Recruitment of HIV-Positive Women in Research: Discussing Barriers, Facilitators, and Research Personnel's Knowledge

Abstract

Background: Women have historically been under-represented in HIV research, partly due to ineffective recruitment strategies.

Objective: To improve the existing understanding of recruitment for HIV-positive women based on a province-wide cross-sectional study.

Methods: A survey was emailed to all site coordinators who recruited participants in a study involving 490 HIV-positive women living in Ontario, Canada. The survey consisted of questions regarding the important recruitment barriers and successes. Quantitative data were then contextualized within extensive knowledge from research personnel and team members.

Results: Completed surveys were received from (89%) site coordinators (34/38) and 98% (31/34) were women. The highest ranked recruitment barriers identified were: sensitivity of the research topic (59%), time/availability constraints (59%), language barriers (53%), HIV disclosure/stigma issues (47%), lack of trust of research personnel (41%), fear of research (41%) and inaccessibility to child care and transportation (41%). The respondents felt that the most important personal attributes for recruitment were research personnel who were respectful (97%), skilled (91%), flexible (88%) and empathetic (88%) and had good communication skills (88%). The most successful recruitment strategies identified were: developing a strong rapport (88%) that was facilitated by an empathetic relationship (100%), acknowledging the sensitive nature of the research topic (94%), providing cash financial compensation (88%), and developing recruitment strategies unique to women (88%).

Conclusion: There are differences in the approaches needed for the recruitment of HIV-positive women in research. For successful recruitment of HIV-positive women, a strong rapport between the research personnel and study participants is important. This rapport is facilitated by having study personnel who are respectful, trustworthy, empathetic, and flexible. Population-specific recruitment strategies are important to ensure adequate recruitment of minority groups in research with greater gender consideration for women requiring specific attention.

Keywords: AIDS; HIV; clinical research; recruitment; women..

Fig. (1)

Percentage and ranking of barriers to recruitment. Study participants were asked to select all potential barriers to recruitment from a pre-established list, and then to rank order the barriers they had identified. While some barriers had equal percentage and ranking scores (sensitive nature of the research topic was ranked highest and was identified by the most percentage, 59% of respondents). Other barriers were ranked lower than the frequency at which they were identified by respondents (transportation costs was ranked 10th despite being selected by 41% of respondents).

Fig. (2)

Percentage and ranking of strategies for the recruitment of HIV-positive women. The percentage of respondents that identified pre-established recruitment strategies, and their ranking, is shown. Recruitment strategies were found to often mirror recruitment barriers. For example, acknowledging the sensitive nature of the research topic before enrolment was identified by the second highest number of respondents (96%) and was ranked second overall as a recruitment strategy. It was identified as the number one barrier by in percentage and ranking.

Fig. (3)

Percentage and ranking of important attributes of research personnel for successful recruitment of HIV-positive women. Study participants were asked to describe important attributes of research personnel in order to successfully recruit HIV-positive women. There was no statistical difference in responses based on demographic characteristics of respondents (insert statistic).