Abstract
Respondent driven sampling (RDS) was originally developed to sample and provide peer education to injection drug users at risk for HIV. Based on the premise that drug users' social networks were maintained through sharing rituals, this peer-driven approach to disseminate educational information and reduce risk behaviors capitalizes and expands upon the norms that sustain these relationships. Compared with traditional outreach interventions, peer-driven interventions produce greater reductions in HIV risk behaviors and adoption of safer behaviors over time, however, control and intervention groups are not similarly recruited. As peer-recruitment may alter risk networks and individual risk behaviors over time, such comparison studies are unable to isolate the effect of a peer-delivered intervention. This analysis examines whether RDS recruitment (without an intervention) is associated with changes in health-seeking behaviors and network composition over 6 months. New York City drug users (N = 618) were recruited using targeted street outreach (TSO) and RDS (2006–2009). 329 non-injectors (RDS = 237; TSO = 92) completed baseline and 6-month surveys ascertaining demographic, drug use, and network characteristics. Chi-square and t-tests compared RDS- and TSO-recruited participants on changes in HIV testing and drug treatment utilization and in the proportion of drug using, sex, incarcerated and social support networks over the follow-up period. The sample was 66% male, 24% Hispanic, 69% black, 62% homeless, and the median age was 35. At baseline, the median network size was 3, 86% used crack, 70% used cocaine, 40% used heroin, and in the past 6 months 72% were tested for HIV and 46% were enrolled in drug treatment. There were no significant differences by recruitment strategy with respect to changes in health-seeking behaviors or network composition over 6 months. These findings suggest no association between RDS recruitment and changes in network composition or HIV risk, which supports prior findings from prospective HIV behavioral surveillance and intervention studies.
Highlights
The absence of a sampling frame for marginalized and/or highly stigmatized populations makes it difficult to recruit representative samples of the target population
Respondentdriven sampling (RDS) is unique in that it relies on the networks of social relationships that connect members of the target population to facilitate sampling from it [2] and uses information about how members of the target population are connected to weight recruits in a way that accounts for non-random sampling
The rationale for peer driven interventions (PDIs) in HIV research is that both human immunodeficiency virus (HIV) and HIV prevention information can be transmitted through HIV risk networks
Summary
The absence of a sampling frame for marginalized and/or highly stigmatized populations (e.g., injection drug users, men who have sex with men, sex workers) makes it difficult to recruit representative samples of the target population. While ‘‘respondent-driven sampling’’ was coined by Heckathorn, Broadhead and colleagues had been using a peer-driven approach to sample and educate injection drug users at risk for HIV since the early 1990s [3], and sociologists have used ‘‘snowball sampling’’ since the mid-1900s [4]. In studies among drug users, respondents typically receive incentives for successfully recruiting other members of the target population (typically no more than 3) and for being effective peer educators or for demonstrating knowledge about HIV prevention [5,6,7,8,9,10,11,12,13,14]. There are a variety of peer driven education interventions, some of which randomize assignment to the intervention group, and others which have been evaluated less rigorously (e.g., those comparing peer-driven interventions with traditional outreach interventions)
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