The Context of HIV Risk Among Drug Users and Their Sexual Partners

Assessing the Reliability and
Validity of Self-Reported Risk
Behavior
David R. Gibson and Martin Young
INTRODUCTION
This chapter presents preliminary data from the AIDS Risk Measurement
Study (ARMS), a survey of intravenous drug users (IVDUs) interviewed
in the San Francisco Bay area from 1991 to 1992. While a principal
objective of the study was to examine correlates of human
immunodeficiency virus (HIV) risk behavior, it included several
methodological experiments both to assess and to improve the reliability
and validity of drug users’ self-reports. The experiments were inspired
by survey research literature (Bradbum and Sudman 1979) that examined
the truthfulness of survey respondents’ answers to questions about such
threatening or sensitive behaviors as drunken driving and bankruptcy.
This small literature documents the extent to which respondents tend to
underreport such behaviors and suggests procedures for minimizing
underreporting. Since HIV risk behavior includes many illicit and
socially stigmatized practices, it seemed worthwhile to undertake a
similar investigation.
This chapter addresses three questions. First, how truthful or accurate is
information that IVDUs provide to researchers concerning practices that
put them at potential risk of infection of HIV? Second, to what extent are
behavioral self-reports contaminated by self-presentation bias-the
tendency of drug users to present a socially desirable image of
themselves? And third, what steps can researchers take to reduce
response bias when asking sensitive or threatening questions?
The sample from which the data for this report were taken was 508
IVDUs who were interviewed at entry to heroin detoxification treatment
at four sites in the San Francisco Bay area between September 1991 and
December 1992. Since the treatment is of brief duration (maximum of
21 days), many clients soon return to active drug use. One hundred
fifty-one subjects were recruited from the street with coupons that made
them eligible for immediate free treatment at the clinics. While a
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