Challenges in ethnoepidemiological research with hard-to-reach populations: Assessing drug use and HIV risk behaviors of trucker networks

ISSUE: Truckers and members of their risk networks including sex workers, drug suppliers, and truck stop employees represent a hard-to-reach population vulnerable for infection with HIV, STIs, and bloodborne infections. Addressing the unique contextual and ethical considerations are necessary when conducting ethnoepidemological research with this population. DESCRIPTION: Respondent driven sampling techniques were used to recruit index and contact members of trucker networks at three locations in a southern U.S. city frequented by truckers. To explore experiences with risk behaviors and networks: (1) focus groups were conducted (N = 28) and (2) in-depth interviews and collection of serological specimens were completed (N = 90) with truckers and members of their risk networks. LESSONS LEARNED: Recruiting members of this population to participate in ethnoepidemiological research required building trust between potential participants and researchers, addressing participants' feelings of discomfort when asked to leave their environments to participate in research activities, and weighing ethical concerns about providing participants who were known substance users with cash incentives. Participants voiced concern over the initial location of research activities leading staff to select alternate locations for focus groups and interviews. Graduate student researchers, despite training and theoretical understanding, were uncomfortable in the field settings and ultimately were replaced with older adults experienced with the target population. RECOMMENDATIONS: These research experiences have implications for other studies and interventions targeting hard-to-reach populations (e.g., truckers, sex workers) involved in illicit activities. Incorporating the lessons learned into methodology and field staff selection and training may increase the quality of data collected.