Respondent-driven Sampling Method Research Articles

An Ecological Analysis of Risk Factors for Runaway Behavior among Individuals Exposed to Commercial Sexual Exploitation

Running away from home is a known risk factor for commercial sexual exploitation among youth; however, research has not fully investigated the process by which multiple factors at individual, familial, and extra-familial levels increase youths' risk for runaway behavior. This study applies an ecological risk factor framework to assess risk for runaway behavior among individuals exposed to commercial sexual exploitation and examines mediating relationships between salient risk factors (i.e. substance abuse, insufficient basic needs, having a much older boyfriend/girlfriend) and runaway behavior. A cross-sectional, retrospective survey was administered to individuals involved in the commercial sex industry using Respondent Driven Sampling methods (N = 273). Bivariate results suggested associations between runaway behavior and childhood emotional and physical abuse, having friends who sold sex, having a much older boyfriend/girlfriend, dropping out of school, being worried about where to eat/sleep, homelessness, and frequent alcohol and drug use prior to entering the commercial sex industry. Hierarchical logistic regression revealed that individuals with runaway behavior histories were more likely to have frequently used alcohol and/or drugs and to have insufficient basic needs compared to those did not run away; however, these factors were no longer significant after accounting for having a much older boyfriend/girlfriend. Having an older boyfriend/girlfriend fully mediated the relationship between frequent alcohol and/or drug use and runaway behavior. Findings support the need for community and school-based prevention programs that target these risk factors with a specific focus on healthy dating relationships, which may reduce risk for runaway behavior and subsequent commercial sexual exploitation.

"My Sexuality…It Creates a Stress": HIV-Related Communication Among Bisexual Black and Latino Men, New York City.

Men who have sex with men and women (including bisexual men) comprise 35% of all men who have sex with men (MSM) in the U.S. It is estimated that 121,800 men who have been bisexually active within the past year are living with HIV in the U.S. Communication about HIV may result in risk-reduction behaviors. However, little is known about the nature or context for HIV prevention communication among bisexual men, particularly for blacks and Hispanic/Latinos who are disproportionately at greater HIV risk. Therefore, we explored patterns and contexts of HIV-related communications occurring within personal social networks among bisexual black and Hispanic/Latino men. Using respondent-driven sampling methods, we conducted semi-structured interviews from 2011 to 2012 among 36 participants living in New York City. We examined interview responses from participants for main themes using computer-assisted thematic analyses. The three main themes identified were: (1) communication strategies (e.g., "You can tell a lot from how a person responds just by the tone of their voice"), (2) barriers (e.g., "My sexuality…it creates a stress"), and (3) motivations for these communications (e.g., "I know that's a(n) issue in the black community…if I could help another brother, I will do it"). Our findings can inform HIV prevention efforts such as social messaging campaigns and other risk-reduction interventions designed for bisexual men.

Prevalence and factors associated with syphilis, HIV and hepatitis B virus infections among men who have sex with men in Togo in 2017

Introduction Hepatitis B and other sexually transmitted infections (STIs) have been linked to an increased risk of HIV transmission and disease progression among men who have sex with men (MSM), but their frequency and distribution in this community have not been extensively studied in Togo. In addition, a holistic understanding of transmission patterns of these STIs is required in order to develop sustainable prevention strategies and reduce transmission among MSM. The objective of the study was to estimate the prevalence and factors associated with syphilis, HIV and hepatitis B virus (HBV) infections among men who have sex with men (MSM) in Togo in 2017. Method A cross-sectional study was conducted in eight main cities in Togo from August 1 to September 30, 2017. MSM aged 18 years and above were recruited using the respondent driven sampling method. Data including socio-demographic characteristics, human immunodeficiency virus (HIV) testing history, condom use patterns, sexual partners characteristics and behaviors were collected using a questionnaire during face-to-face interviews. Blood samples were drawn after the interview for STIs screening using rapid tests. Multivariate logistic regression analyses were performed to identify factors associated with syphilis, HBV and HIV infections among MSM. Results Out of a total of 711 MSM recruited, 69.7% were living in Lome, which is the capital city of Togo. Median age of study participants was 23 years, interquartile range (21–27 years) and 91.4% had at least secondary education level. At least three MSM over ten reported having condomless anal sex during the last month. The prevalence of syphilis, HIV, and HBV infection among 678 (95.3%) MSM who accepted the screening test was 0.0% [upper limit of 95% confidence interval (95% CI) 0.9%], 21.9% (95% CI [18.9–25.3%]), and 7.1% (95% CI [5.3–9.3%]), respectively. Among them, 7 (1.0%) (95% CI [0.4–2.2]) had HIV and HBV co-infection. The prevalence of HBV infection was not associated with HIV infection status (4.7% among MSM infected with HIV and 7.8% among MSM not infected with HIV, P = 0.199). Age, place of residency, nationality, MSM membership, previous HIV screening, and living with a male partner were significantly associated with HIV infection (P Conclusion Our findings emphasize the importance of targeting HIV and viral hepatitis testing and prevention efforts to populations at risk for STIs. Despite all the awareness campaigns, the prevalence of STIs among MSM remains high. This urges the implementation of routine screening, vaccine-based prevention, and education programs for this most-at-risk population.

Abstract 5278: Tobacco and areca nut use among Chuukese youth in Guam

Abstract Background: Little is known regarding the tobacco use of Micronesian population in Guam. According to the Youth Risk Behavior Survey (YRBS) 2013, Micronesian youth have a higher prevalence rate of current smokers (27.2% vs. 15.7% for U.S.) and current smokeless tobacco users (39.7% vs. 8.8% for US) compared to the U.S. They also have the highest rate among all ethnic groups in Guam. This study aims to investigate tobacco use and areca nut use, which may explain high lung and bronchus cancer incidence and mortality rates among Micronesians. The survey in this study focuses on Chuukese youth, the largest group among Micronesians in Guam. Methods: Respondent-driven sampling method (RDS) was used to recruit 364 Chuukese youth (ages 13-19) to complete the survey. YRBS question items that measured cigarette, cigar, and smokeless tobacco use were included in the survey. Measures for areca nut use were also included. Chi-square tests were performed by bivariate analysis. Only high school-level youth are included in the analysis. Results: A total of 237 Chuukese high school students completed the survey. Fourteen percent of the participants currently smoke cigarettes, 6.4% currently smoke cigars, and 23.7% currently use smokeless tobacco. In addition, smokeless tobacco remains highest regarding daily use (11%) within the past 30 days prior the survey. Although there is high use of smokeless tobacco among participants, there are significant associations between gender and cigarette and gender and cigar use only. Boys smoke cigarettes and cigar at higher rates than girls. Among the recruited participants, 32% are areca nut users with tobacco product as an ingredient. There is significantly high association between smokeless tobacco users and areca nut with tobacco users. The majority of cigarette smokers (82.4%) have tried to quit smoking. Fifty-six percent of the smokeless tobacco users have tried to quit as well. However, only 17% of the participants are aware of the Guam Youth Quitline. Conclusion: Results suggest the need to raise awareness among Chuukese youth on tobacco cessation programs on Guam, particularly the smoking cessation quitline. Tobacco cessation efforts should not focus on cigarette use only, but must also be expanded to include the use of smokeless tobacco products and chewing areca nut. Future studies should investigate the roles and implications of tobacco as an ingredient of areca nut chewing among Micronesian youth. Citation Format: Lilnabeth P. Somera, Brayan Simsiman, Grazyna Badowski, Hye-ryeon Lee, Kevin Cassel. Tobacco and areca nut use among Chuukese youth in Guam [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 5278.

Route of Drug Abuse and its Impact on Oral Health-Related Quality of Life among Drug Addicts.

BackgroundVarious studies have tested quality of life (QOL) among drug addicts, however very few have reported any association between oral health-related quality of life (OHRQOL) and mode of drug administration among drug addicts. Hence, the present study was conducted aiming to evaluate the impact of mode of administration of drugs on OHRQOL among drug addicts.MethodsData was collected using respondent-driven sampling (RDS) method among 313 male drug addicts in Sri Ganganagar, Rajasthan, India, using self-administered questionnaires on oral hygiene aids and drug addiction history. OHRQOL was recorded using Oral Health Impact Profile (OHIP-14) questionnaire. The chi-square test, t-test, and Kruskal-Wallis test were used for statistical analysis.FindingsIn this study, 56.2% of the drug addicts reported practicing oral hygiene aids. The main drugs abused were heroin, cocaine, and amphetamines as 51.4%, 35.1%, and 13.4%, respectively. Most of the drug addicts were employed (82.4%) and studied up to primary education (46.3%). The highest mean values of community periodontal index (CPI) and decayed, missing, filled surface (DMFS) were found among the cocaine addicts and amphetamine abusers with rates of 3.11 ± 0.98 and 6.69 ± 8.52, respectively. Poor OHRQOL was observed among addicts who consumed drugs in inhalation since a long time irrespective of the type of the drug, but among them heroin addicted subjects had the poorest OHRQOL.ConclusionOHRQOL was poor among the drug addicts in comparison to general population. Preventive strategies on oral health and other health promotion programs for this vulnerable group can be unified.

A fuzzy logic based estimator for respondent driven sampling of complex networks

Respondent Driven Sampling (RDS) is a popular network-based method for sampling from hidden population. This method is a type of chain referral (or snowball) sampling in which an estimator is used to infer the proportion of the population with that property. Existing RDS estimators are asymptotically unbiased based on various underlying assumptions. However, these assumptions are often violated in practice, and little attention has been given to violation of one of these assumptions on accurately reporting the degree by all nodes. In this paper, we address the violation of this assumption and propose a new estimator based on fuzzy computing. In particular, the number of an individual’s contacts can be a fuzzy concept. Using fuzzy functions, we transform the reported degrees to fuzzy numbers and estimate the infection prevalence in the hidden population by the proposed estimator. We simulate RDS method under the condition that all assumptions are satisfied except the one for the degree, and then evaluate the proposed estimator in synthetic and real datasets. Our results show that the fuzzy-based estimator can reduce the sampling bias in average 54% as compared to the existing methods.

Prevalence of drug use during sex amongst MSM in Europe: Results from a multi-site bio-behavioural survey

BackgroundSubstance use has been consistently reported to be more prevalent amongst Men who have Sex with Men (MSM) compared to the general population. Substance use, in particular polydrug use, has been found to be influenced by social and contextual factors and to increase the risk of unprotected intercourse among MSM. The objective of this analysis was to investigate the prevalence and predictors of drug use during a sexual encounter and to identify specific prevention needs. Methods/designA multi-site bio-behavioural cross-sectional survey was implemented in 13 European cities, targeting MSM and using Time-Location Sampling and Respondent-Driven Sampling methods Multivariable multi-level logistic random-intercept model (random effect of study site) was estimated to identify factors associated with the use of alcohol, cannabis, party drugs, sexual performance enhancement drugs and chemsex drugs. ResultsOverall, 1261 (30.0%) participants reported drug use, and 436 of 3706 (11.8%) reported the use of two or more drugs during their last sexual encounter. By drug class, 966 (23.0%) reported using sexual performance enhancement drugs, 353 (8.4%) – party drugs, and 142 (3.4%) the use of chemsex drugs. Respondents who reported drug use were more frequently diagnosed with HIV (10.5% vs. 3.9%) before and with other STIs during the 12 months prior to the study (16.7% vs. 9.2%). The use of all the analysed substances was significantly associated with sexual encounter with more than one partner. DiscussionSubstance and polydrug use during sexual encounters occurred amongst sampled MSM across Europe although varying greatly between study sites. Different local social norms within MSM communities may be important contextual drivers of drug use, highlighting the need for innovative and multi-faceted prevention measures to reduce HIV/STI risk in the context of drug use.

Human immunodeficiency virus infection predictors and genetic diversity of hepatitis B virus and hepatitis C virus co-infections among drug users in three major Kenyan cities.

BackgroundDrug users act as reservoirs and transmission channels for hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) infections to the general population worldwide. Periodic epidemiological studies to monitor the prevalence and genetic diversity of these infections to inform on interventions are limited.Objective of the studyThe objective of this study was to determine the predictors of HIV infection and genetic diversity of HBV and HCV among drug users in Kenya.Materials and methodsA cross-sectional study on previous drug use history among drug users was conducted in three Kenyan cities using a respondent-driven sampling method between January 2011 and September 2012. Blood samples were collected and analysed for the presence of HBV, HCV and HIV serological markers and to determine the genotypes of HBV and HCV.ResultsThe overall prevalence of HBV, HCV and HIV among drug users was 4.3%, 6.5% and 11.1%, respectively, with evidence of HBV/HIV, HCV/HIV and HBV/HCV/HIV co-infections. The HBV circulating genotypes were A1 (69%) and D6 (19%), whereas HCV genotypes were 1a (72%) and 4a (22%). Injection drug use was a significant predictor of HIV/HCV infections. Younger age (30 years; aOR (adjusted odds ratio) = 0.50, 95% CI (confidence interval): 0.33–0.76; p < 0.001) and early sexual debut (aOR = 0.54, 95% CI: 0.40–0.82; p < 0.05) were negatively associated with detection of any of the three infections. Injecting drug use was positively associated with HCV infection (aOR = 5.37, 95% CI: 2.61–11.06; p < 0.001).ConclusionThis high level of genetic diversity exhibited by HBV and HCV isolates requires urgent implementation of harm reduction strategies and continuous monitoring for effective management of the patients.

Direct and Indirect Effects of Perceived Stigma on Posttraumatic Growth in Gay Men and Lesbian Women in Chile.

This study examined the direct and indirect effects of perceived stigma on posttraumatic growth (PTG) in a sample of gay men and lesbian women in Chile, with coping strategies (positive reappraisal, social support seeking, and active coping strategies) as intermediate variables. Data from 467 gay men (57.4%) and lesbian women (42.6%) were analyzed. A respondent-driven sampling (RDS) method was used. The hierarchical regression analysis indicated the important predictive role of active coping, β = .23, and positive reappraisal, β = .45, in PTG, R2 = .31, p < .001, f2 = 0.16. Results revealed that, in the presence of positive reappraisal coping as an intermediate variable, partial indirect effects are detected between perceived stigma and PTG. Seeking instrumental social support did not produce indirect effects between perceived stigma and PTG, whereas active coping produced partial indirect effects. These findings suggest that the positive reappraisal of a traumatic experience is essential for reporting personal growth. Implications of these more complex relations for counseling interventions and further research are discussed.

68 - Is RDS for YMSM?: Successful Enhancements to Respondent Driven Sampling Methods for Recruiting 15 to 18 Year Old Participants in Philadelphia

Purpose: Identifying and engaging YMSM in various settings in order to enroll them in a study involving an HIV test. Historically, YMSM, especially under the age of 18, can be difficult to reach in Philadelphia as there are limited venues for them to congregate safely in addition to the presence of stigma in communities of color discouraging youth from openly expressing their identities. Identifying other methods to engage these youth in prevention and research is crucial to informing HIV prevention activities. This presentation will describe implementation and outcomes of RDS enhancements that were implemented to reach recruitment goals.

Prevalence of and Risk Factors for Anal Human Papillomavirus Infection in a Sample of Young, Predominantly Black Men Who Have Sex With Men, Houston, Texas.

Young men who have sex with men (MSM) are at increased risk for human papillomavirus (HPV)-associated disease as a result of HPV infection. Our objective was to characterize the prevalence of high-risk anal HPV infection and factors associated with prevalence in a group of young, primarily black MSM in Houston, Texas. MSM aged 18-29 years were recruited using a respondent-driven sampling method to study HIV and sexually transmitted disease transmission and risk. All engaged in peer-recruitment chains and self-collected anal exfoliated cells. Prevalence ratios assessed factors associated with high-risk HPV and HPV types in the 9-valent vaccine. Black race was reported by 87% of men. Slightly over one half (53%) were human immunodeficiency virus (HIV) positive. Approximately 75% of men had at least 1 high-risk HPV type, and 39% of HIV-positive men harbored HPV-16. Analysis that controlled for potential confounders revealed that only HIV infection was associated with high-risk HPV infection. Black MSM would benefit from increased HPV vaccination efforts, owing to high rates of HPV infection, increased HPV disease, and low vaccination series completion rates in this population.

Using risk-tracing snowball approach to increase HIV case detection among high-risk populations in Cambodia: an intervention study

BackgroundEarly HIV diagnosis and initiation onto antiretroviral therapy may prevent ongoing spread of HIV. Risk Tracing Snowball Approach (RTSA) has been shown to be effective in detecting new HIV cases in other settings. The main objective of this study is to evaluate the effectiveness of RTSA in increasing the rate of newly identified HIV cases among high-risk populations. Our second objective was to evaluate the effectiveness of RTSA, as compared to the walk-in group, in increasing the number of HIV tests and early case detection.MethodsThis study was conducted from April 1 to September 30, 2016 at two NGO clinics in Phnom Penh, Cambodia. Respondent driven sampling method was adapted to develop RTSA to reach high-risk populations, including key populations and the general population who have social connections with key populations. Bivariate and multivariate logistic regression analyses were conducted.ResultsDuring the implementation period, 721 clients walked in for HIV testing (walk-in group), and all were invited to be seeds. Of the invited clients, 36.6% agreed to serve as seeds. Throughout the implementation, 6195 coupons were distributed to seeds or recruiters, and resulted in 1572 clients visiting the two clinics with coupons (RTSA group), for a coupon return rate of 25.3%. The rate of newly identified HIV cases among the RTSA group was significantly lower compared to that in walk-in group. However, the highest number of newly identified HIV cases was found during the implementation period, compared to both pre- and post-implementation period. Although statistically not significant, the mean CD4 count of newly identified HIV cases detected through RTSA was almost 200 cells/mm3 higher than that in the walk-in group.ConclusionsAlthough the rate of newly identified HIV cases among the RTSA group was lower than that in the walk-in group, the inclusion of RTSA in addition to the traditional walk-in method boosted new HIV case detection in the two participating clinics. A higher mean CD4 count for the RTSA group may reveal that RTSA may be able to detect HIV cases earlier than the traditional walk-in approach. Further research is needed to understand whether RTSA is a cost-effective intervention to prevent ongoing spread of the HIV among high-risk populations in Cambodia.

Association of recent gay-related stressful events and emotional distress with suicidal behaviors over 12months in Chinese men who have sex with men.

The study was designed to assess the association of gay-related stressful events (GRSEs) and emotional distress with suicidal behaviors over a 12-month period in Chinese men who have sex with men (MSM). A total of 807 MSM were recruited using a respondent-driven sampling method from 4 cities in northeastern China. The GRSEs were measured using the Gay-related Stressful Life Events Scale, depression using the Self-rating Depression Scale, and anxiety using the Self-rating Anxiety Scale. A total of 26.0% of study participants experienced GRSEs during the 3months, and their average Self-rating Depression Scale and Self-rating Anxiety Scale scores were significantly lower than the national norms. Over a 12-month period, the prevalence of suicidal ideation, plan, and attempt was 9.7%, 4.0%, and 3.0%, respectively, each of which is at least 3 to 4 times greater than that of male adults in the general population of China. Multiple logistic regression analysis showed that GRSEs significantly increased the risk of suicidal ideation (odds ratio [OR]=2.3, 95% confidence interval [CI], 1.4-3.7) and plan (OR=2.8, 95% CI, 1.3-6.0). Depressive symptoms significantly increased the risk of suicidal ideation (OR=3.5, 95% CI, 2.1-5.8), plan (OR=4.4, 95% CI, 2.0-9.6), and attempt (OR=5.6, 95% CI, 21.94.8). Anxiety symptoms (OR=3.4, 95% CI, 1.4-8.4) and cohabitation with a same sex partner (OR=3.0, 95% CI, 1.2-7.9) significantly increased the risk of suicide attempt. More efforts to reduce GRSE are worth investigating as a strategy to reduce suicidal thoughts and behaviors in Chinese MSM.

"We Deserve Better!": Perceptions of HIV Testing Campaigns Among Black and Latino MSM in New York City.

In 2014, Black/African-American and Hispanic/Latino men who have sex with men (BLMSM) comprised 64.1% of HIV diagnoses among MSM in the U.S. Routine HIV testing allows earlier diagnosis, linkage to care, and improved health outcomes. HIV testing campaigns may increase HIV awareness and testing behaviors, but perceptions of these campaigns by BLMSM have been understudied. We explored perceptions of HIV testing campaigns with BLMSM in New York City (NYC) to inform campaign strategies that target BLMSM for HIV testing. Using respondent-driven sampling methods, we conducted semi-structured interviews from 2011 to 2012 with BLMSM in NYC who participated in a larger HIV research study. Interview responses from 108 participants were examined for main themes using computer-assisted thematic analyses. The four main themes identified were that HIV testing campaigns should: (1) use non-stereotypical messages and images on the basis of race and sexuality, (2) use non-gay identified images, (3) be maximally inclusive and visible, and (4) raise risk perception of HIV. These findings can inform future campaigns for strengthening HIV testing among BLMSM in support of earlier diagnosis, linkage to care, and reduced disparities.

Evolution of HIV prevalence and behavioral factors among MSM in Togo between 2011 and 2015.

IntroductionThe aim of this study was to assess sexual behavior and measure HIV prevalence among MSM in 2015, in Togo.MethodsWe conducted a cross-sectional study from February to March 2015 in nine major cities of Togo. The respondent-driven sampling method was used to recruit MSM. Behavioral data were collected by interviewer-administered questionnaires. The blood tests were then carried out among MSM to assess their HIV status. Data were inputted into an Epidata database and exported to STATA® 9.0 for analysis. Qualitative variables were compared using the chi-2.ResultsA total of 496 MSM were involved in this study, with 43.35% in the capital, Lome. Over the past 12 months, 88.9% of MSM had had sexual intercourse with men and 24.1% of them had had sex with women. The last sexual intercourse was with a casual partner among 52.9% of MSM. During the last 30 days preceding the survey, 68.5% of MSM had regularly used a condom during active anal intercourse and 71.9% had used it during passive anal intercourse. The national prevalence rate of HIV among MSM was 13.0%. The factors associated with HIV infection were age of MSM OR = 5.30 [1.85-15.1], HIV testing history OR = 2.63 [1.18-5.87] and the city of residence of MSM OR = 5.56 [2.90-10.64].ConclusionThis study confirms that HIV prevalence among MSM is five times higher than in the general population (13% vs 2.5%). Thus, the need to rethink HIV sensitization and prevention strategies targeting hidden and stigmatized populations such as MSM.

HIV Research with Men who Have Sex with Men (MSM): Advantages and Challenges of Different Methods for Most Appropriately Targeting a Key Population.

The difficulty in accessing hard-to-reach populations as men who have sex with men presents a dilemma for HIV surveillance as their omission from surveillance systems leaves significant gaps in our understanding of HIV/AIDS epidemics. Several methods for recruiting difficult-to-access populations and collecting data on trends of HIV prevalence and behavioural factors for surveillance and research purposes have emerged. This paper aims to critically review different sampling approaches, from chain-referral and venue-based to respondent-driven, time-location and internet sampling methods, focusing on its main advantages and challenges for conducting HIV research among key populations, such as men who have sex with men. The benefits of using these approaches to recruit participants must be weighed against privacy concerns inherent in any social situation or health condition. Nevertheless, the methods discussed in this paper represent some of the best efforts to effectively reach most-at-risk subgroups of men who have sex with men, contributing to obtain unbiased trends of HIV prevalence and HIV-related risk behaviours among this population group.

Correlates of sex trading among male non-injecting drug users in Myanmar: a cross-sectional study.

BackgroundSex trading is a recognized risk factor for human immune deficiency virus infection and other sexually transmitted infections among non-injecting drug users (NIDUs). However, very little research has addressed the factors associated with sex trading among male NIDUs in Myanmar.MethodsA cross-sectional study was conducted from January to February 2010 using the respondent-driven sampling method. In total, 210 NIDUs aged between 18 and 49 years, with no history of injecting drug use, and who used non-injected illicit drugs in the last 6 months were recruited. Face-to-face interviews were conducted using a structured questionnaire to collect information on participants’ sexual and drug use behaviors. Binary and multivariate logistic regressions were applied to analyze the resulting data.ResultsOf 210 NIDUs, 84 (40%) reported involvement in the sex trade during the last 3 months. In the adjusted model, factors associated with sex trade involvement included homosexual preference (adjusted odds ratio [AOR] 4.90; 95% confidence interval [CI] 1.61–14.95), having more than two partners (AOR = 3.88; 95% CI 1.55–9.72), had a regular job (AOR = 5.10; 95% CI 1.65–15.72), use of stimulant drugs rather than opiate (AOR = 2.38; 95% CI 1.10–5.15), and who used drugs more than twice per day.ConclusionsMore than one third of NIDUs were involved in sex trading. This study suggested that further comprehensive intervention programs that aim to reduce risk factors of trading sex among NIDUs may consider including NIDUs who used stimulant drugs, had regular/full-time jobs, used drugs more than twice per day, and had homosexual preferences.

A comparison of network sampling designs for a hidden population of drug users: Random walk vs. respondent-driven sampling

Both random walk and respondent-driven sampling (RDS) exploit social networks and may reduce biases introduced by earlier methods for sampling from hidden populations. Although RDS has become much more widely used by social researchers than random walk (RW), there has been little discussion of the tradeoffs in choosing RDS over RW. This paper compares experiences of implementing RW and RDS to recruit drug users to a network-based study in Houston, Texas. Both recruitment methods were implemented over comparable periods of time, with the same population, by the same research staff. RDS methods recruited more participants with less strain on staff. However, participants recruited through RW were more forthcoming than RDS participants in helping to recruit members of their social networks. Findings indicate that, dependent upon study goals, researchers' choice of design may influence participant recruitment, participant commitment, and impact on staff, factors that may in turn affect overall study success.

Sexual identity development: relationship with lifetime suicidal ideation in sexual minority women.

This study draws on a life course perspective to evaluate in a sample of sexual minority women: (1) the relationship between age at reaching sexual identity milestones and risk of suicidal ideation, (2) developmental stages or stages of sexual identity development that represent greatest risk and (3) the relationship between age of reaching milestones and parental support. Research shows higher rates of suicidal ideation among sexual minority women than heterosexual women. Evidence suggests this is partly accounted for by risk factors including sexual identity development and parental support. However, it remains unclear whether there are stages of particularly high risk. This is a cross-sectional study. Data come from a prospective study of sexual minority women that used convenience and respondent-driven sampling methods. Using logistic regression, we examined associations among age at sexual identity developmental milestones, parental support and suicidal ideation in a large (N=820), ethnically diverse sample of sexual minority women. Compared with women who first wondered about their sexual identity in adulthood, those who first wondered in early, middle or late adolescence had greater odds of lifetime suicidal ideation. Younger age at subsequent milestones (first decided or first disclosed) was not associated with heightened risk of suicidal ideation. Parental support was independently associated with suicidal ideation. Findings suggest that where one is in the process of identifying as a sexual minority may be more important than age in understanding risk of suicidal ideation in this population. As individuals come to accept and integrate their sexual minority identity risks associated with younger age diminish. Nurses and other healthcare providers who work with youth should routinely ask about sexual orientation and suicidal ideation and be aware that youth in the earliest stages of coming out as sexual minority may be at particularly high risk of suicide.

Antecedents and outcomes of migrant workers’ sociocultural adjustment in the hospitality industry

Migrant workers are an important part of the labor force for the hospitality industry in developed countries and emerging markets. The purpose of this study is to investigate the relationship between perceived organizational support (POS) and dominant cultural orientation (DCO), sociocultural adjustment (SCA), job satisfaction (JS), life satisfaction (LS), and turnover intention (TI) of migrant workers. This research uses a respondent-driven sampling (RDS) method with a dual incentive system to attain hard-to-reach migrant employees. The findings demonstrate that both POS and DCO have a significant and positive relationship with SCA and, interestingly, that POS has a stronger impact on hospitality migrants’ SCA than DCO. The findings also imply that although personal efforts of migrant workers are important for their effective socialization, positive support from a hospitality organization plays a far more important role. Furthermore, this study highlights the significant relationships between POS and JS and between DCO and LS. The findings also show that SCA had a significant and positive effect on LS and that hospitality migrants who adjust well in their host society tend to have a high satisfaction with their lives in the foreign country and are apt to stay longer in their positions.