How accurately do people who inject drugs report their HIV status, and can socially desirable responding signal inaccurate reports?

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This study examined how accurately people who inject drugs reported their HIV serostatus and whether a measure of socially desirable responding could predict inaccurate reports.

The observational validation study involved 348 people actively injecting drugs who were recruited from ALIVE, a longitudinal study of the natural history of HIV among people who inject drugs. They volunteered for SAFE, a separate HIV prevention study. In ALIVE, participants were provided HIV antibody testing and counseling every 6 months. In SAFE, the same volunteers were asked to report their HIV serostatus, allowing self-reports to be compared with antibody testing.

The ALIVE baseline interview included a scale measuring “self-deception,” a dimension of socially desirable responding.

Among 104 HIV-seropositive participants, 71 (68%) accurately reported their HIV status, 28 (27%) reported it inaccurately, and five (5%) said they did not know or were not sure. Among 242 HIV-seronegative participants, 239 (98%) correctly reported their status.

The reported sensitivity of self-report was 72%, specificity was 99%, positive predictive value was 97%, and negative predictive value was 90%. Among individuals whose self-deception scores were at or below the median, the sensitivity of self-reported HIV serostatus was 81%.

The authors concluded that high scores on some measures of social desirability may indicate questionable validity of self-reported HIV serostatus.