Feasibility and Acceptability of a Prospective Syphilis Sexual Network Study for Sexual Minority Men

In preparation for a prospective syphilis network study of sexual minority men, we conducted a mixed-methods formative study with the following objectives: ( a ) assess acceptability of respondent-driven sampling, ( b ) assess acceptability of study procedures, ( c ) social network seed selection, and ( d ) pilot an ecological momentary assessment (EMA) study to assess social networking, sexual, and substance use behaviors.

We conducted in-depth interviews with 8 providers serving sexual minority men and 5 focus group discussions with 34 sexual minority men, prioritizing 4 target populations: (1) young Black sexual minority men, (2) on preexposure prophylaxis, (3) living with HIV, and (4) not engaged in care. The 4-week EMA pilot was conducted with 40 sexual minority men. Ecological momentary assessment survey responses were analyzed to evaluate how different compensation levels influenced response rates. Brief exit surveys were used to assess EMA app acceptability.

Primary themes identified through qualitative data collection: (1) importance of developing trust and maintaining confidentiality during proposed recruitment activities, (2) importance of compensating participants appropriately for study activities, and (3) cultural considerations for increasing visibility and participation of young Black sexual minority men. All EMA participants reported being "completely comfortable" reporting sexual behavior through the app. Most (78%) preferred the app to in-person interviews. Several participants identified technical issues with the app, including not receiving push notifications and spontaneous closure.

This mixed-methods formative study allowed for adjustments to and tailoring of the planned network study, including recruitment protocols, compensation type and amount, and EMA survey wording and response items.