Behavioral risk assessment for infectious diseases (BRAID): Self-report instrument to assess injection and noninjection risk behaviors in substance users

Abstract

Background Infectious diseases such as Human Immunodeficiency Virus and Hepatitis C are a significant problem among substance abusers. Current risk behavior measures [e.g., HIV Risk Taking Behavior Scale (HRBS) and Risk Assessment Battery (RAB)] were developed for injection drug users and do not include newly identified risks or noninjection drug use behaviors. This study developed and provided initial, internal validation of the Behavioral Risk Assessment for Infectious Diseases (BRAID) to assess infectious disease risk behaviors among alcohol and other drug users. Methods A self-report measure was developed from literature regarding risk behaviors. Participants (total N=998) with alcohol/substance use disorder completed the measure in 2 phases to establish initial psychometric validity. Results Phase 1 (N=270) completed 65 self-report questions; factor analysis revealed a 12-item solution with 5 factors (Unprotected Sex with Risky Partners, Injection Use, Sex on Cocaine/Crack, Condom Availability, and Intranasal Drug Use). Infectious disease history was positively associated with Injection Use (Sample 1) and Unprotected Sex with Risky Partners (Sample 2) and negatively associated with Intranasal Drug Use (Samples 1 and 2). Phase 2 (N=728) added additional injection-related items and confirmed the factor structure of the existing BRAID. Conclusions The BRAID is a 5-factor, 14-item self-report measure of past 6 month risk behaviors that is composed of noninjection and injection risk behaviors and was psychometrically confirmed. Though additional external (convergent/divergent) validation is needed, this report provides preliminary support for the use of the BRAID to assess infectious disease risk in substance users.

Cocaine administration dose-dependently increases sexual desire and decreases condom use likelihood: The role of delay and probability discounting in connecting cocaine with HIV

“…We collected detailed data about drug use (e.g., DSM-IV drug abuse and dependence checklists based on Hudziak et al, 1993), sexual HIV risk behaviors (Behavioral Risk Assessment for Infectious Diseases [BRAID], Dunn et al, In Press; HIV Risk-taking Behavior Scale, Darke et al 1991), verbal intelligence (Quick Test; Ammons and Ammons 1962), and ADHD symptoms (Adult ADHD Self-Report Scale; Kessler et al 2005). In order to familiarize participants with study measures before potential drug effects would be experienced in subsequent laboratory sessions, participants were required to practice completing the subjective drug effects questionnaire, the Sexual Delay Discounting Task (described below), and the Sexual Probability Discounting Task (described below).…”

“…DSM-IV checklists based on Hudziak et al (1993) were used to assess drug abuse and dependence. The Behavioral Risk Assessment for Infectious Diseases (BRAID; Dunn et al, In Press) assessed sexual risk behaviors. The HIV Risk Taking Behavior Scale assessed injection drug use and sexual HIV risk behaviors (Darke et al, 1991).…”

A novel mHealth application for improving HIV and Hepatitis C knowledge in individuals with opioid use disorder: A pilot study

“…Of particular concern is the disproportionate prevalence of human immunodeficiency virus (HIV) and Hepatitis C (HCV) among individuals with OUD. Untreated OUD has been associated with unprecedented recent outbreaks of HIV and HCV (CDC, 2015, 2016; Dunn et al, 2016; Wang et al, 2011). Infectious disease risks among individuals with OUD and other substance use disorders stems from engaging in risky drug use and sexual behaviors (e.g., sharing injection equipment, having unprotected sex, trading sex for drugs).…”

Sexual HIV risk behavior outcomes of brief interventions for drug use in an inner-city emergency department: Secondary outcomes from a randomized controlled trial

“…Further, the HRBS was developed over 30 years ago for use with individuals who inject drugs, thus other measures may better assess HIV risk in primarily non-injecting samples such as ours. For example, the Behavioral Risk Assessment for Infectious Diseases (Dunn et al, 2016) is a promising measure developed for a broader population of substance using adults that was not available at the time we commenced this study. Next, although our interventions allowed for tailoring, particularly during boosters, this strength also poses a potential limitation in that HIV risk behaviors were inconsistently addressed across participants.…”