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If You Are Not Counted, You Don’t Count: Estimating the Number of African-American Men Who Have Sex with Men in San Francisco Using a Novel Bayesian Approach

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Abstract

African-American men who have sex with men (AA MSM) have been disproportionately infected with and affected by HIV and other STIs in San Francisco and the USA. The true scope and scale of the HIV epidemic in this population has not been quantified, in part because the size of this population remains unknown. We used the successive sampling population size estimation (SS-PSE) method, a new Bayesian approach to population size estimation that incorporates network size data routinely collected in respondent-driven sampling (RDS) studies, to estimate the number of AA MSM in San Francisco. This method was applied to data from a 2009 RDS study of AA MSM. An estimate from a separate study of local AA MSM was used to model the prior distribution of the population size. Two-hundred and fifty-six AA MSM were included in the RDS survey. The estimated population size was 4917 (95 % CI 1267–28,771), using a flat prior estimated 1882 (95 % CI 919–2463) as a lower acceptable bound, and a large prior estimated 6762 (95 % CI 1994–13,863) as an acceptable upper bound. Point estimates from the SS-PSE were consistent with estimates from multiplier methods using external data. The SS-PSE method is easily integrated into RDS studies and therefore provides a simple and appealing tool to rapidly produce estimates of the size of key populations otherwise difficult to reach and enumerate.

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Acknowledgments

We thank Ali Mirzazadeh for his valuable suggestions regarding the sensitivity analyses.

Author information

Authors and Affiliations

  1. University of California, Berkeley, 101 Haviland Hall, Berkeley, CA, 94720-7358, USA

    Paul Wesson

  2. University of California, Los Angeles, 8125 Mathematical Sciences Building, Los Angeles, CA, 90095-1554, USA

    Mark S. Handcock

  3. San Francisco Department of Public Health, 25 Van Ness Ave, Suite 500, San Francisco, CA, 94102, USA

    Willi McFarland & H. Fisher Raymond

Authors
  1. Paul Wesson
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  2. Mark S. Handcock
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  3. Willi McFarland
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  4. H. Fisher Raymond
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Corresponding author

Correspondence to Paul Wesson.

Additional information

• Valid and reliable estimates of the size of hidden populations are challenging to obtain.

• Population size estimates are necessary for health policy formation and program planning.

• Respondent-driven sampling (RDS) is widely used to recruit hidden populations in health surveys.

• Sampling probabilities from RDS data can be used to estimate the size of the targeted population.

• This low-cost and accessible method can improve measures of disease burden in hidden populations.

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Wesson, P., Handcock, M.S., McFarland, W. et al. If You Are Not Counted, You Don’t Count: Estimating the Number of African-American Men Who Have Sex with Men in San Francisco Using a Novel Bayesian Approach. J Urban Health 92, 1052–1064 (2015). https://doi.org/10.1007/s11524-015-9981-0

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  • DOI: https://doi.org/10.1007/s11524-015-9981-0

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