An evaluation of assumptions underlying respondent-driven sampling and the social contexts of sexual and gender minority youth participating in HIV clinical trials in the United States

Abstract

Introduction: Respondent-driven sampling has been an effective sampling strategy for HIV research in many settings, but has had limited success among some youth in the United States. We evaluated a modified RDS approach for sampling Black and Latinx sexual and gender minority youth (BLSGMY) and evaluates how lived experiences and social contexts of BLSGMY youth may impact traditional RDS assumptions. Methods: RDS was implemented in three cities to engage BLSGMY in HIV prevention or care intervention trials. RDS was modified to include targeted seed recruitment from venues, internet, and health clinics, and provided options for electronic or paper coupons. Qualitative interviews were conducted among a sub-sample of RDS participants to explore their experiences with RDS. Interviews were coded using RDS assumptions as an analytic framework. Results: Between August 2017 and October 2019, 405 participants were enrolled, 1,670 coupons were distributed, with 133 returned, yielding a 0.079 return rate. The maximum recruitment depth was 4 waves among seeds that propagated. Self-reported median network size was 5 (IQR 2-10) and reduced to 3 (IQR 1-5) when asked how many peers were seen in the past 30 days. Qualitative interviews (n=27) revealed that small social networks, peer trust, and targeted referral of peers with certain characteristics challenged network, random recruitment, and reciprocity assumptions of RDS. HIV stigma and research hesitancy were barriers to participation and peer referral. Conclusions: Small social networks and varying relationships with peers among BLSGMY challenge assumptions that underlie traditional RDS. Modified RDS approaches, including those that incorporate social media, may support recruitment for community-based research but may challenge assumptions of reciprocal relationships. Research hesitancy and situational barriers must be addressed in recruitment and study designs.

Early and long term antibody kinetics of asymptomatic and mild disease COVID-19 patients

“…It was previously reported that some cases of asymptomatic and mildly symptomatic patients failed to mount neutralizing antibodies 1 – 4 , 9 , 10 . However, this study and other studies 5 , 7 , 12 , 22 indicate that by using current laboratory methods, the vast majority (> 95%) do developed detectable levels of IgM, IgG-S and IgG-N. Compared to the asymptomatic and the mild symptomatic cohorts, severe respiratory symptomatic patients generated two–fivefold higher antibody titers.…”

“…Since data in the early stages of the disease were gathered mostly from hospitalized patients or relatively late, after the onset of the infection 2 , 12 – 14 , there is a lack of knowledge about the early antibody kinetics in non-hospitalized patients with asymptomatic and mildly symptomatic disease. Moreover, the data regarding IgG levels against the spike (S) and nucleocapsid (N) antigens are based on blood samples collected at non-consequent timepoints 2 – 8 .…”

The impact of stigma and sexual identity on PrEP awareness and use among at-risk men who have sex with men in four U.S. cities (HPTN 078).

“…People with higher levels of stigma may fear outing to, and by their social networks, and may therefore decline participation when approached by members of their community. A recent analysis by Wirtz et al (2020) demonstrated that among same-gender loving youth in the United States, small social circles, limited peer trust, and HIV stigma may influence referrals in such studies (Wirtz et al, 2020). Additionally, sample size limited our ability to fully interrogate the impact of stigma on PrEP awareness and use by race.…”

Social Determinants of Transactional Sex in a Sample of Young Black and Latinx Sexual Minority Cisgender Men and Transgender Women

“…Participants were recruited using respondent driven sampling (RDS). Targeted seed selection occurred using both direct and indirect seed selection [20]. Direct seed selection consisted of informational flyers directly given to a youth from study staff at a clinical site or at a community-based organization or in-person event (e.g., House Ball, Pride, community informational session).…”