Recruitment Strategies to Prevent Fraudulent Virtual Enrollment While Respecting Privacy in Vulnerable Populations

Recruitment for qualitative research can have an added level of complexity when working with vulnerable populations, as stigma and confidentiality may play an important role in participants' willingness to engage. For example, people with HIV and other stigmatizing conditions may prefer to use a pseudonym to maintain confidentiality and may be discouraged from participation if asked to produce proof of diagnosis with a stigmatized condition. However, efforts to respect participant privacy and minimize burden while providing compensation for their time may leave studies vulnerable to infiltration by ineligible individuals who are motivated by the compensation. This article describes how efforts to respect the unique concerns of a vulnerable and stigmatized population, people who considered breastfeeding while living with HIV, resulted in the enrollment of non-eligible individuals in an in-depth interview study. We describe how the breach was discovered and the subsequent actions taken to balance study integrity with meeting the privacy needs of the target population. This example illuminates how scientific validity can be threatened by enrollment of individuals misrepresenting a target population, and the importance of developing approaches to ensure that vulnerable target populations can be reached while respecting privacy needs.