Multiple strategies to identify HIV‐positive black men who have sex with men and transgender women in New York City: a cross‐sectional analysis of recruitment results

Abstract

IntroductionBlack men who have sex with men and transgender women are at high risk for HIV infection, but are more likely to be unaware of their infection or not in care for diagnosed HIV compared to other races. Respondent driven sampling has been advanced as a method to reach stigmatized and hidden populations for HIV testing. We compared strategies to recruit black, substance‐using men who have sex with men and transgender women to identify newly diagnosed HIV infection, or those previously diagnosed but not in care.MethodsThe STAR (Seek, Test, and Retain) study (ClinicalTrials.gov NCT01790360) used several recruitment strategies to identify black, substance‐using men who have sex with men and transgender women with undiagnosed HIV infection or with previously diagnosed HIV infection but who were not in HIV care. Respondent‐driven sampling, community‐based recruitment and online advertising were used to recruit participants. Incentivized peer referral was integrated into all recruitment strategies. Participants completed interviewer‐administered questionnaires and HIV testing. Demographic and HIV risk‐related characteristics and recruitment strategy were summarized and stratified by HIV status. Associations were tested using Pearson's chi‐squared, Fisher's exact, and Wilcoxon rank sum tests. Factors associated with HIV‐positive diagnosis at p < 0.1 were included in a multivariable logistic regression model.ResultsFrom July 2012 through October 2015, the study enrolled 1929 participants; 96.3% men who have sex with men and 3.7% transgender women. Behavioural risk factors included recent condomless anal sex (55.6%) and recent substance use during sex (73.1%). HIV prevalence was 8.7%. In multivariable analysis, significant associations with HIV infection included being transgender; non‐Hispanic black; gay/homosexual orientation; not homeless; and less likely to have insufficient income for necessities. Among recruitment strategies, respondent driven sampling was least effective in identifying HIV‐positive participants.ConclusionsIntegrating multiple recruitment strategies yielded a large sample of black men who have sex with men and transgender women at substantial risk for HIV. Respondent‐driven sampling was less effective than other strategies at identifying men who have sex with men and transgender women with HIV.

Pre-Exposure Prophylaxis Knowledge and Perceived Effectiveness to Prevent HIV Among Deaf Gay, Bisexual, and Queer Men

“…from fear that their sexual identities and activities could be exposed as a result of stigma from their loved ones, including family members, friends, and partners. [24][25][26] This parallels our findings regarding the strong relationship between deaf GBQ male respondents' level of PrEP knowledge and being accepted by close family and friends. Within this context, deaf GBQ men who are able to be open, maintain close relationships with loved ones, and be accepted by loved ones are more likely to be able to interact with their communities to gain stronger PrEP knowledge.…”

A comparison of the effectiveness of respondent‐driven and venue‐based sampling for identifying undiagnosed HIV infection among cisgender men who have sex with men and transgender women in Tijuana, Mexico

“…Analyses were performed using SAS 9.4 (SAS Institute, Inc. Cary, North Carolina, USA). Consistent with prior studies that compared the effectiveness of VBS and RDS for identifying undiagnosed HIV [23‐26], we did not apply VBS or RDS sampling weights in our analyses. Since our goal was not to obtain population estimates, but instead to directly compare participants recruited via each method, data needed to construct VBS sampling weights were not collected.…”

“…No difference in the proportion of those newly diagnosed with HIV following PCT, VBS or RDS recruitment was observed in a Washington DC study [23], whereas a New York City study found that PCT and RDS were equivalent but more effective than VBS [24], which differs from a Baltimore study where VBS was more effective than both PCT and RDS [25]. In another New York City study, RDS was less effective at identifying newly or previously diagnosed HIV than VBS and online recruitment where those recruited also recruited peers [26]. Within these studies, the relative effectiveness of the methods compared was attributed to the varying subgroups of MSM and TW they each reached, which may reflect contextual factors that affect the extent to which they engage different subgroups across diverse settings [27‐29].…”

“They know what they are getting into:” Researchers confront the benefits and challenges of online recruitment for HIV research

“…Seeking advice from community stakeholders about language and images that will work, while complying with restrictions set by the recruitment website, is an effective strategy that can prevent oversampling and paying for large numbers of ineligible ad clicks. Advice from community advisory boards in past HIV research studies have included suggestions about advertising images/language and the social media platforms best suited for recruiting online (Franks et al, 2018;Raymond et al, 2010;Yuan, Bare, Johnson, & Saberi, 2014). There is also need for empirical research on the opinions of participants from target populations about online recruitment for HIV research specifically.…”

“…The rapid growth of online advertising opportunities over the past twenty years, including sponsored searches (Fain & Pedersen, 2006), contextual ads (Martín-Santana & Beerli-Palacio, 2012), and behavioral advertising (Ur, Leon, Cranor, Shay, & Wang, 2012), has been accompanied by a parallel increase in the use of online paid posts for research recruitment (Gelinas, Pierce, & Cohen, 2017). Online recruitment has been especially effective for the research recruitment targeting socially stigmatized and difficult to locate diverse samples of "hidden populations" for HIV epidemiological, prevention and intervention research (Bowen, Williams, & Horvath, 2004;Chiasson et al, 2006;Du Bois, Johnson, & Mustanski, 2012;Franks et al, 2018;B. S. Mustanski, 2001;Sanchez et al, 2018;Saxton, Dickson, & Hughes, 2013;Simon Rosser et al, 2009).…”