Predictors of correspondence between self-reported substance use and urinalysis screening among a racially diverse cohort of young men who have sex with men and transgender women

Abstract

It is unknown if estimates of illicit drug use among young men who have sex with men and transgender women (YMSM/TW) may be biased due to historical distrust of research or reliable due to more accepting norms for use. Research is needed to examine the validity of drug use self-reports among YMSM/TW. Data came from an ongoing longitudinal study of YMSM/TW aged 16-29 living in Chicago (analytic N = 1029). Baseline urinalysis screens for marijuana, ecstasy, amphetamine, methamphetamine, cocaine, benzodiazepine, and opiate metabolites were compared to self-reported use within different recall periods using measures of concordance. Generalized estimating equations logistic regressions were conducted on three waves of data to identify predictors of disclosing past-6-month use of marijuana and non-marijuana drugs. Past-6-month self-reported use of all non-marijuana substances was <15%. There was excellent agreement between self-reported and drug-tested marijuana use. For other substances, sensitivities within the urinalysis detection window were <0.5 but increased with longer recall periods. Black participants had lower odds of disclosing non-marijuana drug use. Gender minority participants had lower odds of disclosing marijuana use. Participants with a history of arrest had higher odds of disclosing both marijuana and non-marijuana drug use. Wave and year of first research participation were non-significant, suggesting no systematic bias or increasing honesty associated with longer research participation. Programs that rely on self-identification of non-marijuana illicit substance use may be missing a substantial portion of drug-using YMSM/TW. Future epidemiological studies should work to reduce social desirability biases and include biomarker-based drug screenings to increase validity.

A comparison of the utility of urine- and hair testing in detecting self-reported drug use among young adult opioid users

“…Similarly, our findings suggest that urine testing is more efficacious than hair testing in detecting benzodiazepines, validating just over half of self-reported use. To our knowledge, only one other validity study within the past several decades has included benzodiazepines in their analyses (Li et al, 2019). Though their findings were limited to sexual minorities, Li et al also reported a fair level of agreement between urine test results and self-report of benzodiazepine use.…”

Validity of self-reported substance use: research setting versus primary health care setting

“…The sensitivity of the URDS is above 98%. Sensitivities for the URDS compared to TLC ranged from 96% for cocaine to > 99% for Opioids [ 24 ]. Urine samples were analyzed by laboratory in Rafsanjan University of Medical Sciences.…”

Factors Affecting Painkillers, Sedatives/Hypnotics, Nicotine, and Unhealthy Alcohol Use Among Gay and Bisexual Men in Taiwan

“…The weak reinforcing effect of benzodiazepines can lead to their abuse [10]; however, few studies have explored the use of sedatives/hypnotics in sexual minorities. A cohort survey in which 90.2% of the participants were gay and bisexual men demonstrated a 10.2% rate of the self-reported use of benzodiazepines in the past 6 months [11]. Another study indicated that frequent transactional sex was associated with benzodiazepine use for MSM of whom 92.1% were gay and bisexual men [12].…”