Background Social desirability response bias may lead to inaccurate self-reports and erroneous study conclusions. The present study examined the relationship between social desirability response bias and self-reports of mental health, substance use, and social network factors among a community sample of inner-city substance users. Methods The study was conducted in a sample of 591 opiate and cocaine users in Baltimore, Maryland from 2009–2013. Modified items from the Marlowe-Crowne Social Desirability Scale were included in the survey, which was conducted face-to-face and using Audio Computer Self Administering Interview (ACASI) methods. Results There were highly statistically significant differences in levels of social desirability response bias by levels of depressive symptoms, drug use stigma, physical health status, recent opiate and cocaine use, Alcohol Use Disorders Identification Test (AUDIT) scores, and size of social networks. There were no associations between health service utilization measures and social desirability bias. In multiple logistic regression models, even after including the Center for Epidemiologic Studies Depression Scale (CES-D) as a measure of depressive symptomology, social desirability bias was associated with recent drug use and drug user stigma. Social desirability bias was not associated with enrollment in prior research studies. Conclusions These findings suggest that social desirability bias is associated with key health measures and that the associations are not primarily due to depressive symptoms. Methods are needed to reduce social desirability bias. Such methods may include the wording and prefacing of questions, clearly defining the role of “study participant,” and assessing and addressing motivations for socially desirable responses.

Adopting socioecological, intersectionality, and lifecourse theoretical frameworks may enhance our understanding of the production of syndemic adverse health outcomes among gay, bisexual and other men who have sex with men (MSM). From this perspective, we present preliminary data from three related studies that suggest ways in which social contexts may influence the health of MSM. The first study, using cross-sectional data, looked at migration of MSM to the gay resort area of South Florida, and found that amount of time lived in the area was associated with risk behaviors and HIV infection. The second study, using qualitative interviews, observed complex interactions between neighborhood-level social environments and individual-level racial and sexual identity among MSM in New York City. The third study, using egocentric network analysis with a sample of African American MSM in Baltimore, found that sexual partners were more likely to be found through face-to-face means than the Internet. They also observed that those who co-resided with a sex partner had larger networks of people to depend on for social and financial support, but had the same size sexual networks as those who did not live with a partner. Overall, these findings suggest the need for further investigation into the role of macro-level social forces on the emotional, behavioral, and physical health of urban MSM.

Both interventions led to decreases in risk behaviors but no changes in medical outcomes. The characteristics of the trial that may have contributed to these results are examined, and directions for future research are identified.

Aims-To assess the effectiveness of a peer-based, personal risk network focused HIV prevention intervention to 1) train IDUs to reduce injection and sex risk behaviors, 2) conduct outreach to behaviorally risky individuals in their personal social networks (called Risk Network Members), and 3) reduce RNM HIV risk behaviors.Design-Randomized controlled trial with prospective data collection at 6, 12, and 18 months. Intervention condition consisted of 5 group-sessions, one individual session and one session with Index and the RNM. Participants-1) Index participants were aged ≥18 years and self-reported injection drug use in the prior 6 months and 2) their RNMs who were aged ≥18 years and drug users or sex partners of Index.Measurements-Outcomes included: 1) injection risk based on sharing needles, cookers and cotton for injection and drug splitting, 2) sex risk based on number of sex partners, condom use and exchanging sex and 3) Index HIV outreach behaviors.Findings-A total of n=227 Index participants recruited n=366 RNMs. Retention of Index at 18-month follow-up exceeded 85%. Findings suggest the experimental condition was efficacious at 18-months in reducing Index participant injection risk (OR=0.38; 95%CI=0.18-0.77), drug splitting risk (OR=0.46; 95%CI=0.25-0.88), and sex risk among Index (OR=0.53; 95%CI=0.34-0.86). Significant intervention effect on increased condom use among female RNM was observed (OR=0.34; 95%CI=0.18-0.62).

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