Recruitment Strategies to Encourage Southern, Rural Self-identified Heterosexual African American Males into HIV Testing Randomized Controlled Trials

Although African-Americans are disproportionately affected by HIV in the USA, HIV testing for some subgroups of African-American men remains a challenge. The study purpose was to explore effective methods to recruit rural African-American males ages 18-64 who self-identify as heterosexual into an HIV testing trial. The study was conducted in two rural and one mixed county located in North Florida. Community-based recruitment was conducted through ethnographic mapping and general surveillance at “hang-out” venues for the target population. The 3-phased mixed methods design consisted of a cross-sectional survey, a randomized control trial (RCT)of an HIV testing intervention that compared referral to local health departments for HIV testing (control arm)to on-site rapid HIV testing (intervention arm), and a process evaluation with focus groups. Results: From March-December 2011, 634 participants were recruited into the 3 study components:634 into the survey component;601 into the RCT (n=301 in the control arm and n=300 in the intervention arm); and 71 of the 634 into the focus groups. Acceptance for participating in the HIV testing RCT was 94.7%, with 601 of 634 men enrolling in that component; only 33 of 634 (5.2%)completing the survey declined to participate in the RCT. Conclusions: This study demonstrates that rural African American males can be successfully recruited to participate in HIV testing research using multiple, community-engaging strategies. Acceptance of HIV testing was high, suggesting that these community HIV testing strategies can effectively engage African American men in rural settings; these effective HIV testing strategies may warrant expansion to other rural areas.