Background: Traditional screening programs for Chlamydia trachomatis (Ct) and Neisseria gonorrhoeae (GC) infections principally rely on identifying some combination of risk factors to determine who to screen.
Objectives: To develop and evaluate a programmatic approach to modifying Respondent Driven Sampling (RDS) as a method to prospectively screen for Ct/GC in socio-sexual networks of infected and uninfected persons.
Methods: Using two components of RDS methodology, the systematic referral scheme and the dual incentive structure, we developed a program to refer social and sexual contacts for Ct/GC screening. Initial seed participants 15 to 24 years old are identified and asked to recruit their peers for screening, who in turn recruit their peers, and so on. Persons receive incentive for their own participation ($10) in addition to receiving an incentive for the participation of those they refer ($10). Participants are instructed to refer five people from their network of social and sexual contacts. Participants provide a urine specimen for Ct/GC screening and complete a brief survey questionnaire.
Results: Seed identification and recruitment began in January 2009 (data collection ongoing). To date, a total of 121 participants have been recruited of whom 58 (48%) are seeds and 63 (52%) are referrals. Approximately one-fourth of participants successfully recruited referrals into the project. Of the 30 participants successful in recruiting others, 12 (40%) were initial seeds and 18 (60%) were subsequent referrals. The majority of those referred indicated that they were friends with the person who referred them (78%) and 13% were related. Only one participant indicated they were the boy/girlfriend of the person who referred them. Among the referrals, 9 (14%) were Ct positive and 1 (2%) was GC positive.
Conclusions: Adolescents and young adults are willing to refer their social contacts for Ct/GC screening.
Implications for Programs, Policy, and/or Research: Referring social contacts for Ct/GC screening provides a productive complement to traditional contact tracing activities.