Recruiting people who inject drugs (PWID) into research: benefits and challenges of respondent driven sampling (RDS) in a sample in KwaZulu-Natal, South Africa

Abstract

People who inject drugs (PWID) are often excluded in research due to social circumstances and a lack of creativity when recruiting this community. Respondent driven sampling (RDS) is one method used to access marginalised and stigmatised communities such as PWID. This study piloted RDS with PWID in eThekwini District, South Africa, and also explored participants’ perspectives of the usefulness of this approach to recruit PWID. In-depth interviews (IDIs) were conducted with 10 key stakeholders, followed by a cross-sectional survey among 45 PWID recruited via RDS. Further, 11 of these PWID participated in IDIs. Survey data were entered into REDCap and descriptively analysed. IDIs were transcribed, translated and thematically analysed using Dedoose software. Participants described barriers and facilitators accessing PWID for research. Access to PWID was viewed as challenging because of factors including stigma and concerns of criminalisation. However, making use of PWID networks and peers was felt to be important to facilitate recruitment. RDS was described as an acceptable recruitment strategy, and was rated as “not burdensome” by most (98%). RDS was successfully carried out in this pilot. Participation of PWID in research was viewed as important, but challenging. It was felt that participation of PWID could be impacted by concerns of opioid withdrawal, therefore timing (length and time) of participation was important to consider in study design. Reimbursement strategies for PWID participating in research were discussed. Incentives for participation, including cash reimbursement, were viewed favourably for PWID. RDS is plausible for recruitment of PWID in eThekwini District, South Africa. It can be used to further understand PWID networks and to better serve them for future research and appropriate care. N/A, not a clinical trial.