Methods for Recruiting Men of Color Who Have Sex with Men in Prevention-for-Positives Interventions

Abstract

Men who have sex with men (MSM), especially MSM of color, are disproportionately impacted by HIV/AIDS compared to heterosexuals and Caucasians. Nonetheless, fewer sexual and ethnic minorities participate in prevention interventions for people with HIV. We consider recruitment for Positive Connections, a randomized controlled trial comparing unsafe sex prevention interventions primarily for HIV-positive (HIV+) MSM in six US epicenters. One community-based organization (CBO) in each city recruited adult MSM, particularly men of color and HIV+. Recruitment methods included on-line and print advertising, outreach events, health professionals, and social networks. Data on demographics, HIV status, and recruitment method were collected at registration. We tested for differences in registration proportions and attendance rates by recruitment strategy, stratified on race/ethnicity and serostatus. Of the 1,119 registrants, 889 attended the intervention. The sample comprised 41% African American, 18% Latino/Hispanic, and 77% HIV+. Friend referral was reported by the greatest proportion of registrants, particularly among African American (33%) and HIV+ men (25%). Print advertising yielded the largest proportions of non-Hispanic white (27%) and HIV-negative registrants (25%). Registrants recruited on-line were the least likely to attend (45% versus 69% average); this effect was strongest among Latino/Hispanic (27% attendance) and non-Hispanic white men (36%). Retention during the follow-up period did not differ by serostatus, race/ ethnicity, or recruitment method. Differential attendance and retention according to recruitment strategy, serostatus, and racial/ethnic group can inform planning for intervention sample size goals.

HIV Risk and Substance Use in Men Who Have Sex with Men Surveyed in Bathhouses, Bars/Clubs, and on Craigslist.org: Venue of Recruitment Matters

“…Researchers have identified MSM as “invisible” and “hard-to-reach” populations such that traditional probability methods of sampling (e.g., random-digit dialing) are cost-prohibitive or otherwise ineffective [31–34]. Instead, researchers have employed other approaches for sampling MSM, including time–space sampling and targeted sampling.…”

Recruitment and retention strategies in clinical studies with low-income and minority populations: Progress from 2004–2014

“…A recent behavioral intervention study of smokers by Collins and colleagues [56] examined the relationship between recruitment methods and retention and found the likelihood of retention was five times greater if participants were recruited with a combination of proactive and reactive strategies rather than reactive recruitment alone. Results from Positive Connections, a randomized controlled trial comparing unsafe sex prevention interventions primarily for HIV-positive (HIV+) Men-who-have-sex-with-Men in six U.S. epicenters indicated that retention rates did not differ by serostatus, race/ethnicity, or recruitment method [57].…”

Finding and Recruiting the Highest Risk HIV-Negative Men Who Have Sex With Men

“…To be relevant, HIV behavioral surveillance, prevention work, and research must adequately represent those subgroups of MSM at greatest risk of infection (Halkitis, Wolitski, & Millett, 2013; Hatfield et al, 2010; McKellar, Valleroy, Karon, Lemp, & Janssen, 2006). Reflecting this need, one of the objectives of the National HIV/AIDS Strategy included the intensification of HIV prevention efforts among the groups where HIV is most heavily concentrated (CDC, 2011; White House Office of National AIDS Policy, 2010).…”

“…Black MSM have the highest HIV prevalence and incidence rates among MSM in the U.S. (CDC, 2012b; Hatfield et al, 2010; Millett & Peterson, 2007; Prejean et al, 2011). Similarly, disproportionate rates of HIV/AIDS cases occur among Hispanic/Latino MSM (Bedoya et al, 2012; CDC, 2012b; Fernández et al, 2007; Fisher et al, 2011).…”