Sexual behaviors among club drug users: prevalence and reliability

HIV prevention efforts require a focus on reducing high risk sexual behavior. Because these are self-reported, assessments that reduce memory bias and improve elicitation of data are needed. As part of a multi-site psychometric study of club drug use, abuse, and dependence, data were collected with a test-retest design that measured the reliability of the Washington University Risk Behavior Assessment for Club Drugs (WU-RBA-CD). Reliability was assessed separately by sex via kappa coefficients and intraclass correlation coefficients (ICC); z tests compared coefficients by sex. A total of 603 participants were interviewed by independent assessors with 5 days in between interviews. Reliability for all 51 items of the sexual activity section of the WU-RBA-CD ranged from .23 to 1.00; 71% (n = 36) of items resulted in moderate to high reliability (.55-1.00). Number of lifetime sex partners was consistently reported for same-sex partners for both men and women and opposite-sex partners. Items with high reliability included reporting ever being under the influence of ecstasy (.87) or GHB (.87) while having sex. Items with lower reliability included those that queried the determinants of condom use (.45-.82) and about behaviors and attitudes experienced while using drugs (.23-.87). Very few sex differences were revealed in the reliability of reported sexual activities. Overall, the WU-RBA-CD performed with fairly high reliability rates. Assessing situations of when, how, and why individuals use condoms may offer the clearest evaluation of determinants of sexual behaviors, yet those items are not as reliable.