A Comparison Between Respondent-Driven Sampling and Time-Location Sampling Among Men Who Have Sex with Men in Shenzhen, China

Abstract

Men who have sex with men (MSM) are a key population for HIV control and prevention in China. It is difficult to acquire representative samples of this hidden population. Respondent-driven sampling (RDS), based on peer referral, and time-location sampling (TLS) based on random selection of venue-day-time periods, are among the most commonly used sampling methods. However, differences in HIV-related characteristics of MSM recruited by these two methods have not been fully evaluated. We compared sociodemographics, risk behaviors, utilization of HIV-related intervention services, and HIV/syphilis infection rates between samples of 621 RDS MSM and 533 TLS MSM in Shenzhen, China in 2010. We found that the HIV prevalence was comparable in RDS and TLS MSM. TLS recruited larger proportions of more marginalized MSM than RDS: MSM recruited by TLS were older, less educated and more likely to be migrants (without Shenzhen hukou registration), to be non-gay identified and to engage in risky sexual behaviors. On the other hand, MSM recruited by TLS were more likely to have been covered by HIV-related intervention services. To conclude, in Shenzhen, TLS is more effective to reach the marginalized population of MSM. But because TLS can only reach MSM who physically attend venues and HIV-related intervention services are already commonly available at gay venues in Shenzhen, RDS is more informative for allocating prevention efforts than TLS. Furthermore, researchers and public health authorities should take into account the different sample compositions of RDS and TLS and apply sampling methods consistently when evaluating trends over time.

Age bias in survey sampling and implications for estimating HIV prevalence in men who have sex with men: insights from mathematical modelling

“…Although this analysis has focused on HIV prevalence as the main outcome of interest, similar biases may be expected in the estimation of other indicators if RDS samples are biased towards younger MSM. Our results suggest that behavioural indicators such as the fraction of MSM in cohabiting/marital relationships and the fraction of MSM with multiple partners could also be under-estimated if sampling is biased toward younger MSM, consistent with surveys of MSM in Swaziland and China [27,29]. Levels of HIV diagnosis and ART coverage are typically higher in older HIV-positive adults than in younger HIV-positive adults [32,33] and over-representation of young MSM may, therefore, lead to under-estimation of HIV diagnosis and ART coverage in MSM, with consequent problems in estimating progress towards the 90-90-90 targets set by UNAIDS [34].…”

The Parasol Protocol: An Implementation Science Study of HIV Continuum of Care Interventions for Gay Men and Transgender Women in Burma/Myanmar

“…It has shown benefit in reaching individuals who may not be present at venues or who frequent health facilities less often [9]. As such, RDS may have a role beyond research in engaging MSM and TW in HIV testing and other HIV prevention and care interventions, particularly in settings of stigmatization and criminalization [10-12]. …”

Comparing Samples of Men Who Have Sex with Men Recruited Online and in Venues, Jiangsu Province, China, 2013

“…16,17 Although a few studies have compared characteristics of MSM recruited through different sampling methods, none has directly compared TLS and online samples. 14,15,18,19 In the present study, we employed both internet and TLS to sample MSM for a study of social marketing for increasing HIV testing among HIV-negative or unknown status men. We then compared the characteristics of each sample and evaluated the relative merits of each approach.…”