Challenges in Recruiting People Who Use Drugs for HIV-Related Biomedical Research: Perspectives from the Field

Abstract

Recruitment of people who use drugs (PWUD) for HIV-related research has been undertaken since early in the epidemic. In early studies, recruitment was often performed by outreach workers with familiarity with the target population, who distributed risk reduction materials, and administered the surveys being conducted on drug use and risk behaviors. The evolution of effective treatments for HIV has provided opportunities for PWUD to participate in biobehavioral studies testing the efficacy of medical treatment advances and exploring the underlying biomedical basis for prevention and treatment efforts. Recruitment for these studies has led to new challenges for outreach workers and institutions conducting this research. PWUD, particularly those from race/ethnic minority populations, have had lower rates of engagement in HIV care and have been underrepresented in HIV/AIDS medical studies. To address these health disparities, enhanced efforts are needed to increase their participation in biomedical studies. This article examines the challenges identified by experienced outreach workers in recruiting PWUD for HIV-related biomedical studies, including individual (participant)-, institutional-, and recruiter-level challenges, and provides recommendations for addressing them.

Brief Report: The Relationship Between Injection Drug Use Risk Behaviors and Markers of Immune Activation

“…21 While the loss of participants from recruitment to screening was substantial, at approximately 50%, this is not surprising given the unstable life styles of many PWID. Importantly, close to 90% of those who were screened and found eligible for the study completed all components.…”

Research Recruitment: A Case Study on Women with Substance Use Disorder

“…Since studies on research recruitment of women with SUD were limited, the search was broadened to include research recruitment of people who use drugs (PWUD). Ten studies were relevant; seven in international settings (Boucher et al, 2017;Brown et al, 2019;Grové, 2019;MacVicar, Humphrey, & Forbes-McKay, 2018;Sirdifield, Owens, & Brooker, 2016;Thong, Ulph, Barrowclough, & Gregg, 2019;Thornton, Harris, Baker, Johnson, & Kay-Lambkin, 2016) and three in the United States (Ballard, Cooper, & Young, 2019;Batista et al, 2016;Ryan, Smeltzer, & Sharts-Hopko, 2019). The literature emphasized individual factors as prominent challenges regarding research recruitment of women with SUD and PWUD.…”

“…One author used indirect recruitment of offenders on probation to minimize researcher bias but preferred direct recruitment to protect individual rights of research participation (Sirdifield et al, 2016). Other investigators recommended direct recruitment to promote researcher familiarity with the community (Batista et al, 2016;Boucher et al, 2017;MacVicar et al, 2017).…”

Willingness to Participate in Hypothetical HIV Vaccine Trial and Associated Factors among People Who Inject Drugs in Dar es Salaam, Tanzania

“…We aimed for PWIDs who were attending at MOUD clinic due to their availability. Previous research in the United States (US) revealed several challenges in recruiting PWIDs from the community [27]. In this case, using participants at the MOUD clinic helped to overcome some of the challenges observed in the US and this facilitated getting the appropriate participants with low drug withdrawal effects that could hinder cooperation.…”