Recruitment methods for enrolling high-risk men who have sex with men (MSM) into an HIV prevention clinical trial in Cape Town, South Africa

Published: July 22, 2010

Recruitment methods for enrolling high-risk men who have sex with men (MSM) into an HIV prevention clinical trial in Cape Town, South Africa

B. Brown1, E. Burrell2, A. Scheibe1, R. Wood1,3, L.-G. Bekker1,3

1Desmond Tutu HIV Foundation, Cape Town, South Africa, 2University of California at Los Angeles, Los Angeles, United States, 3University of Cape Town, Institute of Infectious Disease and Molecular Medicine, Cape Town, South Africa

Issues: In October 2008, the Desmond Tutu HIV Foundation (DTHF) began enrolling MSM for an HIV prevention clinical trial. In the past, there have been few MSM-focused research studies in South Africa and thus little is known of the best recruitment methods for this community. In order to recruit for this trial, the DTHF initiated multiple recruitment strategies in order to target this historically hard-to-reach community.
Description: Overall, seven recruitment strategies were implemented. They included the use of field workers, internet-based and print advertisements, referrals from both current participants and from within the community, a drop-in office, and community-based events. Before screening for the study each participant was required to complete a pre-screening form in order to determine his demographic and behavioral eligibility.
Lessons learned: A total of 629 completed pre-screening questionnaires were collected from individuals over a 15-month period. Of these individuals, 18.9% (119/629) completed a screening visit and 13.9% (88/629) enrolled into the study. The most successful recruitment strategy was the use of community-based field workers which accounted for 57% (50/88) of total participants enrolled. Often field workers made use of community events which represented 15% (13/88) of total enrolled participants. The most efficient strategy was referrals from current study participants with 43% (9/21) of those referrals eventually enrolling into the study. The least successful strategy was the print advertising campaign which accounted for only 3% (3/88) of total participants enrolled.
Next steps: Ultimately, targeted recruitment efforts (such as field workers or referrals) were more successful in enrolling high-risk HIV negative MSM into this HIV prevention clinical trial. Future clinical trials or research projects based in an African urban setting could take these results into consideration in order to more effectively reach Africa’s traditionally hard-to-reach MSM population for HIV prevention research.

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