Purpose-To determine whether illicit drug users recruited through Respondent-Driven Sampling (RDS) and targeted street outreach (TSO) differ by comparing two samples recruited concurrently with respect to sample selection and potential recruitment biases.Methods-217 heroin, crack, and cocaine users aged 18-40 were recruited through TSO in New York City (2006)(2007)(2008)(2009). 46 RDS seeds were recruited similarly and concurrently yielding a © 2010 Elsevier Inc. All rights reserved.Correspondence: Abby Rudolph, Mailing Address: 3422 Keswick Rd, Baltimore MD 21211, Abby.Rudolph@gmail.com, Phone: 267-261-6395. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Conclusion-These data suggest that RDS and TSO strategies reach different sub-groups of drug users. Understanding the differing capabilities of each recruitment strategy will enable researchers and public health practitioners to select an appropriate recruitment tool for future research and public health practice. KeywordsRespondent Driven Sampling; Targeted Street Outreach; HIV; illicit drug users; sampling biasGenerating a representative sample of illicit drug users for substance abuse and HIV research can be challenging because there is no sampling frame. While convenience, targeted, snowball and time-location sampling methods are used to recruit this population, volunteer and masking biases may result from the inability to sample randomly from the target population. Respondent-Driven Sampling (RDS) aims to reduce these biases with a modified form of chain-referral sampling that regulates peer recruitment and uses probability weights to offset nonrandom recruitment.RDS has recruited geographically(1-3) and demographically diverse samples of injection drug users (IDUs).(4-9) Like samples recruited with other strategies, respondent-driven samples include IDUs from both institutional settings and public venues. RDS also recruits those missed by traditional strategies: those only identified through social networking approaches or through their participation in activities that define the hidden population.(10)Studies comparing respondent-driven samples with chain referral(11), targeted(12,13), traditional outreach(1,2), snowball (14) and time-location samples(3,14,15) have reported differences in demographic characteristics (1,11,12,14), but not in HIV risk behaviors(11).Results from comparison studies should be interpreted with caution, because comparison samples were often recruited over different enrollment periods(14-16) and from different geographic locations.(17) For example, in a study comparing samples rec...

Influenza vaccination coverage remains low and disparities persist. In New York City, a community-based participatory research project (Project VIVA) worked to address this issue in Harlem and the South Bronx by supplementing existing vaccination programs with non- traditional venues (i.e., community-based organizations). We conducted a ten minute survey to assess access to influenza vaccine as well as attitudes and beliefs towards influenza vaccination that could inform intervention development for subsequent seasons. Among 991 participants recruited using street intercept techniques, 63% received seasonal vaccine only, 11% seasonal and H1N1, and 26% neither; 89% reported seeing a health care provider (HCP) during the influenza season. Correlates of immunization among those with provider visits during influenza season included being U.S.-born, interest in getting the vaccine, concern about self or family getting influenza, an HCP’s recommendation and comfort with government. Among those without an HCP visit, factors associated with immunization included being U.S. born, married, interest in getting the vaccine, understanding influenza information, and concern about getting influenza. Factors associated with lack of interest in influenza vaccine included being born outside the U.S., Black and uncomfortable with government. In medically underserved areas, having access to routine medical care and understanding the medical implications of influenza play an important role in enhancing uptake of seasonal influenza vaccination. Strategies to improve vaccination rates among Blacks and foreign-born residents need to be addressed. The use of non-traditional venues to provide influenza vaccinations in underserved communities has the potential to reduce health disparities.

Discrimination can influence risk of disease by promoting unhealthy behaviors (e.g., smoking, alcohol use). Whether it influences the formation of high-risk social ties that facilitate HIV transmission is unclear. Using cross-sectional data from a cohort of illicit drug users, this study examined the association between discrimination based on race, drug use and prior incarceration and risky sex and drug ties. Negative binomial regression models were performed. Participants who reported discrimination based on race and drug use had significantly more sex and drug-using ties. But, after accounting for both racial and drug use discrimination, only racial discrimination was associated with increased sex, drug-using, and injecting ties. Drug users who experience discrimination and subsequently develop more sex and drug-using ties, increase their risk of contracting HIV. Future longitudinal studies illuminating the pathways linking discrimination and social network development may guide intervention development and identify drug-using subpopulations at high risk for disease transmission.

Background Prior research suggests that both social networks and parent drug use influence individual drug use among adolescents and that peers continue to influence drug use among adults. This analysis aims to determine whether parent drug use during childhood is associated with having drug-using networks in adulthood after adjusting for individual adult drug use. Methods 650 young adult drug users were recruited through targeted street outreach and respondent-driven sampling in New York City (2006-2009). Baseline surveys ascertained demographics, network characteristics, drug use behaviors, and parental drug use during childhood. Negative binomial regression was used to evaluate this association. Results The median age was 33 years, 22% injected, 49% were Black, and during childhood 26% of mothers, 32% of fathers, and 13% of primary caregivers used drugs. After adjustment, having >1 parent who used drugs was associated with having a greater proportion of drug using (Adjusted Prevalence Ratio [APR]=1.18; 95%CI:1.01-1.38) and specifically crack-smoking networks (APR=1.71; 95%CI: 1.21-2.43) in adulthood. Females’ networks consisted of more drug users (APR=1.18; 95%CI: 1.01-1.38), injectors (APR=1.44; 95%CI: 1.09-1.90), crack smokers (APR=1.48; 95%CI: 1.18-1.87) and heroin users (APR=1.43; 95%CI: 1.13-1.81); blacks had a greater proportion of crack smoking (APR=1.41; 95%CI: 1.09-1.82), but a smaller proportion of injecting (APR=0.64; 95%CI: 0.43-0.94) and heroin smoking (APR=0.60; 95%CI: 0.47-0.77) networks as adults. Conclusions These data suggest that parental drug use is independently associated with having drug-using networks in adulthood. Interventions that target parents and caregivers and that promote drug cessation could impede risky network formation in both adolescents and adults.

HIV testing services and research among drug users has largely focused on injection drug users (IDUs); yet non-injection drug users (NIDUS) are also at increased risk for HIV due to high-risk sexual behaviors and overlapping networks with IDUs. This study examined drug use, sexual risk, and social network characteristics associated with recent HIV testing (testing within past year) among NIDUs. Interviewer-administered questionnaires were conducted among 418 NIDUs and log-binomial regression models were used to identify correlates of recent HIV testing. Prevalence ratios (PR) with 95% confidence intervals (CI) were reported. Nearly 97% of NIDUs reported having ever been tested for HIV and most participants (85.7%) indicated testing for HIV within the past year. Factors independently associated with recent HIV testing were higher educational attainment (PR: 1.86; 95% CI: 1.03, 3.34) and networks to discuss health and medical services (PR: 1.84; 95% CI: 1.06, 1.20). A prior positive sexually transmitted infection was associated with decreased likelihood of recent HIV test (PR: 0.43; 95% CI 0.25, 0.74). Identifying specific social network characteristics may be effective in facilitating HIV testing and prevention strategies targeting NIDUs.