Lessons learned from respondent-driven sampling recruitment in Nairobi: experiences from the field

Abstract

BackgroundRespondent-driven sampling (RDS) is used in a variety of settings to study hard-to-reach populations at risk for HIV and sexually transmitted infections. However, practices leading to successful recruitment among diverse populations in low-resource settings are seldom reported. We implemented the first, integrated, bio-behavioural surveillance survey among men who have sex with men, female sex workers and people who injected drugs in Nairobi, Kenya.MethodsThe survey period was June 2010 to March 2011, with a target sample size of 600 participants per key populations. Formative research was initially conducted to assess feasibility of the survey. Weekly monitoring reports of respondent characteristics and recruitment chain graphs from NetDraw illustrated patterns and helped to fill recruitment gaps.ResultsRDS worked well with men who have sex with men and female sex workers with recruitment initiating at a desirable pace that was maintained throughout the survey. Networks of people who injected drugs were well-integrated, but recruitment was slower than the men who have sex with men and female sex workers surveys.ConclusionBy closely monitoring RDS implementation and conducting formative research, RDS studies can effectively develop and adapt strategies to improve recruitment and improve adherence to the underlying RDS theory and assumptions.

HIV and STI Prevalence and Risk Factors Among Male Sex Workers and Other Men Who Have Sex With Men in Nairobi, Kenya

“…9 We report here results from a cross-sectional survey to estimate the prevalence of HIV, STIs, and sexual behavior among MSM. To our knowledge, this was the first study in Africa that allowed disaggregating data between MSM who sell sex and those who do not.…”

Collecting data from migrants in Ghana: Lessons learned using respondent-driven sampling

“…Though four of the five most common countries for RDS studies are classified as LMIC, the use of RDS in migration research is often restricted to sampling hard-to-reach international migrant populations in high-income countries . There is a small but growing body of evidence that uses RDS to sample migrants in lower-middle income countries (e.g., Ukraine, Morocco, Kenya) and upper-middle income countries (e.g., South Africa, China, Thailand) (International Organization for Migration 2010; Khamsiriwatchara et al 2011;Tyldum and Johnston 2014;Okal 2016). In the limited evidence on the use of RDS for migrant populations outside of high-income countries, there is little detailed methodological reflection -either positive or negative -on the suitability of this technique for migrant populations in LMIC settings and the lessons learned.…”

Lessons learned from using respondent-driven sampling (RDS) to assess sexual risk behaviors among Kenyan young adults living in urban slum settlements: A process evaluation

“…Young adults living in urban slum settlements engage frequently in sexual risk behaviors, such as condomless sex, transactional sex, or sex with multiple concurrent sexual partners that result in higher risk of HIV and other sexually transmitted infections [6][7][8][9]. In addition to being at increased risk for HIV, young adults living in urban slum settlements are often hidden and not well reached using traditional surveillance systems [10]. School-based sampling strategies in urban slum settings with absenteeism and high drop-out rates result in biased estimates that exclude out-of-school youth, including newly-emerging young adults [11,12].…”

“…However, young adults in urban slum settings risk being inaccessible via households due to housing instability, migration, conflict, or spending significant time away from home in search of employment, which may hinder their ability to connect with other social groups [12]. In addition, young women in Kenya's urban slum settings may not reveal all of their sexual behaviors during HIV surveillance activities at antenatal clinics, which exclude young men [10]. The lack of unbiased global data that adequately includes young adults in urban slum settings who are out-of-school, away from home, and disconnected from health facilities has led to increased interest in respondent-driven sampling (RDS) to reach a larger number of impoverished and underserved youth who are often missed using more traditional sampling methodologies [14].…”