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Respondent-driven sampling as a recruitment method for men who have sex with men in southern sub-Saharan Africa: a cross-sectional analysis by wave
  1. Shauna Stahlman1,
  2. Lisa G Johnston2,
  3. Clarence Yah1,3,
  4. Sosthenes Ketende1,
  5. Sibusiso Maziya4,
  6. Gift Trapence5,
  7. Vincent Jumbe6,7,
  8. Bhekie Sithole8,
  9. Tampose Mothopeng8,
  10. Zandile Mnisi9,
  11. Stefan Baral1
  1. 1Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Center for Public Health and Human Rights, Baltimore, Maryland, USA
  2. 2Department of Global Health Sciences, University of California San Francisco, San Francisco, California, USA
  3. 3Department of Biochemistry and Microbiology, Nelson Mandela Metropolitan University, South Africa
  4. 4Rock of Hope, Manzini, Swaziland
  5. 5Center for the Development of People, Blantyre, Malawi
  6. 6Malawi College of Medicine, Blantyre, Malawi
  7. 7Centre for Global Health, Trinity College, Dublin, Ireland
  8. 8Rock of Hope, Mbabane, Swaziland
  9. 9Ministry of Health, Mbabane, Swaziland
  1. Correspondence to Dr Shauna Stahlman, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Center for Public Health and Human Rights, E7133, 615 N. Wolfe St., Baltimore, MD 21205, USA; sstahlm1{at}jhu.edu

Abstract

Objectives Respondent-driven sampling (RDS) is a popular method for recruiting men who have sex with men (MSM). Our objective is to describe the ability of RDS to reach MSM for HIV testing in three southern African nations.

Methods Data collected via RDS among MSM in Lesotho (N=318), Swaziland (N=310) and Malawi (N=334) were analysed by wave in order to characterise differences in sample characteristics. Seeds were recruited from MSM-affiliated community-based organisations. Men were interviewed during a single study visit and tested for HIV. χ2 tests for trend were used to examine differences in the proportions across wave category.

Results A maximum of 13–19 recruitment waves were achieved in each study site. The percentage of those who identified as gay/homosexual decreased as waves increased in Lesotho (49% to 27%, p<0.01). In Swaziland and Lesotho, knowledge that anal sex was the riskiest type of sex for HIV transmission decreased across waves (39% to 23%, p<0.05, and 37% to 19%, p<0.05). The percentage of participants who had ever received more than one HIV test decreased across waves in Malawi (31% to 12%, p<0.01). In Lesotho and Malawi, the prevalence of testing positive for HIV decreased across waves (48% to 15%, p<0.01 and 23% to 11%, p<0.05). Among those living with HIV, the proportion of those unaware of their status increased across waves in all study sites although this finding was not statistically significant.

Conclusions RDS that extends deeper into recruitment waves may be a promising method of reaching MSM with varying levels of HIV prevention needs.

  • AFRICA
  • HIV
  • GAY MEN
  • IMPLEMENTATION SCIENCE
  • PREVENTION

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