To assess the experienced or perceived barriers and facilitators to health research participation for major US racial/ethnic minority populations, we conducted a systematic review of qualitative and quantitative studies from a search on PubMed and Web of Science from January 2000 to December 2011. With 44 articles included in the review, we found distinct and shared barriers and facilitators. Despite different expressions of mistrust, all groups represented in these studies were willing to participate for altruistic reasons embedded in cultural and community priorities. Greater comparative understanding of barriers and facilitators to racial/ethnic minorities' research participation can improve population-specific recruitment and retention strategies and could better inform future large-scale prospective quantitative and in-depth ethnographic studies.

A Systematic Review of Barriers and Facilitators to Minority Research Participation Among African Americans, Latinos, Asian Americans, and Pacific Islanders.

Ontario HIV Treatment
Network; Canadian Institutes for Health Research; National Institues of Health (AI005535901, K23A106858201, AA015287, MH54907, AI27763); British Columbia Michael Smith Foundation; The Doris Duke Charitable Foundation

https://www.ghdonline.org/uploads/Adherence_to_HAART_A_Systematic_Review_of_Developed_and_Developing_Nation_Patient-Reported_Barriers_and_Facilitators_.pdf

Adherence to HAART: A Systematic Review of Developed and Developing Nation Patient-Reported Barriers and Facilitators

Network analysis is an approach to research that is uniquely suited to describing, exploring, and understanding structural and relational aspects of health. It is both a methodological tool and a theoretical paradigm that allows us to pose and answer important ecological questions in public health. In this review we trace the history of network analysis, provide a methodological overview of network techniques, and discuss where and how network analysis has been used in public health. We show how network analysis has its roots in mathematics, statistics, sociology, anthropology, psychology, biology, physics, and computer science. In public health, network analysis has been used to study primarily disease transmission, especially for HIV/AIDS and other sexually transmitted diseases; information transmission, particularly for diffusion of innovations; the role of social support and social capital; the influence of personal and social networks on health behavior; and the interorganizational structure of health systems. We conclude with future directions for network analysis in public health.

https://www.annualreviews.org/doi/pdf/10.1146/annurev.publhealth.28.021406.144132

Network Analysis in Public Health: History, Methods, and Applications

Background: Reproductive control including pregnancy coercion (coercion by male partners to become pregnant) and birth control sabotage (partner interference with contraception) may be associated with partner violence and risk for unintended pregnancy among young adult females utilizing family planning clinic services Study Design: A cross-sectional survey was administered to females ages 16–29 years seeking care in five family planning clinics in Northern California (N=1278) Results: Fifty-three percent of respondents reported physical or sexual partner violence, 19% reported experiencing pregnancy coercion and 15% reported birth control sabotage One third of respondents reporting partner violence (35%) also reported reproductive control Both pregnancy coercion and birth control sabotage were associated with unintended pregnancy (AOR 183, 95% CI 136–246, and AOR 158, 95% CI 114–220, respectively) In analyses stratified by partner violence exposure, associations of reproductive control with unintended pregnancy persisted only among women with a history of partner violence Conclusions: Pregnancy coercion and birth control sabotage are common among young women utilizing family planning clinics, and in the context of partner violence, are associated with increased risk for unintended pregnancy

Original research article Pregnancy coercion, intimate partner violence and unintended pregnancy ☆

Pregnancy coercion, intimate partner violence and unintended pregnancy ☆

BACKGROUND
Financial compensation for participating in research is controversial, especially when participants are recruited from economically disadvantaged and/or marginalized populations such as drug users. Little is known about these participants’ own views regarding payment for research participation.

Perceptions of Financial Payment for Research Participation among African-American Drug Users in HIV Studies

This study sought to determine whether drug-using male sex workers (MSWs) spatially bridge sexual networks across cities and to determine whether the behaviors of MSWs who bridge differ from the behaviors of those who do not. Data were collected from 42 MSWs in Houston, Texas, between May 2003 and February 2004. Spatial bridging was defined as having traded sex for money in another city before traveling to and trading in Houston. Cities bridged by MSWs were geographically plotted and were primarily located in the Gulf Coast and in Florida. Slightly less than half of MSWs were identified as spatially bridging from one city to another. A significantly higher proportion of MSWs who bridged cities were homosexual (55% vs. 23%) and HIV positive (31% vs. 5%). Those who bridged cities used marijuana and injected drugs more frequently and had significantly more male sex partners than MSWs who did not bridge cities. Despite the small sample size, this study found that many drug-using MSWs spatially bridge sexual networks in cities where they trade sex for money.

Spatial bridging in a network of drug-using male sex workers.

Under-representation of minority populations, particularly African Americans, in HIV/AIDS research is problematic because African Americans bear a greater disease burden from HIV/AIDS. Studies of motivations for participating in research have emphasized factors affecting individuals’ willingness to participate and barriers to participation, especially in regard to HIV vaccine research. Little is known about how underserved minority drug users perceive research and their decisions to participate. This study describes African American drug users’ perceptions of research participation and their decisions to participate based on three kinds of hypothetical HIV/AIDS-related clinical studies. In-depth, qualitative interviews were conducted with 37 underserved, African American crack cocaine users, recruited from participants already enrolled in three different behavioral HIV prevention studies. Interviews were recorded, transcribed, coded for themes and sub-themes and analyzed using directed and conventional content analysis. Participants’ decisions to take part in research often involved multiple motivations for participating. In addition, decisions to participate were characterized by four themes: a desire for information; skepticism and mistrust of research and researchers; perceptions of medical care and monitoring within a study; and participant control in decisions to participate or decline participation. Lack of adequate information and/or medical care and monitoring within a study were related to mistrust, while the provision of information was viewed by some individuals as a right and acknowledgement of the participant’s contribution to the study. Participants perceived, rightly or wrongly, that medical monitoring would control some of the risks of a study. Participants also described situations of exerting control over decisions to enter or withdraw from a research study. Preliminary findings suggest that continuous communication and provision of information may enhance enrollment and adherence. Further exploration of decisions to participate in research will add to the understanding of this complex phenomenon and enhance the ability of individuals with HIV/AIDS to benefit from research.

/pdf/decisions-to-participate-in-research-views-of-underserved-1pfbhwizpr.pdf

Decisions to participate in research: views of underserved minority drug users with or at risk for HIV

Some male sex workers (MSWs) are also engaging in a significant amount of illicit drug use and other high risk behavior. The purpose of this study was to examine demographic characteristics, HIV risk behaviors, and sex partner characteristics in a sample of MSW. Data were collected from 179 men who were trading sex for money in Houston, TX. In the past 30 days they reported an average of 56 male partners and 5 female partners. Of the 179 men, 152 had been tested for HIV and knew their status. Twenty-six percent of those tested had tested positive.

Characteristics, drug use, and sex partners of a sample of male sex workers.

Objectives: To examine the association between condom use and frequency of sex across sexual partner types. Methods: Data were collected from African American drug users residing in Washington, DC. Participants were asked to provide the first name of the last three partners with whom they had had vaginal sex, to define the type of relationship, the number of times they had had vaginal sex in the last 30 days with each partner, and whether they had used a condom during their last sexual encounter with each partner. Condom use was examined by frequency of sex in the past 30 days controlling for partner type. Results: Frequency of sexual encounters varied by partner type. The largest number of sexual encounters was with casual partners, followed by commercial and primary partners, respectively. Within partner types, participants had sex most frequently with primary partners. Condom use was lowest within primary partner relationships. Regardless of partner type, condom use varied consistently depending on the frequency of sex with the same partner. Conclusions: Condom use is related to the frequency of sex between partners when partner type is controlled. The association between frequency of sex and condom use is independent of partner type, suggesting that partner type may become less influential in determining condom use as the frequency of sex increases. This finding suggests that contextual factors determining condom use go beyond partner type designations and include other relationship variables. (Sex Transm Inf 2001;77:433‐435)

https://sti.bmj.com/content/sextrans/77/6/433.full.pdf

Sandra C. Timpson

Papers

Perceptions of Financial Payment for Research Participation among African-American Drug Users in HIV Studies

Spatial bridging in a network of drug-using male sex workers.

Decisions to participate in research: views of underserved minority drug users with or at risk for HIV

Characteristics, drug use, and sex partners of a sample of male sex workers.

An investigation of condom use by frequency of sex.