The validity of injecting drug users' self‐reports about sexually transmitted diseases: a comparison of survey and serological data

Abstract

Researchers studying the validity of injecting drug users' self-reports have often reported a high degree of correspondence between self-reports and several types of criterion variables. In this study, injecting drug users' responses to questions about prior infection with four sexually transmitted diseases were compared with serological test data. For three of the four diseases studied, discrepancies between survey and serological results were quite large, especially when respondents said they had no previous history of infection. Limitations of serological testing, the questions asked, respondent knowledge and the more traditional concern with respondent veracity are discussed as possible explanations for the observed differences. Study data suggest that use of drug injectors' self-reports to measure infection with sexually transmitted diseases or to validate other measures is a questionable practice. Problems encountered in interpreting study results provide support for more frequent use of experimental or quasi-experimental designs and of multivariate analytic techniques when conducting research on response validity.

Poor criterion validity of self‐reported hepatitis B infection and vaccination status among injecting drug users: A review

“…Among adults, acute HBV infection is asymptomatic in 33-50% of cases [18], such that many HBV-infected individuals may be unaware of their exposure. This may especially be the case among IDU, because the symptoms of HBV infection (fatigue, malaise, anorexia, nausea, vomiting, headache, abdominal discomfort, mood disorder, sleep disturbance) can resemble those associated with drug intoxication and/or withdrawal [9]. Competing demands and priorities may impede some IDU from seeking medical intervention even when symptoms are evident [19], such that symptomatic infection remains unconfirmed for these individuals.…”

“…Self-reported HBV infection status among IDU has consistently demonstrated poor sensitivity (Day C, et al, unpublished data) [9][10][11][12][13][14][15][16][17]. In research conducted across a range of settings over the course of almost two decades, substantial proportions (46-95%) of IDU whose serological results indicate exposure to HBV failed to self-report a history of infection (Table 1).…”

Examining Racial/Ethnic Disparities in Sexually Transmitted Diseases Among Recent Heroin-Using and Cocaine-Using Women

“…This study relied on participant self-reports of STDs, which may be less accurate than serological data. 34 However, self-reports of STDs have been found to be valid in comparison to other assessment methods, including medical record reviews and state health department reports. 35 The span of some CIs also suggests some instability in the models.…”

Factors Associated with Sexually Transmitted Infection Underreporting Among Female Sex Workers in China

“…[3][4][5][6] However, self-reported STI has questionable accuracy, and underreporting is commonly seen, particularly in high-risk populations. 7 The underreporting of STI may result from a number of factors: patients were not tested and were unaware of any symptoms or diagnosis, especially asymptomatic STI; patients were tested but unaware of the diagnosis because the results were not received or not understood; and patients were tested and aware of the diagnosis but did not report it.…”