Is formative research important before implementation of a survey using respondent driven sampling (RDS) among MSM in three South African cities?
A. Cloete1, T. Duda1, Y. Ntsepe1, D. Naidoo2, K. Jonas3, L. Simbayi1
1HIV/AIDS, STIs & TB (HAST) Research Programme, Human Sciences Research Council, Cape Town, South Africa, 2HIV/AIDS, STIs and TB Research Programme, Human Sciences Research Council, Durban, South Africa, 3Population Health, Health Systems & Innovation (PHHSI), Human Sciences Research Council, Cape Town, South Africa
Background: We conducted pre-surveillance formative research in order to inform the implementation of a HIV biological and behavioural survey using respondent driven sampling (RDS). This study was conducted in the three urban centres of South Africa, namely Cape Town, Durban and Johannesburg.
Methods: As part of formative activities, we established a Community Advisory Board (CAB) comprising largely of representatives from service providers for MSM in each of the three study cities. We conducted 53 semi-structured interviews with MSM from diverse backgrounds in each of the study cities. Information was gathered focusing on the selection of seeds, acceptability of RDS, level of incentives, staffing and coupon design. For the purposes of RDS analysis, questions on each participant’s network size are essential. Questions on network size were formulated but final decisions regarding whether or not we will obtain accurate responses regarding network size was determined in this activity. As part of formative activities, we conducted structured observations to find appropriate sites for RDS purposes in each of the three study cities.
Results: Overall MSM interviewed demonstrated interest to take part in our study. We found that MSM were socially networked however networks tended to be isolated within race and class categories. In addition, where stigmatisation of same sex behaviours are still apparent, MSM networks remained closed. Hence the selection of seeds is important in order to bridge race and socio-economic status divides. Moreover, concerns were raised regarding issues of confidentiality, anonymity, protection from further stigmatization, in particular for MSM who remain closeted. As a result, discreet and accessible interview sites were established in each of the three study cities.
Conclusions: We found that pre-surveillance formative research is not only important but is an essential step in the successful implementation of any RDS study, in particular in contexts where MSM remain stigmatized.
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