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

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criminal history was unlikely to be threatening. Gibson and colleagues (1987) found heroin addicts’ answers to questions about their psychological or social functioning to be moderately to highly correlated with a short form of the Marlowe-Crowne social desirability scale. In particular, the answers were highly skewed by the tendency to deny negative information about themselves and their families. Test-Retest Reliability In the present study, two attempts were made to assess the reliability of IVDUs’ self-reports. First, part of the sample was reinterviewed to determine whether their answers would be consistent across two interviews; second, IVDU heterosexual couples (48 women and 48 men) were interviewed separately to determine how closely their reports about sexual practices agreed. Test-retest correlations and correlations of partners’ self-reports have been examined in a number of studies (for a review, see Catania et al. 1990) and frequently have been interpreted as validity indicators. Reliability, however, while necessary to validity, is not sufficient to establish the accuracy of self-reports. Reporting biases are as likely to be reflected in a retest as in an initial interview, and partners’ reports may be spuriously consistent due to shared biases. Unfortunately, there is not a gold standard against which to evaluate the validity of self-reports, at least at the individual level. The retest interviews were conducted an average of 10 days following the initial interview. Both interviews were conducted by trained interviewers during clients’ daily visits to the drug treatment clinics. On both occasions, respondents were asked to report their sexual and injection practices during the 30 days prior to their admission to the detoxification program (for several behaviors, a 6-month reporting period was also used, and clients were asked whether the behaviors had ever been practiced). Respondents were not told of the principal reason for the second interview, only that some additional information not obtained in the first interview was needed (additional items were added to the second interview to disguise the intent). The interval of 10 days was selected to be long enough so respondents would not remember what they had said at the first interview but short enough so they would be able to accurately report about their behavior during the month prior to their entry to treatment. 221
Table 2 shows percentage agreement in answers across the two interviews. The figures indicate a reasonable degree of reliability, ranging from 77 percent to 90 percent. The behavior least reliably reported was borrowing of injection equipment (30-day indicator), with 77 percent agreement. The most accurate measures were for the rarest behaviors such as anal intercourse, with only 12 and 2 respondents, respectively, reporting this behavior at either interview. Reliability of Sexual Behavior Reported by Heterosexual Couples Table 3 shows sexual data from 29 couples who reported mutually monogamous sexual behavior for the 30 days prior to entering drug treatment. The couples were identified discreetly by clinic intake workers and were not aware that a purpose of the study was to assess the reliability of self-reported sexual practices. Interpartner agreement about sexual practices was very close to agreement between the test and retest. The behavior least reliably reported was oral sex (79 percent), while there was complete agreement about whether the couple had been sexually abstinent. Respondents as Informants The lack of a gold standard for validating self-reports makes assessment of their accuracy difficult at best. Two attempts were made to validate self-reports of needle sharing that shed some light on the probable accuracy of the information given. The first was suggested by experiments conducted by Bradbum and Sudman (1979) in which college students were interviewed about their own and their friends’ use of alcohol and marijuana. The assumption was made that the level of alcohol and marijuana actually used would be similar for respondents and friends. Analysis of the data, however, indicated overall that the students reported their friends used alcohol and marijuana more often than they did themselves, suggesting that they may have underreported their own use. A further suggestion that self-reported use was less accurate was that the variances of measures of their own use were larger than for measures of their friends’. In the present study, in addition to asking respondents about their own borrowing of needles and syringes, they were asked whether they had observed others doing so during that time (past 30 days). While only 222
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National Institute on Drug Abuse RE
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ACKNOWLEDGMENT This monograph is ba
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Drug Use and HIV Risk Among Male Se
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Partners. The review was held April
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Inciardi, J.A.; Lockwood, D.; and P
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highlights the critical importance
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AUTHOR Richard H. Needle, Ph.D., M.
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Blower and colleagues (1991) have p
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Even in areas with low seroprevalen
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involves using a syringe to draw bl
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Hispanics were less likely to repor
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victimization through theft, violen
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sharing? When are needles deliberat
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Chitwood, D.D.; McCoy, C.B.; Inciar
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Page, J.B.; Smith, P.C.; and Kane,
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HIV/AIDS Risks Among Male, Heterose
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during that time, and the possibili
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All of these issues and considerati
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ecoming the norm for both male and
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the skin on his penis while having
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REFERENCES Ball, J.C., and Chambers
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Johnson, A.M.; Petherick, A.; David
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Vogt, M.W.; Craven, D.E.; Crawford,
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transmission from males to females
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(this volume), there is little atte
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Clayton, R.; Voss, H.; Robbins, C.;
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Female Drug Abusers and the Context
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have the data but interpret it supe
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important to examine current studie
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found in this study was low socioec
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who trade sex for crack; and simila
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esponsibilities in perspective. Suc
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Robles and colleagues (1990) examin
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The lack of rational thought separa
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Factors Associated With Sexual Risk
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Factors Associated With Poverty A n
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encouraging such women to leave the
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Hispanic women but extramarital aff
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coherence—the sense that life is
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the change agent may be a crucial f
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Centers for Disease Control and Pre
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Jemmott, J.B.; Jemmott, L.S.; Spear
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O’Leary, A.; Celentano, D.; Maiba
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Drug Use and HIV Risk Among Gay and
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with 34.6 percent of gay men and 28
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found among both hustlers and call
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Substance Use and HIV-Transmitting
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TABLE 1. Prevalence of substance us
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less than 2 percent of participants
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TABLE 2. Quantity of alcohol use am
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A fourth study of gay/bisexual men,
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in mind, however, that most of the
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seropositivity and reported NMPD us
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interaction and education than men
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Geographic differences found in the
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that they are intending or desirous
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enough is known in general about th
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REFERENCES Calzavara, L.M.; Coates,
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Ostrow, D.G.; Beltran, E.; Chmiel,
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Drug Use and HIV Risk Among Male Se
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prostitutes were HIV positive, as c
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Trade hustlers are usually heterose
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TABLE 1. Number of Completed Interv
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diagnosed slightly more often than
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TABLE 2. Injection Drug Use by Type
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By the 100th interview, the screeni
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SUMMARY AND CONCLUSIONS In general,
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Plant, M. Sex work, alcohol, drugs
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HIV Risk in Drug-Using Adolescents
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AUTHOR Vincent L. Smeriglio, Ph.D.
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comprise 23 percent of all adolesce
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232 (18 percent) of the cases; and
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Although these data provide an over
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Most of these were unprotected sexu
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national epidemiologic survey of hi
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Hawkins et al. 1992; Newcomb et al.
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higher rates of HIV/AIDS in adolesc
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Boyer, C.B. Psychosocial, behaviora
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Irwin, C.E., Jr., and Shafer, M.A.
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Zweig Greenberg, MS.; Singh, T.; Ht
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the types of intervention strategie
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from a study group of 52 youths who
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forearm during a sexual episode. At
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I was nice looking, like I can do a
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It is unclear whether the disinhibi
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continual sexual dysfunction was re
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TWEAKING, FREAKING, AND OVER-AMPING
Page 175 and 176: highway of love. It’s like, I’d
Page 177 and 178: Unprotected sexual activity is more
Page 179 and 180: alternatives and opportunities, and
Page 181 and 182: the night and food for the morning.
Page 183 and 184: 7. also can help youths explore and
Page 185 and 186: Jessor, R., and Jessor, S.L. Proble
Page 187 and 188: AUTHORS Mary Jane Rotheram-Borus, P
Page 189 and 190: Brunswick goes on to discuss the le
Page 191 and 192: permission-giving introductions to
Page 193 and 194: conversion and perhaps even serocon
Page 195 and 196: TABLE 1. Ecological paradigm of con
Page 197 and 198: TECHNICAL ISSUES Technical issues i
Page 199 and 200: eliability. It seems obvious that q
Page 201 and 202: sometimes as many as three zip code
Page 203 and 204: Resources and effort are required t
Page 205 and 206: Brunswick, A.F.; Lewis, C.S.; and M
Page 207 and 208: The Context of Risk: Ethnographic C
Page 209 and 210: same meaning may be extended to dru
Page 211 and 212: THE CONTEXT OF RISK Context is an a
Page 213 and 214: hurried, and adequate needle cleani
Page 215 and 216: degrading sexual acts, poignantly m
Page 217 and 218: searched me and I had stashed the c
Page 219 and 220: REFERENCES Agar, M. The Professiona
Page 221 and 222: Ouellet, L. J.; Jimenez, A.D.; John
Page 223 and 224: Assessing the Reliability and Valid
Page 225: TABLE 1. Sociodemographic profile o
Page 229 and 230: FORENSIC TECHNIQUES TO DOCUMENT SEL
Page 231 and 232: cross-tabulated with dichotomous me
Page 233 and 234: TABLE 6. Relationship of question t
Page 235 and 236: aggravate self-presentation bias. T
Page 237 and 238: TABLE 8. Percent of subjects report
Page 239 and 240: intercourse, and since anal interco
Page 241 and 242: Future Directions for Studies on th
Page 243 and 244: abusers, and other variables are ne
Page 245 and 246: Behavior patterns can be clarified
Page 247 and 248: As Des Jarlais noted, designs and a
Page 249 and 250: strengths within a setting or indiv
Page 251 and 252: National Institute on While limited
Page 253 and 254: 62 NEUROSCIENCE METHODS IN DRUG ABU
Page 255 and 256: 89 BIOLOGICAL VULNERABILITY TO DRUG
Page 257 and 258: 111 MOLECULAR APPROACHES TO DRUG AB
Page 259 and 260: 127 PROGRESS AND ISSUES IN CASE MAN
Page 261: NIH Publication No. 94-3750 Printed
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The Context of HIV Risk Among Drug Users and Their Sexual Partners

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