Original Communication
Respondent-Driven Sampling in a Multi-Site Study of Black and Latino Men Who Have Sex with Men

https://doi.org/10.1016/j.jnma.2015.12.009Get rights and content

Abstract

Purpose

Respondent-driven sampling (RDS) was used to recruit four samples of Black and Latino men who have sex with men (MSM) in three metropolitan areas to measure HIV prevalence and sexual and drug use behaviors. We compared demographic and behavioral risk characteristics of participants across sites, assessed the extent to which the RDS statistical adjustment procedure provides estimates that differ from the crude results, and summarized our experiences using RDS.

Methods

From June 2005 to March 2006 a total of 2,235 MSM were recruited and interviewed: 614 Black MSM and 516 Latino MSM in New York City, 540 Black MSM in Philadelphia, and 565 Latino MSM in Los Angeles County.

Crude point estimates for demographic characteristics, behavioral risk factors and HIV prevalence were calculated for each of the four samples.

RDS Analysis Tool was used to obtain population-based estimates of each sampled population’s characteristics.

Results

RDS adjusted estimates were similar to the crude estimates for each study sample on demographic characteristics such as age, income, education and employment status. Adjusted estimates of the prevalence of risk behaviors were lower than the crude estimates, and for three of the study samples, the adjusted HIV prevalence estimates were lower than the crude estimates. However, even the adjusted HIV prevalence estimates were higher than what has been previously estimated for these groups of MSM in these cities. Each site faced unique circumstances in implementing RDS.

Conclusions

Our experience in using RDS among Black and Latino MSM resulted in diverse recruitment patterns and uncertainties in the estimated HIV prevalence and risk behaviors by study site.

Introduction

Although they represent only 2% of the United States population, men who have sex with men (MSM) account for an estimated 61% of all new HIV infections in U.S. 1, 2 In 2010, among HIV-positive MSM, new diagnoses among Blacks (37%) and Latinos (23%) were disproportionately higher than among Whites (37%) in comparison to the racial/ ethnic distribution of the U.S. population (13%, 15%, and 66%, respectively).2 Given the burden of HIV in minority MSM populations, it is imperative to conduct research to identify factors that place Black and Latino MSM at risk for infection and to facilitate the design and implementation of targeted behavioral and biomedical interventions.

Black and Latino MSM are often difficult to recruit into research studies. It is particularly challenging to recruit representative samples of MSM because there are no sampling frames from which to generate a probability sample.3 Silvestre et al. explored recruitment barriers for Black and Latino men in urban settings and noted that recruiting MSM of color required attention to cultural norms of the “target” group, use of members of the “targeted” community, and the use of promotional materials that were accepted by community members.4 Fernandez et al. describe the use of Internet methods to recruit Latino MSM in Miami.5 They found that men recruited through Internet chat rooms did present at physical study sites, although formative work in the community and inclusion of members of the targeted community were necessary to ensure their successful recruitment.

Venue-based (time-space) sampling has been the most broadly used method to recruit MSM populations for HIV behavioral research.3, 6 The Centers for Disease Control and Prevention (CDC) first implemented venue-based sampling in 1994 with the multi-site Young Men’s Survey;7 this method continues to be used to recruit MSM ages 18 years and older for CDC’s National HIV Behavioral Surveillance system.8 Despite its widespread use, some experts believe that venue-based sampling may miss non-gay-identified or minority MSM who do not frequent predominantly gay-identified venues.3

In this report we describe the use of Respondent-Driven Sampling (RDS),12 a form of chain-referral sampling, for recruiting four samples of Black and Latino MSM in three U.S. metropolitan areas. RDS has increased in popularity as a means to reach persons from hard-to-reach populations for which construction of a sampling frame is not feasible, such as injection drug users,9 ecstasy users,10 and Latino MSM.11 We were particularly interested in 1) describing the RDS recruitment statistics across our study sites; 2) comparing the demographic and behavioral risk characteristics across each site; 3) assessing the extent to which the RDS statistical adjustment produces estimates that differ from the crude results, especially with respect to estimating HIV prevalence and behavioral risk; and 4) describing benefits and problems associated with using RDS as a sampling strategy, as well as suggesting recommendations for future studies that recruit Black and Latino MSM.

Section snippets

Methods

Data were collected as part of the CDC’s Brothers y Hermanos (ByH) study. The chief aims of the study included identifying the structural, psychological, socio-cultural and behavioral factors associated with elevated HIV transmission among Black and Latino MSM. From June 2005 through March 2006, Latino MSM were recruited in Los Angeles County and New York City, and Black MSM were recruited in New York City and Philadelphia. To be eligible, participants had to 1) be male (and identify as such),

Results

A total of 2,235 MSM were recruited and interviewed: 614 Black MSM and 516 Latino MSM in New York City (NYC), 540 Black MSM in Philadelphia, and 565 Latino MSM in Los Angeles County.

Discussion

Our experience using RDS to enroll and to estimate HIV prevalence, risk behaviors and psychosocial factors among Black and Latino MSM resulted in diverse recruitment patterns and potential uncertainties in the estimated HIV prevalence, risk behaviors, and demographic distributions by study site.

The RDS weighted adjustments are inversely related to social network size.15 For example, in our study the HIV-positive group had a much smaller adjusted network size than the HIV negative group in the

Acknowledgements

The authors thank the study participants, the collaborating community-based partners, and the Brothers y Hermanos research team. The authors also thank Dr. Lucia Torian for insightful comments on the manuscript.

References (23)

  • J. Wang et al.

    Respondent-Driven Sampling to Recruit MDMA Users: a Methodological Assessment

    Drug Alcohol Depend

    (2005)
  • D.W. Purcell et al.

    Estimating the Population Size of Men Who Have Sex with Men in the United States to Obtain HIV and Syphilis Rates

    The Open AIDS Journal

    (2012)
  • HIV Surveillance Report, 2010; vol. 22

  • S. Semaan et al.

    Street and network sampling in evaluation studies of HIV risk-reduction interventions

    AIDS Rev

    (2002)
  • A.J. Silvestre et al.

    Recruiting minority men who have sex with men for HIV research: results from a 4-city campaign

    Am J Public Health

    (2006)
  • M.I. Fernandez et al.

    The Internet as recruitment tool for HIV studies: viable strategy for reaching at-risk Hispanic MSM in Miami?

    AIDS Care

    (2004)
  • D.A. MacKellar et al.

    Surveillance of HIV risk and prevention behaviors of men who have sex with men—a national application of venue-based, time- space sampling

    Pub Hlth Reports

    (2007)
  • L.A. Valleroy et al.

    HIV prevalence and associated risks in young men who have sex with men. Young Men’s Survey Study Group

    JAMA

    (2000)
  • HIV Risk, Prevention, and Testing Behaviors Among Men Who Have Sex With Men — National HIV Behavioral Surveillance System, 21 U.S. Cities, United States, 2008

    MMWR

    (2011)
  • D.D. Heckathorn et al.

    Extensions of Respondent Driven Sampling: A New Approach to the Study of Injection Drug Users Aged 18–25

    AIDS Behav

    (2002)
  • J. Ramirez-Valles et al.

    From Networks to Populations: The Development and Application of Respondent-Driven Sampling Among IDUs and Latino Gay Men

    AIDS Behav

    (2005)
  • Cited by (9)

    View all citing articles on Scopus

    Financial disclosure and Disclaimer: This study was funded through a cooperative agreement from the U.S. Centers for Disease Control and Prevention. The findings and conclusions in this paper are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

    View full text