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Correlates of Staying Safe Behaviors Among Long-Term Injection Drug Users: Psychometric Evaluation of the Staying Safe Questionnaire

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Abstract

We report on psychometric properties of a new questionnaire to study long-term strategies, practices and tactics that may help injection drug users (IDUs) avoid infection with HIV and hepatitis C. Sixty-two long-term IDUs were interviewed in New York City in 2009. Five scales based on a total of 47 items were formed covering the following domains: stigma avoidance, withdrawal prevention, homeless safety, embedding safety within a network of users, and access to resources/social support. All scales (α ≥ .79) except one (α = .61) were highly internally consistent. Seven single-item measures related to drug use reduction and injection practices were also analyzed. All variables were classified as either belonging to a group of symbiotic processes that are not directly focused upon disease prevention but nonetheless lead to risk reduction indirectly or as variables describing prevention tactics in risky situations. Symbiotic processes can be conceived of as unintentional facilitators of safe behaviors. Associations among variables offer suggestions for potential interventions. These Staying Safe variables can be used as predictors of risk behaviors and/or biological outcomes.

Resumen

Informamos sobre las propiedades psicométricas de un nuevo cuestionario para estudiar estrategias a largo plazo, prácticas y tácticas que pueden ayudar a usuarios de drogas inyectables (UDI) a evitar la infección de VIH y hepatitis C. Se entrevistaron sesenta y dos UDI en Nueva York en 2009. Se desarrollaron cinco escalas basadas en un total de 47 elementos cubriendo las siguientes áreas: evitar el estigma; prevención del síndrome de abstinencia; protección de infección cuando sin hogar; incorporación de protección dentro de redes de usuarios y acceso a recursos/apoyo social. Las escalas presentaron coherencia interna (rango alfa de Cronbach: .61 a .86). Todas las escalas (α ≥ .79) excepto una (α = .61) presentaron alta coherencia interna. Siete medidas de variable única relacionadas con la reducción del consumo de drogas y las prácticas de inyección también se analizaron. Todas las variables fueron clasificadas como pertenecientes a procesos simbióticos que no están directamente enfocados en la prevención de infecciones pero, sin embargo, conducen a la reducción del riesgo indirectamente, o como variables que describen tácticas de prevención en situaciones de riesgo. Procesos simbióticos pueden ser concebidos como facilitadores involuntarios de comportamientos seguros. Las asociaciones entre las variables ofrecen sugerencias para posibles intervenciones. Estas variables para “permanecer protegido” (Staying Safe) puede ser utilizadas como predictores de conductas de riesgo y/o resultados biológicos.

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Acknowledgements

This research was supported by US National Institute on Drug Abuse grants R01 DA19383 (Staying Safe: Long-Term IDUs Who Have Avoided HIV & HCV) and R21 DA026328 (Staying Safe: Training IDUs in Strategies to avoid HIV and HCV infections).

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Authors and Affiliations

  1. National Development and Research Institutes, Inc., 8th Floor, 71 West 23rd Street, New York, NY, 10010, USA

    Peter Vazan, Pedro Mateu-Gelabert, Milagros Sandoval & Samuel R. Friedman

  2. NYU College of Nursing, New York, NY, USA

    Charles M. Cleland

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  1. Peter Vazan
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  2. Pedro Mateu-Gelabert
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  3. Charles M. Cleland
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  4. Milagros Sandoval
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  5. Samuel R. Friedman
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Correspondence to Samuel R. Friedman.

Appendix

Appendix

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Table 4 Items that compose the scales and subscales
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Vazan, P., Mateu-Gelabert, P., Cleland, C.M. et al. Correlates of Staying Safe Behaviors Among Long-Term Injection Drug Users: Psychometric Evaluation of the Staying Safe Questionnaire. AIDS Behav 16, 1472–1481 (2012). https://doi.org/10.1007/s10461-011-0079-8

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