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Purpose-To determine whether illicit drug users recruited through Respondent-Driven Sampling (RDS) and targeted street outreach (TSO) differ by comparing two samples recruited concurrently with respect to sample selection and potential recruitment biases.Methods-217 heroin, crack, and cocaine users aged 18-40 were recruited through TSO in New York City (2006)(2007)(2008)(2009). 46 RDS seeds were recruited similarly and concurrently yielding a © 2010 Elsevier Inc. All rights reserved.Correspondence: Abby Rudolph, Mailing Address: 3422 Keswick Rd, Baltimore MD 21211, Abby.Rudolph@gmail.com, Phone: 267-261-6395. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Conclusion-These data suggest that RDS and TSO strategies reach different sub-groups of drug users. Understanding the differing capabilities of each recruitment strategy will enable researchers and public health practitioners to select an appropriate recruitment tool for future research and public health practice. KeywordsRespondent Driven Sampling; Targeted Street Outreach; HIV; illicit drug users; sampling biasGenerating a representative sample of illicit drug users for substance abuse and HIV research can be challenging because there is no sampling frame. While convenience, targeted, snowball and time-location sampling methods are used to recruit this population, volunteer and masking biases may result from the inability to sample randomly from the target population. Respondent-Driven Sampling (RDS) aims to reduce these biases with a modified form of chain-referral sampling that regulates peer recruitment and uses probability weights to offset nonrandom recruitment.RDS has recruited geographically(1-3) and demographically diverse samples of injection drug users (IDUs).(4-9) Like samples recruited with other strategies, respondent-driven samples include IDUs from both institutional settings and public venues. RDS also recruits those missed by traditional strategies: those only identified through social networking approaches or through their participation in activities that define the hidden population.(10)Studies comparing respondent-driven samples with chain referral(11), targeted(12,13), traditional outreach(1,2), snowball (14) and time-location samples(3,14,15) have reported differences in demographic characteristics (1,11,12,14), but not in HIV risk behaviors(11).Results from comparison studies should be interpreted with caution, because comparison samples were often recruited over different enrollment periods(14-16) and from different geographic locations.(17) For example, in a study comparing samples rec...

This paper explores how perceived stigma and layered stigma related to injection drug use and being HIV positive influence the decision to disclose one’s HIV status to family and community and experiences with stigma following disclosure among a population of HIV positive male injection drug users (IDUs) in Thai Nguyen, Vietnam. In qualitative interviews conducted between 2007 and 2008, 25 HIV positive male IDUs described layered stigma in their community but an absence of layered stigma within their families. These findings suggest the importance of community level HIV prevention interventions that counter stigma and support families caring for HIV positive relatives.

The full impact of secondary stigma (stigma directed at family) on an HIV-positive individual is unknown. This qualitative research explores perceptions of secondary stigma in the Vietnamese context and its influence on the ways in which an injection drug user (IDU) copes with HIV infection. Data on experiences learning one’s HIV status, disclosure decisions, family reactions, and stigma from family and community were collected through in-depth interviews with 25 HIV-positive IDUs recruited through a health center in Thai Nguyen, Vietnam. Participants felt despair when learning they were HIV-positive and expressed concerns focused on the emotional burden and the consequences of HIV stigma that extended to family. Many participants engaged in self-isolating behaviors to prevent transmission and minimize secondary stigma. Data illustrated the strong value given to family in Vietnam and underscored the importance of secondary stigma in the coping process including gaining social support and engaging in risk reduction.