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Evaluating Outcome-Correlated Recruitment and Geographic Recruitment Bias in a Respondent-Driven Sample of People Who Inject Drugs in Tijuana, Mexico

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Abstract

Respondent-driven sampling’s (RDS) widespread use and reliance on untested assumptions suggests a need for new exploratory/diagnostic tests. We assessed geographic recruitment bias and outcome-correlated recruitment among 1,048 RDS-recruited people who inject drugs (Tijuana, Mexico). Surveys gathered demographics, drug/sex behaviors, activity locations, and recruiter-recruit pairs. Simulations assessed geographic and network clustering of active syphilis (RPR titers ≥1:8). Gender-specific predicted probabilities were estimated using logistic regression with GEE and robust standard errors. Active syphilis prevalence was 7 % (crude: men = 5.7 % and women = 16.6 %; RDS-adjusted: men = 6.7 % and women = 7.6 %). Syphilis clustered in the Zona Norte, a neighborhood known for drug and sex markets. Network simulations revealed geographic recruitment bias and non-random recruitment by syphilis status. Gender-specific prevalence estimates accounting for clustering were highest among those living/working/injecting/buying drugs in the Zona Norte and directly/indirectly connected to syphilis cases (men: 15.9 %, women: 25.6 %) and lowest among those with neither exposure (men: 3.0 %, women: 6.1 %). Future RDS analyses should assess/account for network and spatial dependencies.

Resumen

El uso amplio y la confianza en suposiciones no comprobadas del muestreo dirigido por los participantes (MDP) sugiere la necesidad de pruebas exploratorias o de diagnóstico. Nosotros evaluamos el sesgo de reclutamiento geográfico y el reclutamiento correlacionado con el desenlace entre 1048 personas que se inyectan drogas reclutadas por MGP (Tijuana, México). Las encuestas recabaron información demográfica, comportamientos sexual y de drogas, ubicación de las actividades, y pares reclutador-reclutado. Las simulaciones evaluaron agrupamientos por red y geográficos de sífilis activa (títulos de RPR ≥1:8). Se estimaron probabilidades predictivas especificas por genero por medio de regresión logística con EEG y error estándar robusto. La prevalencia de sífilis activa fue del 7 % (crudo: hombres = 5.7 % y mujeres = 16.6 %; por ajuste de MGP: hombres = 6.7 % y mujeres = 7.6 %). Los agrupamientos de sífilis en la Zona Norte, una colonia conocida por el comercio sexual y de drogas. Las simulaciones de redes revelaron sesgo por reclutamiento geográfico y reclutamiento no aleatorio por condición de sífilis. Las prevalencias específicas de genero estimadas que tenían en cuenta el agrupamiento se dieron más altas entre aquellos que vivían/trabajaban/se inyectaban/compraban drogas en la Zona Norte y directa/indirectamente se conectaban a los casos de sífilis (hombres: 15.9 %, mujeres: 25.6 %) y fueron más bajas en aquellos con ninguna de las exposiciones (hombres: 3.0 %, mujeres: 6.1 %). Análisis de MDP a futuro deberían tener en cuenta/evaluar las dependencias espaciales y de red.

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Abbreviations

CI:

Confidence interval

GEE:

Generalized estimating equations

HIV:

Human immunodeficiency virus

IQR:

Interquartile range

PWID:

People who inject drugs

RDS:

Respondent driven sampling

RDSAT:

Respondent driven sampling analysis tool

RPR:

Rapid plasma reagin

TPPA:

Treponema pallidum particle agglutination assay

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Acknowledgements

This research was supported by National Institute on Drug Abuse Grants R01DA019829 and R37DA019829 (PI: Strathdee) and K01DA020364 (PI: Brouwer); A.E.R. was funded by NIH/NIDA Grant K01DA033879; T.L.G. was funded by NIH/NIDA Grant K01DA034523.

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Authors and Affiliations

  1. The Calverton Center, Pacific Institute for Research and Evaluation, 11720 Beltsville Drive Suite 900, Calverton, MD, 20705, USA

    Abby E. Rudolph

  2. Division of Global Public Health, Department of Medicine, University of California San Diego, La Jolla, CA, USA

    Abby E. Rudolph, Tommi L. Gaines, Alicia Vera & Kimberly C. Brouwer

  3. Pro-COMUSIDA, Tijuana, Baja California, Mexico

    Remedios Lozada

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  1. Abby E. Rudolph
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  3. Remedios Lozada
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  4. Alicia Vera
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  5. Kimberly C. Brouwer
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Correspondence to Abby E. Rudolph.

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Rudolph, A.E., Gaines, T.L., Lozada, R. et al. Evaluating Outcome-Correlated Recruitment and Geographic Recruitment Bias in a Respondent-Driven Sample of People Who Inject Drugs in Tijuana, Mexico. AIDS Behav 18, 2325–2337 (2014). https://doi.org/10.1007/s10461-014-0838-4

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