Bias in Online Recruitment and Retention of Racial and Ethnic Minority Men Who Have Sex With Men
Bias in Online Recruitment and Retention of Racial and Ethnic Minority Men Who Have Sex With Men
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DOI：
10.2196/jmir.1797
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发表时间：
2011-04-01
影响因子：
7.4
通讯作者：
DiClemente, Ralph J.
中科院分区：
文献类型：
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作者：
Sullivan, Patrick S.;Khosropour, Christine M.;DiClemente, Ralph J.
背景：互联网已成为男男性接触者 (MSM) 结识潜在性伴侣的越来越受欢迎的场所。鉴于 MSM 中在线寻求性行为的迅速增加，基于互联网的干预措施代表了一项重要的 HIV（人类免疫缺陷病毒）预防策略。不幸的是，黑人和西班牙裔男男性行为者在美国受到艾滋病毒流行的影响尤为严重，他们在在线研究中的代表性不足。目的：我们的目标是在一项针对从在线社交网站招募的男男性行为者的在线艾滋病毒行为风险研究中，检查和量化与有色人种男男性行为者招聘不足和保留不足相关的因素。方法：通过 MySpace.com 上的横幅广告招募使用互联网的男男性行为者，目标对象为在其报告中报告的男性。 MySpace 将他们的年龄描述为至少 18 岁，性取向为同性恋、双性恋或不确定。使用多变量逻辑回归模型来估计 MySpace 用户点击横幅广告的种族和民族分层的几率。为了描述调查保留率，Kaplan-Meier 生存曲线和多变量 Cox 比例风险模型确定了与调查退出相关的因素。结果：超过 30,000 名 MySpace 用户点击了研究横幅广告（点击率为 0.37%，即 8,257,271 次展示中的 30,599 次点击）。与白人（1,464,262 次展示中的 0.48% 或 6995 次点击）MySpace 用户相比，黑人（1,785,088 次展示中的 0.36% 或 6474 次点击）和西班牙裔（2,510,434 次展示中的 0.35% 或 8873 次点击）MySpace 用户的点击率较低。然而，与白人模特相比，黑人男性对展示黑人模特的广告的点击率更高（调整后的比值比 [OR] = 1.83，95% 置信区间 [CI] 1.72 - 1.95），而西班牙裔参与者在看到展示亚洲模特的广告与白人模特的广告时点击率更高（调整后的 OR = 1.70，95% CI 1.62 - 1.79）。在同意参与的 9005 名男性中，有 6258 名 (69%) 完成了整个调查。在仅报告男性性伴侣的参与者中，相对于非西班牙裔白人参与者，非西班牙裔黑人和西班牙裔参与者退出调查的可能性明显更大（风险比 [HR] = 1.6，95% CI 1.4 - 1.8 和 HR = 1.3，95% CI 1.1 - 1.4）。受过大学教育的男性比高中教育水平的男性更有可能完成调查（HR = 0.8，95% CI 0.7 - 0.9），而与自我认定为同性恋的男性相比，自我认定为异性恋的男性更有可能退出调查（HR = 2.1，95% CI 1.1 - 3.7）。结论：这项分析确定了与招募和保留男性员工相关的几个因素。 MSM 在线调查。不同的点击率和有色人种男男性行为者调查退出率的增加表明，在基于互联网的研究中招募和留住黑人和西班牙裔男男性行为者的方法至关重要。尽管通过改变广告的种族/民族构成来将横幅广告定位到有色人种男同性恋者可能会增加点击率，但一旦这些研究参与者参与调查，减少他们的流失仍然是一个挑战。
Background: The Internet has become an increasingly popular venue for men who have sex with men (MSM) to meet potential sex partners. Given this rapid increase in online sex-seeking among MSM, Internet-based interventions represent an important HIV (human immunodeficiency virus) prevention strategy. Unfortunately, black and Hispanic MSM, who are disproportionately impacted by the HIV epidemic in the United States, have been underrepresented in online research studies.Objective: Our objective was to examine and quantify factors associated with underrecruitment and underretention of MSM of color in an online HIV behavioral risk research study of MSM recruited from an online social networking site.Methods: Internet-using MSM were recruited through banner advertisements on MySpace.com targeted at men who reported in their MySpace profile their age as at least 18 and their sexual orientation as gay, bisexual, or unsure. Multivariable logistic regression models were used to estimate the odds stratified by race and ethnicity of the MySpace user clicking through the banner advertisement. To characterize survey retention, Kaplan-Meier survival curves and multivariable Cox proportional hazards models identified factors associated with survey dropout.Results: Over 30,000 MySpace users clicked on the study banner advertisements (click-through rate of 0.37%, or 30,599 clicks from 8,257,271 impressions). Black (0.36% or 6474 clicks from 1,785,088 impressions) and Hispanic (0.35% or 8873 clicks from 2,510,434 impressions) MySpace users had a lower click-through rate compared with white (0.48% or 6995 clicks from 1,464,262 impressions) MySpace users. However, black men had increased odds of click-through for advertisements displaying a black model versus a white model (adjusted odds ratio [OR] = 1.83, 95% confidence interval [CI] 1.72 - 1.95), and Hispanic participants had increased odds of click-through when shown an advertisement displaying an Asian model versus a white model (adjusted OR = 1.70, 95% CI 1.62 - 1.79). Of the 9005 men who consented to participate, 6258 (69%) completed the entire survey. Among participants reporting only male sex partners, black non-Hispanic and Hispanic participants were significantly more likely to drop out of the survey relative to white non-Hispanic participants (hazard ratio [HR] = 1.6, 95% CI 1.4 - 1.8 and HR = 1.3, 95% CI 1.1 - 1.4, respectively). Men with a college-level of education were more likely to complete the survey than those with a high-school level of education (HR = 0.8, 95% CI 0.7 - 0.9), while men who self-identified as heterosexual were more likely to drop out of the survey compared with men who self-identified as gay (HR = 2.1, 95% CI 1.1 - 3.7).Conclusions: This analysis identified several factors associated with recruitment and retention of MSM in an online survey. Differential click-through rates and increased survey dropout by MSM of color indicate that methods to recruit and retain black and Hispanic MSM in Internet-based research studies are paramount. Although targeting banner advertisements to MSM of color by changing the racial/ethnic composition of the advertisements may increase click-through, decreasing attrition of these study participants once they are engaged in the survey remains a challenge.