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Author Notes:

Corresponding Author: Eric J. Nehl Email: enehl@emory.edu

Drs. Wong and He designed the study and wrote the protocol.

Mr. Zheng managed participant recruitment and the data used in the study.

Dr. Nehl assisted with the design and completion of the statistical analysis.

Ms. Chen and Mr. Ibragimov analyzed the data and participated in the writing of the manuscript.

All the authors contributed to and approved the final manuscript.

Author Disclosure: No conflict declared

The funders had no further role in study design; in the collection, analysis and interpretation of data; in the writing of the report; or in the decision to submit the paper for publication.

Subjects:

Research Funding:

Funding for this study was provided by a grant from the Eunice Shriver National Institute on Child Health and Human Development (R01HD056956) to Frank Y. Wong (last author).

Preparation of this study was supported in part by the Emory Center for AIDS Research (P30 AI050409) to both the second and last authors.

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Substance Abuse
  • Psychiatry
  • CAGE
  • MSM
  • China
  • Validity
  • ALCOHOL-RELATED PROBLEMS
  • GENERAL-POPULATION SURVEY
  • SUBSTANCE USE
  • SCREENING INSTRUMENTS
  • RISK BEHAVIORS
  • YOUNG MEN
  • HIDDEN POPULATIONS
  • DRINKING PATTERNS
  • PRIMARY-CARE
  • MONEY BOYS

Validity of the CAGE questionnaire for men who have sex with men (MSM) in China

Tools:

Journal Title:

Drug and Alcohol Dependence

Volume:

Volume 160

Publisher:

, Pages 151-156

Type of Work:

Article | Post-print: After Peer Review

Abstract:

Background: Detection of heavy drinking among men who have sex with men (MSM) is crucial for both intervention and treatment. The CAGE questionnaire is a popular screening instrument for alcohol use problems. However, the validity of CAGE for Chinese MSM is unknown. Method: Data were from three waves of cross-sectional assessments among general MSM (n = 523) and men who sell sex to other men ("money boys" or MBs, n = 486) in Shanghai, China. Specifically, participants were recruited using respondent-driven, community popular opinion leader, and venue-based sampling methods. The validity of the CAGE was examined for different cutoff scores and individual CAGE items using self-reported heavy drinking (≥14 drinks in the past week) as a criterion. Results: In the full sample, 75 (7.4%) of participants were classified as heavy drinkers. 32 (6.1%) of general MSM and 43 (8.9%) of MBs were heavy drinkers. The area under curve statistics for overall sample was 0.7 (95% CI: 0.36-0.77). Overall, the sensitivities (ranging from 18.7 to 66.7%), specificities (ranging from 67.5 to 95.8%), and positive predictive values (ranging from 14.1 to 26.4%) for different cutoff scores were inadequate using past week heavy drinking as the criterion. The ability of CAGE to discriminate heavy drinkers from non-heavy drinkers was limited. Conclusions: Our findings showed the inadequate validity of CAGE as a screening instrument for current heavy drinking in Chinese MSM. Further research using a combination of validity criteria is needed to determine the applicability of CAGE for this population.

Copyright information:

© 2016 Elsevier Ireland Ltd.

This is an Open Access work distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/).
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