AIDS knowledge and attitudes among injection drug users: the issue of reliability
Longshore, D.; Hsieh, S.C.; Anglin, M.D.
Aids Education and Prevention Official Publication of the International Society for Aids Education 4(1): 29-40
1992
ISSN/ISBN: 0899-9546 PMID: 1543642 Document Number: 326539
This study pertains to a survey of 365 injection drug users (IDUs) in Los Angeles County from methadone maintenance/detoxification or residential drug free programs and earlier studies of AIDS risk reduction. The sample was stratified by ethnicity and gender and appeared to represent the local IDU population with treatment experience. There were 129 whites, 118 Hispanics, and 85 blacks; 174 were women and 158 men. 189 had completed high school and 143 had not. The purpose of the study was to investigate the reliability of indexes measuring AIDS-related knowledge and attitudes. Background information is provided on AIDS risk demographics and measurement, AIDS knowledge and attitudes, and summary of prior research. The instrument was newly designed to measure general knowledge about AIDS, perceived susceptibility to HIV infection and to self-efficacy regarding drug, and sex related risk reduction techniques and response efficacy of those techniques, and drug and sex-related risk reduction norms. 45 questions were asked by trained interviewers and answered by respondents in English in a Likert agree/disagree format. The results showed that knowledge, susceptibility, self-efficacy/drugs, self efficacy/sex, and norms/sex had the highest alphas ranging from .64 to .78. The minimum acceptable level is .50. The response norm/drugs is barely acceptable at .56. In the demographic analysis, alphas are the lowest for Hispanics in 7 out of 8 indexes, and with statistically significant differences in 4 indexes: response efficacy/drugs, response efficacy/sex, self-efficacy/sex, and norms/drugs. Response efficacy/sex and norms/drugs reach the acceptable minimum of .50 for blacks and whites only. Self-efficacy/sex for total does not reach a minimum acceptable level, however, it does for white at .58 and almost reaches acceptability for blacks at .43. There are inconsistent patterns by sex. In general, men are less reliable on the susceptibility index and women on the response efficacy/sex and self-efficacy/sex indices. Respondents with a high school education had alphas of .61 compared with .56 for low education respondents. There is lower reliability among lower educated respondents on self-efficacy/drugs and norms/drugs. The implications are that subgroup reliability is related to responses, such that low education and Hispanics score lower. Inconsistency of response may be due to methodological problems, which may be corrected statistically or by asking open-ended questions, and affect the effectiveness of interventions.