Background
Identifying effective strategies to engage Black sexual minority men living with HIV (SMM LWH), including those with diversity in HIV care outcomes, socio-economic status, and geography, is crucial to obtaining a robust understanding of the HIV epidemiology in this population and developing effective public health programming to end the U.S. HIV epidemic. However, strategies to effectively recruit this group demonstrate inconsistent efficacy and those with suboptimal care outcomes remain elusive. Therefore, we implemented and assessed targeted recruitment strategies for a digital, limited interaction cohort study to identify the most effective ways to engage this population.
Methods
A total of 1,006 Mid-Atlantic Black SMM LWH were recruited between 2023-2024 using targeted active and passive strategies including geosocial networking apps (i.e., Jack’d), community/clinical e-newsletters, private social media groups on Facebook, friends/word of mouth, and participants from previous studies. Bivariate analyses tested for associations between recruitment method and sociodemographic characteristics along with HIV care outcomes. Kruskal-Wallis and Chi-Square tests were conducted for associations with ordinal and binary measures respectively.
Results
Most participants were ages 25-44 (94.6%). Both advertisements were associated with recruitment spikes significantly greater than expected proportions. Jack’d ads yielded the most participants (36.3%) followed by friends/word of mouth (23.5%). Jack’d ads were associated with recruiting Black SMM LWH who were 18-34 years old, had lower education, and annual income of $80,000 or less. Participants recruited through Jack’d ads were more likely to have detectable HIV loads and have missed ART doses in the past month.
Conclusions
Geosocial networking platforms show significant promise to engage Black SMM LWH with sub-optimal HIV care outcomes, particularly younger individuals with lower socioeconomic status. Friends and social networks also show promise to engage this oftentimes referred to subpopulation as “hard-to-reach.” Future research should optimize and expand online advertising strategies and social networks to address care disparities, improve health outcomes, and reduce community viral load to mitigate further HIV transmission.