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Testing for amphetamine-type stimulant (ATS) use to ascertain validity of self-reported ATS use among young female sex workers in Cambodia

Vannda Kab1, Jennifer Evans2, Neth Sansothy3, Ellen Stein2, Marie Claude-Couture2, Lisa Maher4, Kimberly Page2* and on behalf of the Young Women's Study Collaborative

Author Affiliations

1 School of Public Health, University of California at Berkeley, Berkeley, California, USA

2 Department of Epidemiology and Biostatistics, University of California San Francisco, 50 Beale Street, Ste 1200, San Francisco, CA, 94105, USA

3 Cambodia National Center for HIV, AIDS, Dermatology and STDs, Phnom Penh, Cambodia

4 The Kirby Institute (formerly the National Centre in HIV Epidemiology and Clinical Research), Sydney, New South Wales, Australia

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Addiction Science & Clinical Practice 2012, 7:11  doi:10.1186/1940-0640-7-11

Published: 28 June 2012



To assess concordance between self-reported amphetamine-type stimulant (ATS) use and toxicology results among young female sex workers (FSW) in Phnom Penh, Cambodia.


Cross-sectional data from the Young Women’s Health Study-2 (YWHS-2), a prospective study of HIV and ATS use among young (15 to 29 years) FSW in Phnom Penh, Cambodia, was analyzed. The YWHS-2 assessed sociodemographic characteristics, HIV serology, HIV risk, and ATS use by self-report and urine toxicology testing at each quarterly visit, the second of which provided data for this assessment. Outcomes include sensitivity, specificity, positive- and negative predictive values (overall and stratified by age), sex-work setting, and HIV status.


Among 200 women, prevalence of positive toxicology screening for ATS use was 14% (95% confidence interval [CI], 9.2, 18.9%) and concurrent prevalence of self-reported ATS was 15.5% (95% CI, 10.4, 20.6%). The sensitivity and specificity of self-reported ATS use compared to positive toxicology test results was 89.3% (25/28), and 96.5% (166/172), respectively. The positive predictive value of self-reported ATS use was 80.6% (25/31); the negative predictive value was 98.2% (166/169). Some differences in concordance between self-report and urine toxicology results were noted in analyses stratified by age group and sex-work setting but not by HIV status.


Results indicate a high prevalence of ATS use among FSW in Phnom Penh, Cambodia, and high concordance between self-reported and toxicology-test confirmed ATS use.