Visual versus written cues: a comparison of drug injectors' responses. Have surveys using the written word underestimated risk behaviors for hepatitis C?

We examined differences in responses of injecting drug users (IDUs) about sharing injecting paraphernalia using written questions ("written cues") versus video recordings of IDUs engaged in sharing behaviors ("visual cues"). Data were collected in 2007 in cities Liverpool, England and Glasgow, Scotland (N = 204). Participants completed a computer-assisted questionnaire with questions about sharing asked using visual and written cues. McNemar's chi-squared tests and logistic regression models were used. Respondents provided significantly different responses to questions about sharing when asked using visual versus written cues; a considerable proportion of IDUs said they had never shared via front/back loading and via sharing water/bleach for flushing out injecting equipment using written cues but confirmed they had participated in these behaviors when asked using visual cues. Implications and future research are discussed.