Persons at high risk for HIV infection in Kisumu, Kenya: identifying recruitment strategies for enrolment in HIV-prevention studies

Abstract

A combination of in-depth interviews (n = 38) and surveys (n = 203) were used to (1) identify strategies to recruit persons at high risk for HIV infection; (2) determine whether one strategy was more successful than others; and (3) describe motivators and barriers to participation in HIV-prevention studies. From in-depth interviews, four main recruitment strategies were identified: (1) use of a person with specific knowledge of a target population (link person mobilization); (2) use of co-workers or contemporaries (peer mobilization); (3) use of group or association leaders (leader mobilization); and (4) contacting persons by study staff directly (staff contact mobilization). The odds of inconsistently using condoms during sex were greater among those recruited using the peer mobilization (adjusted odds ratio [AOR] = 3.59; 95% confidence interval [CI] = 1.35-9.54) and the leader mobilization strategies (AOR = 2.76; 95% CI = 1.04-7.38) compared with the link person mobilization strategy. The main motivators for taking part in an HIV research study were receiving HIV-prevention education, HIV information or counselling, and receiving compensation for study participation. The main barriers were fear of lack of confidentiality and HIV testing concerns. Using evaluated strategies to recruit persons at high risk for HIV infection and addressing barriers to participation will improve the conduct and outcome of HIV-prevention studies.

The willingness to participate in biomedical research involving human beings in low‐ and middle‐income countries: a systematic review

“…Confidentiality concerns were mentioned 12 times , ranked in the top three, four times , and ranked first, three times . Confidentiality concerns were ranked highest by research participants in North Africa and the Middle East (second), even though it was ranked fifth overall.…”

“…The gaining of knowledge through research participation was mentioned 16 times overall, ranked in the top three reasons four times, and was given as the top reason in one paper to participate . Knowledge was ranked fifth in Sub‐Saharan Africa and Eastern Europe, in HIV research, by male and patient participants and for hypothetical studies.…”

“…The gaining of knowledge through research participation was mentioned 16 times overall, [25,27,41,44,54,59,60,62,67,73,76,81,82,[86][87][88] ranked in the top three reasons four times, [44,59,67,88] and was given as the top reason in one paper to participate [44]. Knowledge was ranked fifth in Sub-Saharan Africa and Eastern Europe, in [20,32,36,69,78], and ranked sixth overall.…”

“…Despite being ranked third overall, stigmatisation was consistently ranked higher for HIV research, specifically in Sub-Saharan Africa and Asia, among non-patients, and female participants. Stigmatisation was in fact only mentioned once in relation to non-HIV research, suggesting that despite being mentioned 20 times overall [22,23,31,32,36,37,41,42,47,50,52,53,68,69,75,86,93,94,98,107], being ranked in the top 35 times [23,32,41,50,94], and as the top reasons thrice [23,41,50], it is not one of the more important reasons for non-participation when looking at human subjects research in general.…”

“…Additional reasons given for non-participation were costs [44,58,69,103,111], cultural insensitivity [37,101], fear of false-positive test results after participation in HIV research [36,44,45,50,59,86,93,94], fear of knowledge of health status [19,28,30,54,68], insufficient compensation [21,43], invasive procedures, [1,20,30,39,54,78,87,106] lack of interest [30,34,37,61,86,95,102,104,105,109], lack of clarity [1,30,37,51,52,91,111], not willing to comply to terms of research [55,68,…”