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An Assessment of the Feasibility and Acceptability of a Friendship-Based Social Network Recruitment Strategy to Screen At-Risk African American and Hispanic/Latina Young Women for HIV Infection

Cherrie B. Boyer, PhD; Lisa Hightow-Weidman, MD, MPH; James Bethel, PhD; Su X. Li, MD; Lisa Henry-Reid, MD; Donna Futterman, MD, MSN, ARNP, PNP-BC; Donna Maturo, MSN; Diane M. Straub, MD; Kourtney Howell, BA; Shirleta Reid; Jaime Lowe, BS; Bill G. Kapogiannis, MD; Jonathan M. Ellen, MD
JAMA Pediatr. 2013;167(3):289-296. doi:10.1001/2013.jamapediatrics.398.
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Objectives  To examine the feasibility and acceptability of a friendship-based network recruitment strategy for identifying undiagnosed human immunodeficiency virus (HIV) infection within young women's same-sex friendship networks and to determine factors that facilitated and hindered index recruiters (IRs) in recruiting female friendship network members (FNMs) as well as factors that facilitated and hindered FNMs in undergoing HIV screening.

Design  A cross-sectional study design that incorporated dual incentives for IRs and their female FNMs.

Setting  The IRs were recruited through 3 Adolescent Trials Network for HIV/AIDS Interventions sites within their Adolescent Medicine Trials Units. Data were collected from January 1, 2009, through June 30, 2010.

Participants  The IRs self-identifying as HIV positive, negative, or status unknown were enrolled to recruit FNMs to undergo HIV screening.

Main Outcome Measures  Self-reports of HIV risk and facilitators and barriers to network recruitment and HIV screening were assessed using an audio-computer-assisted self-interview. Participants were identified as HIV negative or positive on the basis of an OraQuick HIV test with confirmatory enzyme-linked immunosorbent assay and/or Western blot tests.

Results  Nearly all (156 [98.1%]) eligible IRs agreed to participate and most (78.4%) recruited 1 or more FNMs. Of the 381 FNMs, most (342 [89.8%]) agreed to HIV screening. Although a high acceptance of HIV screening was achieved, the HIV prevalence was low (0.26%).

Conclusion  Our findings provide compelling evidence to suggest that use of a female friendship network approach is a feasible and acceptable means for engaging at-risk young women in HIV screening, as shown by their high rates of agreement to undergo HIV screening.

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