those with lower risk drinking (reference group). Adding PEth improved model fit based on the likelihood ratio test (p=.027). Compared to those with lower risk drinking, individuals self-reporting abstinence but with PEth ≥8 ng/mL had higher mortality (aHR 2.15, 95% CI: 1.40, 3.29) (Figure 2a). Those with both self-report and PEth suggesting abstinence, at-risk and high risk drinking groups also had increased mortality risk but the association was not statistically significant. Further adjustment for smoking, injection drug use, and education results minimally attenuated the association: (aHR 2.04, 95% CI: 1.33, 3.12) comparing individuals self-reporting abstinence but with PEth ≥8 ng/mL to those with lower risk drinking (data not otherwise shown). Results were similar in the restricted sample; specifically, compared to those with lower risk drinking, significantly higher mortality was observed only among those individuals with self-reported abstinence but with a PEth ≥8 ng/mL (aHR: 2.74, 95 % CI: 1.10, 6.83) (Figure 2b).
