Barriers and facilitators to participation of men who have sex with men and transgender women in HIV research in Jamaica

Abstract

To assess potential barriers and facilitators to participation in bio-behavioural surveillance surveys of men who have sex with men and transgender women (trans women) in Jamaica, we recruited participants for individual interviews and focus group discussions. Respondents included 3 trans women; 46 gay, bisexual and other men who have sex with men; and 3 cis gender women. Data from 46 men and 3 trans women were analysed to describe barriers and facilitators to participation in research. Barriers identified were: lack of perceived benefits from research participation due to high socioeconomic status; concerns about confidentiality and unintended disclosure; HIV fatigue and fear of knowing one’s HIV status; distrustful inter-group dynamics; and undesirable study location and hours. Facilitators to participation in research were: belonging to a marginalised subgroup of men who have sex with men or trans women; incentives; and trust in researchers and community input in planning the study. Findings emphasise the need to understand the individual, interpersonal and structural factors that shape relationships, disclosure and interactions to successfully enrol diverse samples of men who have sex with men and trans women.

Keywords:

• Transgender persons
• gay and other men who have sex with men
• sexual and gender minorities
• bio-behavioural surveillance surveys
• Jamaica

Acknowledgements

We would like to thank participants for generously sharing their insights, experiences and time with our study team. We thank our interviewers, the leadership and staff members of local NGOs and advocacy groups, and the members of the prevention TWG who supported recruitment and data collection. Finally, we thank Ivan Cruickshank, Neish McLean and Willi McFarland for providing feedback and comments. The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the US Centers for Disease Control and Prevention (CDC).

Disclosure statement

No potential conflict of interest was reported by the authors.

Funding

The US Centers for Disease Control and Prevention.

Notes

1 The term ‘men who have sex with men is used in HIV research to create an epidemiological category of groups of men with diverse sexual practices, sexual desires and sexual identities (Aggleton and Parker 2015). Men in this study reported insertive and/or receptive anal sex with other men in the last 12 months, and identified as gay, bisexual or heterosexual.

2 This paper describes findings from formative research used to plan a national BBSS among men who have sex with men and trans gender persons in Jamaica. The research was conducted to help the research team determine if RDS was an appropriate sampling method and to inform study logistics.

3 Participants spontaneously used the epidemiological category, ‘MSM’, to signify their identity.

4 Participants were informed that the minimum level of consent for participating in the proposed BBSS would be (1) a rapid HIV test and (2) a rapid syphilis test along with (3) completion of a behavioural questionnaire.