Barriers to and facilitators of optimal functioning of respondent-driven sampling for recruitment of young men who have sex with men (YMSM) into HIV-related research

The purpose of this study was to identify and describe facilitators of and barriers to optimal functioning of respondent-driven sampling (RDS) for recruitment of young men who have sex with men (YMSM) into HIV-related research. RDS is being used to recruit a sample of 450 YMSM between ages 16- 20 into a longitudinal study of HIV-related risk, known as “Crew 450.” Recruitment for Crew 450 began in 2009 with a recruitment rate of approximately 6-8 participants/ month in the initial seven months; a rate approximately 50%-60% slower than expected. A set of three focus groups were held in late 2010 with 16 Crew 450 participants to identify barriers and facilitators from the participants' perspective. Data were analyzed using a content analysis approach. Respondents reported barriers and facilitators in three main areas: social network factors, recruitment process, and study-related accessibility and acceptability. The most salient barriers were relatively small eligible network size and participants' ability to understand and describe the study to others to effectively recruit into the study. Key facilitators included the flexibility and accessibility of front-line staff members to assist in the recruitment process and the perceived benefits of study participation (e.g., free HIV testing). Based on participant feedback, study procedures and materials were revised to respond to participant suggestions and optimize identified facilitators. Analysis of study enrollment data to date suggests some success with these changes; the recruitment rate has steadily increased towards the target rate. These findings are important for future use of RDS with this population.