Abstract
ObjectivesConcerns related to stigma and confidentiality limit HIV-related study recruitment and retention of Black men who have sex with men and women (MSMW). This paper examines lessons learned from recruitment strategies utilized in enrolling 437 participants between 2007 and 2011 for a randomized controlled trial to test a culturally specific HIV risk-reduction intervention for Black MSMW.MethodsInterested respondents completed a brief screener and participants completed surveys at baseline and at post, 3 and 6 months follow-up. Recruitment patterns were assessed by examining the source of study information reported when respondents were asked how they learned about the study. Chi-square tests were then conducted to examine differences in the distribution of participants by self-reported HIV status, age group and socio-economic status (SES) for each type of study information source.ResultsRegardless of HIV or SES, study respondents were more likely to have received information about the study through a service agency than from other sources. Participants ages 30–49 and 50+ years were most likely to have learned about the study from an agency (34.9% and 27.0%, respectively) or another participant/friend (20.1%, 23.1%) and least likely to have found out from bus (0.8%, 0.0%) or radio (1.3%, 0.0%) advertisements; whereas younger participants were more likely to have heard about the study through a friend/participant (23.4%) than an agency (15.4%). Although, 14.1% of participants’ ages less than 30 years reported the Internet as their source of study information, this compared to just 2.7% and 4.8% for participants in the 30–49 and 50-plus age groups.ConclusionsWhile agencies and referrals from personal networks appear to be the most significant recruitment source for potential HIV research participants, there is evidence that Internet based tools may enhance recruitment, particularly among younger Black MSMW.
Highlights
Starting from the premise that obtaining reliable and generalizable research findings requires effective recruitment and retention of the target population, low minority participation rates in health-related research can reduce study applicability and efficiency [1,2,3]
In African American communities, churches often serve as a recruitment resource for research participants [14]; yet there is limited support when studies target risky sexual behavior and sexual minority populations [15,16]
Conspiracy beliefs about HIV being a man-made disease to harm people of African descent dissuade some Black men from engaging in HIV research [20,21]
Summary
Starting from the premise that obtaining reliable and generalizable research findings requires effective recruitment and retention of the target population, low minority participation rates in health-related research can reduce study applicability and efficiency [1,2,3]. Fear and distrust towards medical research has been fostered by studies in which minorities were deceived or taken advantage of, [4,5,6,7] and by individual and community experiences of poor or discriminatory healthcare encounters This distrust, together with lack of reading level appropriate and language-specific information, complex informed consent processes, [8] and limited access to healthcare and transportation [9] has contributed to low research participation rates [2,10]. In response to the Federal requirements designed to foster equitable selection of research participants, many researchers have implemented culturally, linguistically and socially relevant recruitment strategies [11] Despite these efforts, recruiting specific subgroups such as minorities from large metropolitan areas remains challenging [12]. Conspiracy beliefs about HIV being a man-made disease to harm people of African descent dissuade some Black men from engaging in HIV research [20,21]
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