Evidence map›Paper›PMID 41340600›Full record

ArticleAddiction (Abingdon, England)2026

Substance Use and Sex Index version 2 (SUSI-2): Validation of a brief questionnaire for the measurement of behaviours associated with transmission of blood borne viruses and sexually transmitted infections.

Brendan Clifford, Raimondo Bruno, Liam Acheson, Michael E Cecilio, Krista J Siefried, Jack Freestone, Vincent J Cornelisse, Brendan Crozier, Nicky Bath, Nadine Ezard

Abstract readValidation Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Addiction (Abingdon, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Brendan CliffordNational Centre for Clinical Research on Emerging Drugs, University of New South Wales, Sydney, Australia.ORCID https://orcid.org/0000-0002-9178-9013
Raimondo BrunoNational Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia.
Liam AchesonNational Centre for Clinical Research on Emerging Drugs, University of New South Wales, Sydney, Australia.ORCID https://orcid.org/0000-0002-2343-5504
Michael E CecilioThe Kirby Institute, University of New South Wales, Sydney, Australia.
Krista J SiefriedNational Centre for Clinical Research on Emerging Drugs, University of New South Wales, Sydney, Australia.ORCID https://orcid.org/0000-0002-6534-3325
Jack FreestoneNational Centre for Clinical Research on Emerging Drugs, University of New South Wales, Sydney, Australia.
Vincent J CornelisseThe Kirby Institute, University of New South Wales, Sydney, Australia.ORCID https://orcid.org/0000-0003-0657-9677
Brendan CrozierSouth East Sydney Local Health District, Sydney, Australia.
Nicky BathLGBTQI+ Health Australia, Sydney, Australia.
Nadine EzardNational Centre for Clinical Research on Emerging Drugs, University of New South Wales, Sydney, Australia.

Funding

St Vincent's Health Australia Inclusive Health Program
6 · The paper itself

Abstract

aimsThis study sought to validate a community-acceptable Substance Use & Sex Index (SUSI) for use in substance use intervention research. SUSI aims to measure behaviours associated with the transmission of blood-borne viruses (BBV) and sexually transmitted infections (STI) among people who use substances and incorporate contemporary sexual and drug practices.

designValidation of a self-administered online behavioural questionnaire. SETTING AND

participantsAn Australian anonymous online questionnaire advertised through health services and social media resulted in 289 respondents with a mean age 35 years (standard deviation [SD] 10.9 years). MEASUREMENTS: A 26-item scale assessing BBV- and STI-associated behaviours based on previous piloting and expert review was assessed for scale structure using exploratory and confirmatory factor analytic approaches. Item Response Theory (IRT) analyses were applied in decisions to retain and categorise items. Item weightings were defined following expert consensus informed by local BBV, STI and HIV epidemiological profiles. Test-retest reliability was examined on a subsample (n = 98) over three to five days. Criterion validity of the new SUSI-2 scale was examined in comparison to the HIV Risk-taking Behaviour subscale of the Opiate Treatment Index (OTI-HRBS).

findingsFactor analysis identified a two-factor model ("sex"; "drugs with sex"), with moderate magnitude correlation (r = 0.38; 95% confidence interval [CI] 0.19-0.54) between factors and acceptable model fit (p = 0.061). IRT discrimination was statistically significant for all items (p < 0.05). Kappa values for test-retest reliability (n = 98 subsample) ranged from 0.66 to 1.00 with high agreement (all above 87%). Free text responses indicated the questionnaire items were acceptable to respondents, with minimal suggestion for improvements. There was a statistically significant positive correlation between the SUSI-2 and OTI-HRBS sex subscales (weighted r = 0.63, p < 0.001) and between the SUSI-2 sex with drugs and OTI-HRBS drug subscale (weighted r = 0.21, p < 0.01). Four additional items were retained to reflect local other BBV and STI transmission risk.

conclusionsThe Substance Use & Sex Index 2 (SUSI-2) appears to be a valid and acceptable two-factor brief scale for the measurement of behaviours associated with blood-borne viruses and sexually transmitted infections for use in substance use interventional research.

Indexed as

Blood-Borne InfectionsSexual BehaviorSexually Transmitted DiseasesSubstance-Related DisordersAdolescentAdultAustraliaFactor Analysis, StatisticalFemaleHumansMaleMiddle AgedReproducibility of ResultsRisk-TakingSurveys and QuestionnairesYoung Adultbehaviour change measurementblood borne virusclinical trialshuman immunodeficiency virus (HIV)injecting drug usesexually transmitted infections

Identifiers

PMID41340600
PMCPMC12887923

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.