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Implementation Challenges to Using Respondent-Driven Sampling Methodology for HIV Biological and Behavioral Surveillance: Field Experiences in International Settings

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An Erratum to this article was published on 16 December 2008


Using respondent-driven sampling (RDS), we gathered data from 128 HIV surveillance studies conducted outside the United States through October 1, 2007. We examined predictors of poor study outcomes, reviewed operational, design and analytical challenges associated with conducting RDS in international settings and offer recommendations to improve HIV surveillance. We explored factors for poor study outcomes using differences in mean sample size ratios (recruited/calculated sample size) as the outcome variable. Ninety-two percent of studies reported both calculated and recruited sample sizes. Studies of injecting drug users had a higher sample size ratio compared with other risk groups. Study challenges included appropriately defining eligibility criteria, structuring social network size questions, selecting design effects and conducting statistical analysis. As RDS is increasingly used for HIV surveillance, it is important to learn from past practical, theoretical and analytical challenges to maximize the utility of this method.

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Special thanks to all of the RDS investigators who shared their protocols and related documents with us. We also wish to thank Meade Morgan, Senior Statistician, Global AIDS Program, Centers for Disease Control and Prevention, Atlanta, Georgia, for his contribution to the discussion on conducting regression analysis with RDS data and to Daniel Tancredi, of the Center for Healthcare Policy and Research, University of California, Davis, for his assistance with Poisson regression analysis. The authors acknowledge the support of the University Technical Assistance Projects at the Center for Global Health Equity, Tulane University, and the Institute for Global Health, University of California, San Francisco. Disclaimer: The findings and conclusions in this paper are those of the authors and do not necessarily represent those of donor agencies.

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Correspondence to Lisa Grazina Johnston.

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Johnston, L.G., Malekinejad, M., Kendall, C. et al. Implementation Challenges to Using Respondent-Driven Sampling Methodology for HIV Biological and Behavioral Surveillance: Field Experiences in International Settings. AIDS Behav 12 (Suppl 1), 131–141 (2008).

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