Measurement of HIV risk behaviors among intravenous drug users
British Journal of AddictionPublished 1 March 1992
Jack Samuels, David Vlahov, James C. Anthony, Richard E. Chaisson
Citations78
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TL;DR
Difficulties and approaches for measuring drug use and other intimate behaviors in intravenous drug users are discussed and attempts to come to terms with these measurement issues in the context of HIV infection in intravenOUS drug users should lead to the further development of methods for use.
Abstract
This paper reviews issues related to the measurement of drug use and other behaviors in studies of human immunodeficiency virus (HIV) infection in intravenous drug users. These issues include: (1) choice of variables, (2) study design, (3) time frame of measurement, (4) categories of measurement, (5) interviewer effects, and (6) validity of measurement. Difficulties and approaches for measuring drug use and other intimate behaviors in intravenous drug users are discussed. Attempts to come to terms with these measurement issues in the context of HIV infection in intravenous drug users should lead to the further development of methods for use in the general context of drug abuse research.
Keywords
Medicine
Journal of the American Statistical AssociationSurvey Research Methods.
4,799 Citations1985Susan Losh-Hesselbart, Floyd J. Fowler
The Journal of Nervous and Mental DiseaseAn Improved Diagnostic Evaluation Instrument for Substance Abuse Patients
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The results lend support to the abiding concern about the risk of HIV infection among cocaine users and allow a test for whether the association was a spurious artifact of studying drug users recruited solely from drug treatment programs.
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PubMedPredictors of decline in CD4 lymphocytes in a cohort of homosexual men infected with human immunodeficiency virus.
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Significant predictors of steeper decline of CD4 counts were high CD8 count, low hemoglobin, low platelets, high serum IgA, high cytomegalovirus antibody, and low HIV antibody.
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Archives of Internal MedicineIntravenous Drug Abusers and the Acquired Immunodeficiency Syndrome (AIDS)
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Needle sharing supports the hypothesis of AIDS transmission by a blood-borne route, can explain the spread of AIDS and the high rate of seropositivity to the putative AIDS agent among IV drug abusers, and is a logical link between IVdrug abusers and male homosexuals, the two largest groups with AIDS.
The American Journal of Drug and Alcohol AbuseTrends of HIV-1 Risk Reduction among Initiates into Intravenous Drug Use 1982–1987
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International Journal of the AddictionsThe Validity of Self-Reported Heroin Use
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American Journal of Public HealthDemographic characteristics, risk behaviors, and HIV seroprevalence among intravenous drug users by site of contact: results from a community-wide HIV surveillance project.
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International Journal of the AddictionsThe Validity and Reliability of Self-Reported Data from Heroin Addicts: Mailed Questionnaires Compared with Face-to-Face Interviews
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