| Sumario: | Background: Black and Latino communities are disproportionately affected by HIV, and are often underrepresented in sexual health research. It is crucial to understand their participation in research, and gauge the impact of non-response bias in reported results. A sequential multimodal approach to recruitment could potentially increase the response rates and representativeness of the sample by increasing the likelihood of response from the participants. However, data on the use of various recruitment approaches (i.e. low-barrier strategies) for engaging patients from urban Federally Qualified Health Centers in sexual health research are limited. Methods: We analyzed survey recruitment data among patients prescribed PrEP at Federally Qualified Health Centers serving largely black and Latino/a communities to understand the impact of virtual recruitment. We used four sequential attempts over 6 months to recruit participants for an incentivized patient feedback survey on sexual health and PrEP services. We also examined demographic differences, including age, sexual identity, gender identity and race/ethnicity, between responders and non-responders. Results: We recruited participants from January to June 2022. The overall response rate was 20.8% (54/259). There was an incremental increase in responses based on the number of strategies used: 66.7% (36/54) of participants were recruited by using one strategy (email only), 22.2% (12/54) were recruited by using two strategies (email and phone calls) and 11.1% (6/54) were recruited using three (email, phone calls and SMS) or four strategies (email, phone calls, SMS and an additional phone call). Responders had received a more recent PrEP prescription compared with non-responders; mean ± s.d. months between the most recent PrEP prescription and the first recruitment attempt date of the study was 15 ± 17 months for responders and 27 ± 24 months for non-responders. We observed no other significant differences in demographic characteristics between responders and non-responders. Conclusion: Response rates to an online sexual health survey among urban Federally Qualified Health Center patients were low using sequential multimodal virtual recruitment approaches, particularly among those without recent healthcare engagement. There were no demographic differences between responders and non-responders. Findings highlight the need for alternative innovative methods for research engagement and to reduce potential bias. Black and Latino communities are disproportionately affected by HIV, and are underrepresented in sexual health research. We tested a multimodal virtual outreach strategy (email, SMS, phone calls) to recruit patients on PrEP from urban health centers for a sexual-health survey. Response rates were low, particularly among those without recent healthcare engagement. These findings indicate that virtual, low-barrier strategies alone are insufficient and may introduce bias, highlighting the need for alternative strategies to ensure equitable, representative participation.
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