Instrument validity: HIV and other sexually transmitted infections in homeless people.
Anna Cláudia Freire de Araújo Patrício, Richardson Augusto Rosendo da Silva, Ivoneide Lucena Pereira and 5 others
PMID 36197430WHAT IT FOUND
Nine items about previous STIs, drug use, sex for money, partners, sharps sharing and violence measured HIV and STI vulnerability in homeless adults, but the score did not diagnose HIV.
Key findings
01Among 100 homeless people, rapid tests were positive for HIV in 5%, syphilis in 29%, hepatitis B in 1%, and hepatitis C in none.
02Item response theory validated nine of the original 16 questionnaire items as measures of vulnerability to HIV and other sexually transmitted infections.
03At a cut-off of 4, the HIV vulnerability score had an area under the ROC curve of 0.680, sensitivity 60.00%, specificity 68.08%, accuracy 67.68%, positive predictive value 9.09%, and negative predictive value 96.97%.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was done in one city and only with homeless people who used two social services, so it may not apply to homeless people who do not access services. Most participants were men, 84%, which may limit how well the questionnaire fits women. The vulnerability items were self-reported behaviours, not observed or laboratory measures. The reported ROC and cut-off analysis was for HIV, so it does not show how the score performs for syphilis, hepatitis B or hepatitis C.
The easy way to misread this
Do not use the vulnerability score as a diagnostic HIV test. The paper reports low sensitivity and low positive predictive value at the chosen cut-off, so a high score does not confirm infection.