AIDS and Behavior

, Volume 21, Issue 7, pp 2180–2187 | Cite as

Reproducibility of Respondent-Driven Sampling (RDS) in Repeat Surveys of Men Who have Sex with Men, Unguja, Zanzibar

  • Ahmed Khatib
  • Shaaban Haji
  • Maryam Khamis
  • Christen Said
  • Farhat Khalid
  • Mohammed Dahoma
  • Ameir Ali
  • Asha Othman
  • Susie WeltyEmail author
  • Willi McFarland
Behavioral Surveillance


To assess the reproducibility of respondent-driven sampling (RDS) in obtaining comparable samples across two survey rounds, we conducted integrated bio-behavioral surveillance surveys (IBBSS) using RDS in 2007 and 2011 among men who have sex with men (MSM) on Unguja island in Zanzibar. Differences in the two rounds were assessed by comparing RDS-adjusted population estimates, stratified estimates, and bottleneck plots. Participants in the 2011 survey round were younger (31.4 vs. 9.9% under 19 years old, p < 0.001), more likely to have tested for HIV in the last year (53.7 vs. 10.6%, p < 0.001), and less likely to have injected drugs in the last 3 months (1.0 vs. 23.2%, p < 0.001) compared to participants in the 2007 round. HIV prevalence was 12.3% in 2007 compared to 2.6% in 2011 (p < 0.001). The difference in HIV prevalence persisted after stratifying and adjusting for known differences in the two surveys rounds. Bottleneck plots suggest that recruitment chains were “trapped” in the social networks of MSM who injected drugs to a greater extent in 2007 than in 2011. We conclude that the two rounds of RDS sampled different subsets of the MSM population on Unguja, particularly with respect to inclusion of MSM within the social networks of people who inject drugs. Findings underscore the need to evaluate the reproducibility of RDS in repeated rounds of IBBSS and to develop new sampling methods for key populations at high risk for HIV in order to track the epidemic, develop evidence-based prevention and care programs, and assess their impact.


Respondent-driven sampling Men who have sex with men HIV Sampling methods Recruitment methods Vulnerable populations Zanzibar Tanzania 



We thank the numerous members of the research design and data collection team as well as the men who participated in this study.


This research was supported by the President’s Emergency Plan for AIDS Relief (PEPFAR) through the Centers for Disease Control and Prevention (CDC), cooperative agreement 5UGPS002039-02, and Global Fund Round 6 for HIV/AIDS.

Compliance with Ethical Standards

Conflict of interest

The authors have no conflicts of interest.

Research Involving in Human Participants

The research did involve human subjects in Zanzibar.

Ethical Review

The research was reviewed and cleared by the Zanzibar Ethical Review Board (ZAMREC), CDC ADS Non-Research Determination and UCSF’s Committee on Human Research Protection.

Informed Consent

All participants were consented using an approved informed consent form.


The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the CDC or Global Fund.


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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Ahmed Khatib
    • 1
  • Shaaban Haji
    • 1
  • Maryam Khamis
    • 1
  • Christen Said
    • 3
  • Farhat Khalid
    • 1
  • Mohammed Dahoma
    • 2
  • Ameir Ali
    • 1
  • Asha Othman
    • 1
  • Susie Welty
    • 3
    Email author
  • Willi McFarland
    • 3
  1. 1.Zanzibar Integrated HIV TB and Leprosy ProgramMinistry of HealthZanzibarTanzania
  2. 2.Directorate of Preventive Services and Health EducationMinistry of HealthZanzibarTanzania
  3. 3.Global Health SciencesUniversity of CaliforniaSan FranciscoUSA

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