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

cross-tabulated with dichotomous measures of risk behavior, for example,
borrowing of syringes (none versus some).
The data in table 5 indicate that self-reported injection behavior may be
significantly underreported to staff in drug treatment settings due to selfpresentation
bias, while, with one exception (anal intercourse), reported
sexual practices appeared to be unrelated with social desirability. The
26-point spread between the first and fourth quartiles in the percentage of
respondents reporting that they borrowed needles (past 30 days) suggests
that at least some respondents found this question threatening. The scores
for the lowest quartile of social desirability may approach those that
would be obtained if social desirability did not color self-reports.
Question Threat
The social desirability measure assumes a generalized disposition to
project a socially desirable image. In a related analysis, the authors
examined whether self-reports might be a function less of persons than
the perceived social sensitivity of specific sets of questions. Following
questions about injection behaviors, respondents were told: “We now
want to ask you about the questions we’ve been asking-about sharing of
outfits and the like.” Respondents were then asked four questions such
as, “How (sensitive, uncomfortable, nervous, uneasy) do you think these
questions would make most drug users?” A similar set of items followed
the questions about sexual practices: “How (sensitive, uncomfortable,
nervous, uneasy) do you think most people would find these questions?”
(about condoms and number of sex partners and so forth). The questions
were intended to be unobtrusive measures of respondents’ own feelings
toward the items. The response choices ranged from “not at all,” to
“somewhat,” to “quite a bit.”
Descriptive statistics indicated that the average respondent found both
sets of questions to be “somewhat” intimidating, with there being a fair
degree of variability in the perceived threat of the questions (standard
deviation of about half a point on a 3-point scale). The measures were
collapsed into thirds by level of threat (“not at all,” “somewhat,” “quite a
bit”) before cross-tabulating with self-reported behaviors. The analysis
(see table 6) showed that question threat was related to only one behavior,
oral sex, with there being a 20-point plus difference between the lowest
and highest third in the percentage of respondents reporting oral sex.
226