The Frequency of High-Risk Behaviors Among Iranian College Students Using Indirect Methods: Network Scale-Up and...

Area of Science:

• Public Health
• Epidemiology
• Social Science

Background:

• Direct questioning often underestimates sensitive behaviors due to social stigma.
• Indirect survey methods are crucial for accurately assessing prevalence of stigmatized behaviors like illicit drug use and sexual activity.

Purpose of the Study:

• To indirectly estimate the prevalence of specific risky behaviors among Iranian college students.
• To compare the efficacy of two indirect estimation methods: network scale-up (NSU) and crosswise model (CM).

Main Methods:

• Recruited 563 students from a major Iranian medical university.
• Employed both the crosswise model (CM) and network scale-up (NSU) to estimate prevalence.
• Assessed prevalence of opium use, alcohol consumption, relationships with the opposite sex (RWOS), and extra/pre-marital sex (EPMS).

Main Results:

• Crosswise model (CM) estimated higher prevalence for alcohol consumption (16.8% vs. 8.1%), methamphetamine use (7.2% vs. 1.2%), tramadol use (14.8% vs. 4.8%), RWOS (42.3% vs. 31.9%), and EPMS (12.4% vs. 7.1%).
• Both methods estimated 2.2% prevalence for opium use.
• Network scale-up (NSU) yielded lower prevalence estimates for most behaviors.

Conclusions:

• The network scale-up (NSU) method may underestimate prevalence due to a transmission barrier, where individuals lack awareness of friends' behaviors.
• Risky behaviors, including substance use and sexual activity, appear to be relatively common among Iranian college students.
• Indirect methods provide valuable insights into sensitive behaviors in stigmatized populations.