Risk Assessment Battery (RAB)
The RAB is a self-administered questionnaire designed for repeat administration with substance using populations. It was developed to provide a rapid (less than fifteen minutes) and confidential, non-interview method of assessing both drug use practices and sexual behaviors associated with HIV transmission. The RAB provides a measure of HIV risk behaviors, which is broken down into sub-scales for drug risk and sex risk and combined to yield a measure of total risk.
The 45 questions of the RAB are simply worded and use discrete response categories. Respondents are asked to "check-off" the answer that best describes their behavior. There are no open-ended questions, minimizing the need for writing skills. A brief set of instructions is included on the first page of the RAB. However, as with all self-administered questionnaires, it is particularly important to provide the respondent with a proper introduction and explanation of the form, its purpose, and how it is to be completed. Given the very sensitive nature of the information collected, it is also important that individuals administering the RAB address the issue of confidentiality. While the more private approach of the self-administered questionnaire should reinforce the confidential nature of the assessment, it is very important that respondents understand that the confidentiality of their responses will be protected.
A staff member should be available during administration of the RAB to screen for reading difficulties, answer questions as they arise and ensure that the items are being attended to properly.
There are two global sections within the RAB: 1) drug and alcohol use during the past 30 days, and 2) syringe use and sexual behavior during the previous six months. Questions have been constructed to provide maximum coverage and sensitivity to potential risk behaviors within these categories. Since self-report may be expected to provide underestimates of behaviors that are socially unacceptable, we have assembled items that assess a wider range of behaviors associated with HIV infection. Thus, questions ask not only about the behaviors directly responsible for viral transmission such as syringe sharing and unprotected sexual activity, but also associated with these activities (e.g. syringe acquisition, shooting gallery attendance, exchange of money or drugs for sex). The inclusion of these items is intended to identify individuals at increased risk of HIV exposure, even if transmission behaviors are not directly reported. However, affirmation of these "peripheral behaviors" does not prove that transmission behaviors have actually occurred. For example, an individual who has visited a shooting gallery on numerous occasions during the assessment interval may not have shared a needle or had unprotected sex, even though these behaviors are common in shooting galleries. However, these peripheral behaviors may be more readily reported by some respondents despite their reluctance to report primary transmission events such as sharing a syringe or unprotected sexual activity.
As a self-administered questionnaire, the RAB offers an efficient tool for screening individuals who may be at risk for HIV infection. Further, it provides a means to target and evaluate interventions in a more precise manner.
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