Applying Maslow's Hierarchy of Needs to Understand Research Participation Among Young Men Who Have Sex With Men

Young men who have sex with men (YMSM) are underrepresented in biomedical research. Although prior studies have documented barriers to participation, none have applied a framework to understand layered motivations and barriers to participation. This study takes a novel approach by applying Maslow's hierarchy of needs as an interpretive framework to explore factors influencing YMSM participation in a Phase I HIV prevention trial, with a specific focus on how different needs shape research participation.

We conducted in-depth, semistructured interviews with 44 YMSM (ages 18-24 years) eligible for a Phase I trial evaluating a rectal pre-exposure prophylaxis (PrEP) product. Interviews explored motivations, perceived risks, logistical constraints, and staff interactions. Data were analyzed thematically using a hybrid inductive-deductive approach, with themes later organized according to Maslow's hierarchy of needs.

Participants described a range of motivations across all tiers of Maslow's hierarchy. Higher-order needs, such as altruism, personal growth, and community contribution, were prominent drivers for participation. However, barriers to participation, such as mistrust of institutions, stigma, scheduling burdens, and transportation challenges, correlated with unfulfilled basic needs. Participants recommended youth-centered outreach, flexible logistics, and transparent and upfront communication to promote engagement.

YMSM decision-making around biomedical research is complex. Addressing only lower-tier barriers, such as offering transportation and flexible appointment times, is insufficient. Instead, researchers must adopt a humanistic, developmentally informed approach that amplifies aspirational motivators. Using Maslow's framework offers a novel lens to align recruitment strategies with the lived experiences and needs of youth.