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.