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Validity of Injecting Drug Users' Self Report of Hepatitis A, B, and C

OBJECTIVE: To test the validity of drug users self-reports of diseases associated with drug use, in this case hepatitis A, B, and C. DESIGN: Injecting drug users (n = 653) were recruited and asked whether they had been diagnosed previously with hepatitis A, B, and/or C. These self-report data were compared to total hepatitis A antibody, hepatitis B core antibody, and hepatitis C antibody seromarkers as a means of determining the validity of the self-reported information. SETTING: Anchorage, Alaska. PARTICIPANTS: Criteria for inclusion included being at least 18-years old; testing positive on urinalysis for cocaine metabolites, amphetamine, or morphine; having visible signs of injection (track marks). INTERVENTION: Serological testing for hepatitis A, B, and C. MAIN OUTCOME: Findings indicate high specificity, low sensitivity, and low kappa coefficients for all three self-report measures. RESULTS: Subgroup analyses revealed significant differences in sensitivity associated with previous substance abuse treatment experience for hepatitis B self-report and with gender for hepatitis C self-report. CONCLUSION: Given the low sensitivity, the validity of drug users, self-reported information on hepatitis should be considered with caution. ABBREVIATIONS: HAV = hepatitis A virus; HBV = hepatitis B virus; HCV = hepatitis C virus; HIV = human immunodeficiency virus; IDU = injection drug user; STD = sexually transmitted disease.