Accuracy and Utility of the AUDIT-C with Adolescent Girls and Young Women (AGYW) Who Engage in HIV Risk Behaviors in South Africa.

Hazardous drinking is a risk factor associated with sexual risk, gender-based violence, and HIV transmission in South Africa. Consequently, sound and appropriate measurement of drinking behavior is critical to determining what constitutes hazardous drinking. Many research studies use internal consistency estimates as the determining factor in psychometric assessment; however, deeper assessments are needed to best define a measurement tool. Rasch methodology was used to evaluate a shorter version of the Alcohol Use Disorders Identification Test, the AUDIT-C, in a sample of adolescent girls and young women (AGYW) who use alcohol and other drugs in South Africa (n =100). Investigations of operational response range, item fit, sensitivity, and response option usage provide a richer picture of AUDIT-C functioning than internal consistency alone in women who are vulnerable to hazardous drinking and therefore at risk of HIV. Analyses indicate that the AUDIT-C does not adequately measure this specialized population, and that more validation is needed to determine if the AUDIT-C should continue to be used in HIV prevention intervention studies focused on vulnerable adolescent girls and young women.