Try out PMC Labs and tell us what you think. Learn More. Social media, such as Facebook, may present an Craigslist sex Rosenberg to reach broad samples of MSM, but the extent to which those samples are comparable with men recruited from venue-based, time-space sampling VBTS is unknown.
The Kaplan-Meier method was used to assess month retention. Surveillance and research studies may recruit via Facebook with little evidence of bias, relative to VBTS. In VBTS, after a period of formative research, venues eg, bars, dance-clubs attended by MSM are identified by health department staff members and calendars marking the days and times of venue attendance are created. Afterwards, venues, days, and times are randomly chosen for recruitment each month [ 8 ]. Although it is an effective method to recruit MSM and to minimize some types of biases, it has limitations.
First, hiring, training, and retaining outreach staff is difficult as recruitment at venues requires staff that 1 are able to work highly variable schedules, including late nights and weekends, in outdoor settings, and poor weather, 2 collect valid and reliable data in many different venues, 3 minimize adverse events in venues, such as encounters with intoxicated and disorderly patrons, and 4 be culturally competent and racially diverse.
Third, support from the MSM community eg, members of HIV prevention community planning groups, MSM community-based organizations, and advocacy groups is crucial to formative research and the identification and access to important venues. Finally, seasonal patterns of venue attendance are an important barrier to recruitment [ 8 ].
Additionally, there are still concerns about how to best control for selection bias in VBTS due to the unequal sampling probabilities of participants, Craigslist sex Rosenberg MSM who visit gay venues more frequently are more likely to be sampled [ 8 - 11 ].
The limitations of VBTS, have led to an interest in developing other sampling methods that may allow researchers to complement VBTS by reaching comparable populations; the Internet and social media may present such an opportunity. The growth of the Internet, social networking websites, and mobile technology usage, especially among minorities, have presented new opportunities for recruiting and studying MSM populations.
Online recruitment presents potential advantages over VBTS: it has a greater reach, is less time consuming, and less expensive [ 1617 ]. However, online recruitment methods are not without limitations; Internet research has relied on convenience samples, and determining the source population limits the external validity of [ 18 ].
A recent study identified that banner-advertisement recruitment methods may underrepresent minority MSM, MSM with less education, and MSM who do not identify as gay [ 19 ]. Finally, excluding duplicate responders and computer robots, which can perform a wide variety of automated tasks on the Internet, determining adequate compensation, ensuring confidentiality, and developing appropriate consent procedures continue to be important concerns [ 20 ].
The comparability of online and VBTS samples of MSM has recently received scrutiny, with the former method generally considered to yield higher risk samples [ 1421 - 24 ].
To date, most Web-based studies of MSM have been cross-sectional with sampling occurring at specific online venues that are believed to contain higher-risk individuals eg, Craigslist, Manhunt, Grindrhave had low minority representation, and used self-reported data on HIV or sexually transmitted infections STI [ 24 - 27 ]. Facebook is a social networking site where a wide range of social interactions occur and, in comparison with other online venues, is not specifically used for seeking sex partners.
Finally, although the ability to recruit and retain a Web-based follow-up study using and text messaging has been demonstrated [ 2829 ], the relative success of retention in MSM in in-person studies recruited using online and VBTS methods is untested. The study methods have been described [ 31 ].
Recognizing the growing importance of Facebook as a social space for MSM and to increase recruitment, Facebook was included as a venue within our sampling frame 6 months after enrollment began. Facebook encompasses a broad range of social interactions that aligned with the variety of venues sampled through VBTS eg, bars, clubs, coffee shops, restaurants.
Recruitment through Facebook took place from January to December via placement of banner advertisements. Types of venues included in the sampling frame included bars, dance clubs, fitness clubs or gymnasiums, Gay Pride events, parks, restaurants, retail businesses, sex establishments, social organizations, street locations, and other special events.
Venue-date-time units were randomly sampled. At sampled venue-day-time units, male attendees were systematically sampled and approached by the study staff and administered a recruitment script and screening questions using a hand-held device. For Facebook sampling, paid banner advertisements were placed in the Facebook advertising interface.
Advertisements were delivered only to men 18 years of age or older who selected residing in Atlanta and interest in relationships with other men as demographic options on their Facebook profiles. Participants clicking on the banner advertisements were redirected to a Web-based survey where, after giving consent to screening, they were administered the same screening questions used for VBTS recruitment.
At the enrollment visit, potential participants were screened again for eligibility.
Following the written informed consent process, participants were tested for HIV, chlamydia and gonorrhea urethral and rectalsyphilis, and substances of abuse urine dipstick [ 31 ]. Participants completed a baseline computer-administered self-interview questionnaire. Those who tested HIV-negative were prospectively followed for 2 years, with visits at 3, 6, 9, 12, 18, and 24 months. This study was approved by the Emory University institutional review board protocol The Craigslist sex Rosenberg used in InvolveMENt is published [ 31 ]; responses to the baseline questionnaire were used in the present analysis.
To assess recent social media usage and Atlanta venue attendance, participants were asked the following: 1 Which of the following websites have you visited in the last month? Sexual risk behaviors were collected as partner totals. Using partnership-level responses on up to 5 most recent sex partners in 6 months, we created additional individual-level measures of partners met online, any serodiscussion [ 34 ], any sex with a discordant ie, when one partner is infected but not the other or unknown status partner, and alcohol or drug use at last sex.
InvolveMENt used race-stratified sampling to ensure that equal s of black and white MSM were recruited, thus, to adhere to the de of our study and to understand race-specific aspects of recruitment all were examined stratified by race. Participant use of social media and visits to Atlanta venues in the month was summarized and compared by recruitment method VBTS and Facebook using the Pearson chi-square test.
For individuals recruited via VBTS, differences in Facebook use overall and by venue of recruitment were described. Demographic characteristics were described for both recruitment methods overall and by race; differences were compared using Pearson chi-square tests.
Partner counts were described as medians and group differences were tested using Wald chi-square tests in bivariate negative-binomial regression. The prevalence of urethral STI in our sample was too small to permit analysis.
Due to ificant differences in the age distribution between recruitment methods, we used multivariate models to assess whether levels of key outcomes differed when controlling for race and age. We used multiple multivariate logistic regression models to estimate the effect of recruitment for dichotomous outcomes, with comparisons made using predicted marginal prevalence ratios PR and Wald chi-square tests. For partner counts, outcomes were modeled using negative binomial regression, although Poisson and log-linear models were also considered.
All models yielded similar parameter estimates and P values, and a goodness of fit test that compared the negative binomial and Poisson models [ 35 ] found Craigslist sex Rosenberg the negative binomial provided the best fit.
Measures of association estimated in negative binomial models were risk ratios RRs. All logistic and negative binomial models included race, age, and recruitment-method terms. An interaction term between recruitment method and race was included when modeling the outcome of syphilis infection because we detected a ificant interaction using the Breslow-Day test, and was tested with a likelihood ratio test during our modeling procedure. Retention to the month visit was analyzed using the Kaplan-Meier method. Log-rank tests were performed to compare recruitment groups by race.
All analyses were performed using SAS V9. Screening for Involvement occurred from July through December with sampling occurring at events located at 94 individual venues. Of 19, men approached at Atlanta venues, Of 6, men who clicked on the Facebook advertisement, A total of MSM were included in the analysis, of whom Of Facebook recruits, Among MSM recruited at Atlanta venues, Internet use and Atlanta venue attendance in the month are shown in Table 1.
Demographic comparisons by recruitment method are shown in Table 2. Interactions Craigslist sex Rosenberg race and demographic variables were not ificant. The of total and UAI partners in the 12 months were higher for Facebook recruits compared with Atlanta-venue recruits overall and among white MSM Table 3. Tests of interaction between race and recruitment type for risk behavior outcomes, substance use, partnership attributes, and HIV-testing were all non-ificant.
Although within-race differences between Facebook and Atlanta-venue recruits were nonificant, Atlanta-venue recruits overall were more likely to be infected with a rectal STI compared with Facebook recruits. Multivariate models adjusting simultaneously for race and age are presented in Table 5and were similar to obtained in bivariate analyses.
Adjusted multivariate models for risk behaviors, testing, and infections at baseline by recruitment type Facebook vs Atlanta Venues adjusting for age and race, InvolveMENt, Atlanta, GA. Study retention by race for Facebook and Venue recruits is shown in Figure 1.
A total of individuals were followed prospectively of whom Race-recruitment method-specific retention to the month visit estimates were We found no difference in month retention rates between recruitment methods.
Additionally, cost per screening completed and per study participant were lower for Facebook relative to VBTS. Our findings indicate that recruiting through Facebook may yield comparable samples with those obtained by current VBTS recruitment with similar retention and at a lower cost.
Although these findings support the notion that MSM recruited via Facebook might also have been sampled from Atlanta venues, it is unclear Craigslist sex Rosenberg Facebook recruits would have participated in the study had they been approached at Atlanta venues. More research is needed to explore whether ificant differences exist between MSM recruited via Internet and VBTS in factors motivating them to take part in research studies. Additionally, while This difference may be due to the oversampling of certain venues, because Facebook use differed by venue of recruitment; the difference might also be driven by the higher of white MSM recruited through Facebook, because they reported lower proportions of Facebook use in the month.
Nevertheless, research has shown that there are ificant differences in samples obtained at different venues [ 36 ], the expansion of this research to differences in the use of social media among different samples of MSM may provide insight into ways of complementing VBTS samples. ZIP: 77471 77469