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Int J Drug Policy. 2018 May;55:165-168. doi: 10.1016/j.drugpo.2018.03.020. Epub 2018 Apr 11.

Substance Use and Sex Index (SUSI): First stage development of an assessment tool to measure behaviour change in sexualised drug use for substance use treatment studies.

Author information

1
Alcohol & Drug Service, St Vincent's Hospital Sydney, 390 Victoria St, Darlinghurst, NSW 2010, Australia; Faculty of Medicine, UNSW Sydney, Sydney, NSW 2052, Australia. Electronic address: Nadine.Ezard@svha.org.au.
2
School of Medicine, University of Tasmania, Churchill Ave, Sandy Bay, TAS 7005, Australia. Electronic address: beatrice.webb@utas.edu.au.
3
Alcohol & Drug Service, St Vincent's Hospital Sydney, 390 Victoria St, Darlinghurst, NSW 2010, Australia; Sydney Nursing School, University of Sydney, Sydney, NSW 2006, Australia. Electronic address: Brendan.Clifford@svha.org.au.
4
Alcohol & Drug Service, St Vincent's Hospital Sydney, 390 Victoria St, Darlinghurst, NSW 2010, Australia. Electronic address: Michael.Cecilio@svha.org.au.
5
School of Medicine, Sydney, University of Notre Dame, 160 Oxford St, Darlinghurst, NSW 2010, Australia. Electronic address: Amanda.Jellie1@my.nd.edu.au.
6
German Institute for Addiction and Prevention Research (DISuP), Catholic University of Applied Sciences, North Rhine-Westphalia, Wörthstraße 10, 50668 Cologne, Germany; Centre for Social Research in Health, UNSW Sydney, Sydney, NSW 2052, Australia. Electronic address: toby.lea@unsw.edu.au.
7
Alcohol & Drug Service, St Vincent's Hospital Sydney, 390 Victoria St, Darlinghurst, NSW 2010, Australia. Electronic address: Craig.Rodgers@svha.org.au.
8
Victorian AIDS Council, Level 5, 615 St Kilda Rd, Melbourne, VIC 3004, Australia. Electronic address: Simon.Ruth@vac.org.au.
9
School of Medicine, University of Tasmania, Churchill Ave, Sandy Bay, TAS 7005, Australia. Electronic address: Raimondo.Bruno@utas.edu.au.

Abstract

BACKGROUND:

Existing tools for measuring blood-borne virus (BBV) and sexually transmitted infection (STI) transmission risk behaviours in substance use interventions have limited capacity to assess risk behaviours across varied social, cultural and epidemiological contexts; have not evolved alongside HIV treatment and prevention innovations; or accounted for sexual contexts of drug use including among a range of lesbian, gay, bisexual, transgender, intersex and queer (LGBTIQ) sub-communities. The Substance Use and Sex Index (SUSI) is a new brief, simple tool being developed to assess change in HIV and STI risk behaviours for substance use treatment studies.

METHODS:

A 26-item questionnaire was piloted online among community volunteers (n = 199). Concurrent and predictive validity were assessed against risk-taking (RT-18) and STI testing items (Gay Community Periodic Surveys).

RESULTS:

The developed scale comprised nine items measuring: condomless penile (anal or vaginal) sex, unprotected oral sex, shared toy use, bloodplay, chemsex (consumption of drugs for the facilitation of sex), trading sex for drugs, being 'too out of it' to protect self, injecting risk and group sex. Factor-analytic approaches demonstrated that items met good fit criteria for a single scale. Significant, moderate magnitude, positive relationships were identified between total SUSI score and both RT-18 risk-taking and recent STI testing. Qualitative feedback underscored the importance of culturally-embedded question formulation.

CONCLUSION:

The results support the conceptual basis for the instrument, highlighting the need for further scale content refinement to validate the tool and examine sensitivity to change. SUSI is a step towards improving outcome measurement of HIV/BBV/STI transmission risk behaviours in substance use treatment studies with greater inclusiveness of experiences across different population groups.

KEYWORDS:

Blood-borne virus; Chemsex; HIV; Party and play; Risk behaviours; Risk environments; Sexually transmitted infection; Substance use

PMID:
29655906
DOI:
10.1016/j.drugpo.2018.03.020
[Indexed for MEDLINE]

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