Utilizing social network theory and double incentivized recruitment to target high-risk heterosexual males for rapid STI screening.
*Scott Andrew White, Tulane University
Keywords: Chlamydia, Social Network, New Orleans, Mycoplasma Genitalium, Heterosexual Males, Rapid Urine Screening
Context: Over 1.3 million cases of Chlamydia trachomatis (Ct) were reported in the US in 2010 with highest rates found among African Americans and those living in the South; Louisiana ranked 3rd in the country. For men, most infections are asymptomatic and no national Ct screening program exists. Ct is highly infectious and tends to cluster in social networks that propagate transmission. Asymptomatic Ct+ males are a hard to reach population that requires innovative sampling techniques; therefore, targeting these ‘core’ transmitter groups for increased screening and treatment may effectively decrease Ct rates among men and women. Objectives: To determine the feasibility and effectiveness of utilizing social network referral in primarily African American populations to recruit men for rapid urine screening of N. gonorrhoeae, C. trachomatis and M. genitalium by measuring referral rates, prevalence of bacterial STIs, health seeking behaviors and sexual risk behaviors in this sub-population of social contacts. Methods: In New Orleans, LA, previously Ct+ men enrolled in a study of repeat bacterial infections are enlisted to act as social network recruiters. Participants are provided four referral cards to give to eligible men in their social network (friends, family, etc.). Men presenting at the clinic with a referral card are interviewed and urine screened. For each successful referral, a $10 incentive is provided to the recruiter and the man screened. Recruitment activity is monitored during the recruitment period and qualitative interviews are conducted with unsuccessful recruiters to elicit barriers to program utilization. Results: This study is ongoing. Initial results show high infection rates but also identify various barriers to implementation, particularly the ability of the recruit to come to the clinic. Further targeted screening, increased incentives and enhanced recruitment materials are proposed.