Bias in Online Recruitment and Retention of Racial and Ethnic Minority Men Who Have Sex With Men

Abstract

BackgroundThe Internet has become an increasingly popular venue for men who have sex with men (MSM) to meet potential sex partners. Given this rapid increase in online sex-seeking among MSM, Internet-based interventions represent an important HIV (human immunodeficiency virus) prevention strategy. Unfortunately, black and Hispanic MSM, who are disproportionately impacted by the HIV epidemic in the United States, have been underrepresented in online research studies. ObjectiveOur objective was to examine and quantify factors associated with underrecruitment and underretention of MSM of color in an online HIV behavioral risk research study of MSM recruited from an online social networking site.MethodsInternet-using MSM were recruited through banner advertisements on MySpace.com targeted at men who reported in their MySpace profile their age as at least 18 and their sexual orientation as gay, bisexual, or unsure. Multivariable logistic regression models were used to estimate the odds stratified by race and ethnicity of the MySpace user clicking through the banner advertisement. To characterize survey retention, Kaplan-Meier survival curves and multivariable Cox proportional hazards models identified factors associated with survey dropout.ResultsOver 30,000 MySpace users clicked on the study banner advertisements (click-through rate of 0.37%, or 30,599 clicks from 8,257,271 impressions). Black (0.36% or 6474 clicks from 1,785,088 impressions) and Hispanic (0.35% or 8873 clicks from 2,510,434 impressions) MySpace users had a lower click-through rate compared with white (0.48% or 6995 clicks from 1,464,262 impressions) MySpace users. However, black men had increased odds of click-through for advertisements displaying a black model versus a white model (adjusted odds ratio [OR] = 1.83, 95% confidence interval [CI] 1.72 - 1.95), and Hispanic participants had increased odds of click-through when shown an advertisement displaying an Asian model versus a white model (adjusted OR = 1.70, 95% CI 1.62 - 1.79). Of the 9005 men who consented to participate, 6258 (69%) completed the entire survey. Among participants reporting only male sex partners, black non-Hispanic and Hispanic participants were significantly more likely to drop out of the survey relative to white non-Hispanic participants (hazard ratio [HR] = 1.6, 95% CI 1.4 - 1.8 and HR = 1.3, 95% CI 1.1 - 1.4, respectively). Men with a college-level of education were more likely to complete the survey than those with a high-school level of education (HR = 0.8, 95% CI 0.7 - 0.9), while men who self-identified as heterosexual were more likely to drop out of the survey compared with men who self-identified as gay (HR = 2.1, 95% CI 1.1 - 3.7). ConclusionsThis analysis identified several factors associated with recruitment and retention of MSM in an online survey. Differential click-through rates and increased survey dropout by MSM of color indicate that methods to recruit and retain black and Hispanic MSM in Internet-based research studies are paramount. Although targeting bann...

Social Media Use and HIV-Related Risk Behaviors in Young Black and Latino Gay and Bi Men and Transgender Individuals in New York City: Implications for Online Interventions

“…[18][19][20][21][22][23][24][25][26] However, a limitation of prior research is that most have largely recruited adult White MSM, in part because of Whites' initial greater access to and adoption of online social networking sites and also perhaps due to recruitment biases in Internetbased studies. 27 Although more recent studies have included higher proportions of ethnic/racial minority MSM and transgender persons, these studies do not readily report specifically on YMCSM or young transgender women, and how the results of these studies translate into tailored social media-based interventions for urban YMCSM and transgender women is unclear. Given the large disparities in new HIV infections among YMCSM and transgender women, 2,4,28 studies that specifically examine social media use and access among these groups are needed.…”

Reducing HIV Vulnerability Through a Multilevel Life Skills Intervention for Adolescent Men (The iREACH Project): Protocol for a Randomized Controlled Trial (Preprint)

“…As indicated below, a detailed retention plan for the study will draw on previously successful retention protocols to achieve ≥80% retention at the first follow-up visit. We will use successful best practices from previous studies 16,49 to retain participants (e.g., comprehensive locator information that includes participants' cell phone number, e-mail, Facebook and/or other social media usernames), while being sensitive to undue disclosure of AMSM participating in the study. In addition, we allow participants to specify the day of the week and time of day when they would like to receive electronic follow-up surveys 16 .…”

HIV testing intervention development among men who have sex with men in the developed world

“…packages should fit through standard mail slot) A variety of kit-collection options should exist (e.g. harnessing user preference and perceptions of control) Health literacy considerations [25][26][27][28] Yet, how these vulnerabilities intersect with other important markers, such as age and poverty, are not well documented. Equally, the relationships between vulnerabilities and testing technology and the behavioural domain of HIV testing remain underexplored to date.…”