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Recorded presentation

Greg Scott, Ph D¹, Lauretta E. Grau, Ph D², and Robert Heimer, Ph D². (1) Sociology Department, DePaul University, 990 W. Fullerton Ave., Rm. 1118, Chicago, IL 60614, 773-325-4893, gscott@depaul.edu, (2) Department of Epidemiology and Public Health, Yale University, PO Box 208034, 60 College St., New Haven, CT 06520

Our inquiry into the recruitment of injection drug users (IDUs) into a randomized controlled trial of hepatitis B vaccination at syringe exchange programs (SEPs) in Chicago and Connecticut investigated what many perceive to be a significant barrier to IDU health maintenance – securing IDU participation in a multi-visit vaccination effort. Data from structured interviews and ethnographic immersion in Chicago permit examination of recruitment trends. In the first few months of the trial—which essentially constituted an IDU health promotion campaign—study staff had to aggressively promote the campaign to IDU clients of SEPs. A “tipping point” marked the end of this initial phase as IDUs began recruiting their most intimate fellow injectors. Several months later another significant shift occurred as IDUs began referring not just their intimate fellow injectors but also less well-known fellow injectors, including drug acquisition partners, co-conspirators in illicit money-making enterprises, and other IDUs known superficially through exposure at open-air drug markets. Ethnographic investigation discovered that these substantial pivots reflected the efforts of a small number of IDUs loosely connected with multiple IDU networks. These “connectors” not only increased the number of IDUs recruited into the study; they also extended the geographic range, ethnic composition, age distribution, and sero-status of new participants. Ultimately the shift toward IDU-driven recruitment through loose rather than intimate social ties produced a roughly 50 percent increase in the number of participants enrolled. We conclude with a series of observations and recommendations concerning the initiation and monitoring of recruitment patterns in IDU health promotion efforts.

Learning Objectives:

• Articulate the recruitment challenges facing staff of the hepatitis vaccine study in its initial phase.
• Identify changes in the patterns of IDU recruitment into the study/health campaign.
• Assess the explanatory factors behind changes in these patterns.
• Develop an understanding of how these factors reflect the social organization of IDU subcultures.
• Consider programmatic, health service, public policy, and ethnographic research implications concerning the recruitment of IDUS into health promotion campaigns and studies.

Keywords: Intravenous Drug Use, Hepatitis B

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation