Background Neighbourhoods with drug markets (as compared to those without) may be more likely to have a greater concentration of STI infected sex partners. The objectives of this study were to assess the reliability and validity of three measures of neighbourhood drug markets.
Methods Data were collected from a cross-sectional household study of English-speaking, sexually-active persons, 15–24 years of age (n=568) residing in selected neighbourhoods (n=63). Participants responded via ACASI to “In your neighbourhood, are there any places like a street corner, block, house, club, bar, or other place where drug activity, like people selling or buying drugs, happens?” Survey reports were aggregated to the neighbourhood level and coded to > (vs <) 50% of residents reporting yes. To supplement this measure, information was obtained from systematic social observations (SSOs) using a multi-item assessment tool. Multiple rater information on a block was aggregated to the greater value to generate one value for a block unit. Ratings were summed to create one continuous measure at the neighbourhood level. Additionally drug arrest data on drug manufacturing, distribution, or intent to distribute was measured as a count per neighbourhood. We conducted reliability analyses using intraclass correlations and inter rater reliabilities and convergent validity testing using Poisson and linear regression.
Results Within-neighbourhood respondent agreement on survey-reports of neighbourhood drug markets had a reliability 0.50 and an intra class correlation of 0.10 (p<0.001). Neighbourhood survey-reports were significantly associated with gonorrhoea counts (IRR) 3.05, 95 CI% 2.07 to 4.51, p<0.001) and socioeconomic status (SES) (ß −1.74, 95 CI% −2.54 to −0.93, p<0.001). The SSO drug market inter rater reliability was significant and moderate at the block level (0.57, p<0.05) with a reliability of 0.88. The SSO measure was not associated with gonorrhoea counts (IRR 1.18, 95 CI % 0.94 to 1.49, p=0.15) and was significantly associated with SES (ß −0.65, 95 CI% −0.99 to −0.31, p<0.000). Drug arrest counts were significantly associated with gonorrhoea counts (IRR 1.01, 95 CI% 1.00 to 1.01, p=0.002) and SES (ß −0.01, 95 CI% −0.02 to −0.01, p<0.001).
Conclusions The results suggest that neighbourhood drug markets can be measured through the use of household survey-reports and drug arrest data; the use of SSOs was less clear. The mismatch of the drug market measures may have been due to differences between the measures in sensitivity and specificity.
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