From Willingness to Involvement: Development of a Successful Brand Strategy for Recruitment of Diverse MSM in a Longitudinal HIV Research Study

Background:  We conducted formative research to develop a HIV prevention research brand strategy. The development of the "InvolveMENt" brand focused on effective messaging of study aims, communication of study credibility, promotion of study resonance, and bolstering motivation to participate. Our goal was to achieve equally proportionate inclusion (50/50) and high retention (≥80% at 24 month follow up) of black MSM compared to white MSM for the longitudinal cohort study to explain disparities in HIV incidence between black and white MSM aged 18-39 years. Younger MSM (ages 13-24) have experienced a substantial increase in new infections (22%, N=8,800 cases) from 2008-2010 22 percent with young black MSM representing the majority (55%, N=4,800 cases) of infections in this group.  As a result, young black MSM remain disproportionally impacted by the disease compared to other groups Black MSM are underrepresented in HIV biomedical and behavioral research studies which impacts generalizability of study findings. 

Program background: The InvolveMENt study examines the disparity of HIV prevalence and infection rate between white and black MSM, and ultimately help reduce the risk of HIV for all MSM.By December 2012, the "InvolveMENt" study enrolled 461 (57%) black and 350 (43%) white non-Hispanic MSM and achieved a high retention rate at 24-months: 82% and 83% for black and white participants, respectively.

Evaluation Methods and Results:We employed a mixed methods approach including focus groups (N=6 of 5-13 persons each) comprised of white /multiracial (n=14, 28%) and black (n=38, 72%) MSM and questionnaires inclusive of sociodemographic and study participation intention items. Partner organizations facilitated recruitment of men from a variety of community settings to ensure broad sociodemographic representation of black MSM. Descriptive statistics and chi-square analyses were performed on quantitative data from focus group participants (N=54). Qualitative data were transcribed, independently coded by two coders, and content analyzed to identify common themes related to participating in HIV prevention research studies. We established a high intercoder reliability (ICR) of k=0.92. Quantitative results indicated that younger black MSM (18-30 years) were less likely to think about joining prevention studies compared to older (≥30 years) black MSM (x²=5.92, p=0.015). Qualitative results indicate four prominent themes: (1) underlying issues that influence participation, (2) participation barriers and motivators, (3) perceptions of HIV research, and (4) the need for increased and consistent black MSM presence in pre-implementation, implementation, and post-implementation of clinical trials. A strong theme emerged regarding the need for improved community engagement of social networks, education, novel social marketing, and the establishment of coalitions to effectively address misconceptions about HIV prevention research and foster greater participation in HIV research.

Conclusions: Despite reservations about prevention study participation, black MSM in our formative study expressed a need for active involvement and greater education about HIV research to facilitate their engagement in HIV prevention research. Thus, the brand concept of "InvolveMENt" emerged, emphasizing a strong need for inclusion. 

Implications for research and/or practice:The findings highlight the importance of behavioral-communication translational research to effectively engage hard-to-reach populations.