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

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TABLE 9. Percent of male and female subjects reporting sexual behaviors to male and female interviewers (N = 93) Sexual Behavior Male respondents Vaginal intercourse, past 30 days Used condoms some, past 30 days Used condoms 100 percent, past 30 days Oral sex, past 30 days Anal intercourse, past 6 months Female respondents Vaginal intercourse, past 30 days Used condoms some, past 30 days Used condoms 100 percent, past 30 days Oral sex, past 30 days Anal intercourse, past 6 months Male Female interviewer interviewer 82.1 75.9 26.1 40.9 21.7 27.3 55.6 55.2 17.9 10.3 89.5 64.7 † 35.3 54.6 5.9 27.3 † 44.4 64.7 15.8 5.9 † Differences between male and female interviewers significant at p < 0.10. DISCUSSION The present study yielded some indirect but nevertheless interesting information concerning the probable validity of self-reported risk behavior. The pattern of findings across the experiments suggested that the most threatening questions for respondents were the items pertaining to sharing of injection equipment. Answers to questions about borrowing of syringes appeared to be less reliable than questions about sexual practices and much more strongly correlated with social desirability. Also, there appeared to be a large discrepancy between respondents’ reports of their own injection behavior and the behavior of fellow drug users whom they had the opportunity to observe. Among the sexual variables, questions about oral and anal sex proved to be the most sensitive, while respondents’ answers to questions about condoms appeared to be both reasonably reliable and uncontaminated by self-presentation bias. This finding is encouraging, since oral sex may be less risky than other sexual practices, such as unprotected vaginal 233
intercourse, and since anal intercourse appears to be a relatively rare practice in this population. The experiments with questionnaire format suggest the problem of response bias can to some extent be alleviated by use of long, permissiongiving introductions to questions and perhaps also by asking sensitive questions late versus early in the questionnaire. While response bias probably cannot be eliminated, it can be corrected in multivariate analyses by inclusion of a measure of social desirability or other measure of presentation bias. In experimental studies, such bias is ordinarily corrected by randomization, although it adds to random measurement error. A limitation of several of the findings reported here is that they are based on small sample sizes. These findings in particular need to be replicated with larger samples. With larger samples, patterns not evident in the present data may also be discovered. REFERENCES Amsel, Z.; Mandell, W.; Matthias, W.; Mason, C.; and Hocherman, I. Reliability and validity of self-reported illegal activities and drug use collected from narcotic addicts. Int J Addict 11:325-336, 1976. Bale, R.; Van Stone, W.; Engelsing, T.; Zarcone, V.; and Kuldav, J. The validity of self-reported heroin use. Int J Addict 11:325-336, 1976. Bradbum, N.M., and Sudman, S. Improving Interview Method and Questionnaire Design. San Francisco: Jossey Bass, 1979. Catania, J.; Gibson, D.R.; Chitwood, D.D.; and Coates, T.J. Methodological problems in AIDS behavioral research: Influences on measurement error and participation bias in studies of sexual behavior. Psychol Bull 108:339-362, 1990. Catania, J.; McDermott, L.; and Pollack, L. Questionnaire response bias and face-to-face interview samples bias in sexuality research. J Sex Res 22:52-72, 1986. DeMaio, J. Social desirability and survey measurement: A review. In: Turner, CF. and Martin, E., eds., Surveying Subjective Phenomena, Vol. 2. New York: Russell Sage Foundation, 1984. Gibson, D.R.; Guydish, J.; Wraxall, B.G.D.; Blake, E.T.; Clark, G.; and Case, P. Using forensic techniques to verify self-reports of needlesharing (letter). AIDS 5:1149-50, 1991. 234
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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
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highway of love. It’s like, I’d
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Unprotected sexual activity is more
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alternatives and opportunities, and
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the night and food for the morning.
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7. also can help youths explore and
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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
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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 and 226: TABLE 1. Sociodemographic profile o
Page 227 and 228: Table 2 shows percentage agreement
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: TABLE 8. Percent of subjects report
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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