{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T00:29:02Z","timestamp":1775262542722,"version":"3.50.1"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,11,18]],"date-time":"2022-11-18T00:00:00Z","timestamp":1668729600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,11,18]],"date-time":"2022-11-18T00:00:00Z","timestamp":1668729600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"National Institutes for Health, National Cancer Institute","award":["R01CA206477"],"award-info":[{"award-number":["R01CA206477"]}]},{"name":"National Institutes for Health, National Cancer Institute","award":["R01CA206477"],"award-info":[{"award-number":["R01CA206477"]}]},{"name":"National Institutes for Health, National Cancer Institute","award":["R01CA206477"],"award-info":[{"award-number":["R01CA206477"]}]},{"name":"National Institutes for Health, National Cancer Institute","award":["R01CA206477"],"award-info":[{"award-number":["R01CA206477"]}]},{"name":"Public Health Program, College of Health Sciences and Education, Touro University California"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Med Res Methodol"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Anal human papillomavirus (HPV) disproportionately affects men who have sex with men (MSM), particularly those who are older and those living with HIV. After experiencing difficulty recruiting older MSM into a study on aging and anal HPV, we conducted a sub-study to gain feedback on our recruitment methods and explore barriers and facilitators to participating in anal HPV research.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We conducted focus groups with 30 men who have sex with men (MSM), both HIV-negative and MSM living with HIV, ages 50\u201375.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>We identified multiple themes that were barriers to participation including: (1) <jats:italic>lack of knowledge<\/jats:italic> about human papillomavirus and anal cancer; (2) <jats:italic>research focused on anal cancer<\/jats:italic> or discomfort with topics or procedures concerning the anus; (3) <jats:italic>stigma<\/jats:italic> including stigma associated with being men who have sex with men, being out, being a receptive partner, and being considered \u201colder\u201d in the gay community; and (4) <jats:italic>confidentiality concerns<\/jats:italic> including a fear of breach of confidentiality. Facilitators to participation were also identified; these <jats:italic>motivational<\/jats:italic> factors include altruism, wanting recommendations from a doctor, and desire to receive the best available care.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Researchers seeking to enroll older men who have sex with men should be aware of these barriers and facilitators to participation in order to maximize recruitment.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12874-022-01752-0","type":"journal-article","created":{"date-parts":[[2022,11,18]],"date-time":"2022-11-18T20:05:17Z","timestamp":1668801917000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["\u201cThe problem is that our culture is just so messed up about aging.\u201d Recruiting older men who have sex with men (MSM) into research studies: an example from a study of aging, HIV, and anal HPV."],"prefix":"10.1186","volume":"22","author":[{"given":"Alexandra L.","family":"Hernandez","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher Scott","family":"Weatherly","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sahai","family":"Burrowes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica Lopez","family":"Jimenez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryan","family":"Gonzalez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joel M.","family":"Palefsky","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,11,18]]},"reference":[{"key":"1752_CR1","unstructured":"Margolies L, Goeren B. Anal cancer, HIV, and gay\/bisexual men. Poz [Internet]. 2009;(157):1\u20132."},{"issue":"1","key":"1752_CR2","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1002\/ijc.33185","volume":"148","author":"GM Clifford","year":"2021","unstructured":"Clifford GM, Georges D, Shiels MS, Engels EA, Albuquerque A, Poynten IM, et al. A meta-analysis of anal cancer incidence by risk group: Toward a unified anal cancer risk scale. Int J Cancer. 2021;148(1):38\u201347.","journal-title":"Int J Cancer"},{"key":"1752_CR3","doi-asserted-by":"crossref","unstructured":"Hernandez AL, Weatherly CS, Gonzalez R, Farhat S,  Da Costa M, Calderon J,  et al. Rationale and Design of the Anal HPV, HIV and Aging (AHHA) Study: protocol for a prospective study of anal HPV infection and HSIL among men who have sex (MSM) living with HIV and HIV-negative MSM ages 50 and older. Frontiers in Epidemiology. In press (2022).","DOI":"10.3389\/fepid.2022.992718"},{"key":"1752_CR4","unstructured":"Centers for Disease Control and Prevention. HIV Among People Aged 50 and Older [Internet]. Bethesda; 2018. Available from: https:\/\/www.cdc.gov\/hiv\/group\/age\/olderamericans\/index.html."},{"key":"1752_CR5","doi-asserted-by":"publisher","unstructured":"High KP, Brennan-Ing M, Clifford DB, Cohen MH, Currier J, Deeks SG, et al. HIV and aging: state of knowledge and areas of critical need for research. A report to the NIH Office of AIDS Research by the HIV and Aging Working Group. J Acquir Immune Defic Syndr [Internet]. 2012 Jul 1;60 Suppl 1:S1-18. https:\/\/doi.org\/10.1097\/QAI.0b013e31825a3668.","DOI":"10.1097\/QAI.0b013e31825a3668"},{"key":"1752_CR6","unstructured":"Centers for Disease Control and Prevention. HIV Surveillance Supplemental Report Vol 23(1) [Internet]. Bethesda; 2018. Available from: http:\/\/www.cdc.gov\/hiv\/library\/reports\/hiv-surveillance.html."},{"key":"1752_CR7","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1146\/annurev-med-042909-093756","volume":"62","author":"SG Deeks","year":"2011","unstructured":"Deeks SG. HIV infection, inflammation, immunosenescence, and aging. Annu Rev Med [Internet]. 2011;62:141\u201355. https:\/\/doi.org\/10.1146\/annurev-med-042909-093756.","journal-title":"Annu Rev Med [Internet]"},{"issue":"11","key":"1752_CR8","doi-asserted-by":"publisher","first-page":"1130","DOI":"10.1093\/cid\/cir626","volume":"53","author":"B Hasse","year":"2011","unstructured":"Hasse B, Ledergerber B, Furrer H, Battegay M, Hirschel B, Cavassini M, et al. Morbidity and aging in HIV-infected persons: the Swiss HIV cohort study. Clin Infect Dis [Internet]. 2011 Dec;53(11):1130\u20139. https:\/\/doi.org\/10.1093\/cid\/cir626.","journal-title":"Clin Infect Dis [Internet]"},{"key":"1752_CR9","doi-asserted-by":"crossref","unstructured":"Katz MH, Chang SW, Buchbinder SP, Hessol NA, O\u2019Malley P, Doll LS. Health insurance and use of medical services by men infected with HIV. J Acquir Immune Defic Syndr Hum Retrovirol [Internet]. 1995 Jan 1;8(1):58\u201363.","DOI":"10.1097\/00042560-199501000-00009"},{"issue":"3","key":"1752_CR10","doi-asserted-by":"publisher","first-page":"M146","DOI":"10.1093\/gerona\/56.3.m146","volume":"56A","author":"L Fried","year":"2001","unstructured":"Fried L, Tangen C, Walston J, Newman A, Hirsch C, Gottdiener J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol. 2001;56A(3):M146\u201356. https:\/\/doi.org\/10.1093\/gerona\/56.3.m146.","journal-title":"J Gerontol"},{"issue":"8","key":"1752_CR11","doi-asserted-by":"publisher","first-page":"e0181494","DOI":"10.1371\/journal.pone.0181494","volume":"12","author":"B Cornwell","year":"2017","unstructured":"Cornwell B, Schneider JA. Social venue range and referral chain impact: Implications for the sampling of hidden communities. PLoS One [Internet]. 2017;12(8):e0181494. https:\/\/doi.org\/10.1371\/journal.pone.0181494.","journal-title":"PLoS One [Internet]"},{"issue":"2","key":"1752_CR12","doi-asserted-by":"publisher","first-page":"86","DOI":"10.5681\/hpp.2011.009","volume":"1","author":"A Shaghaghi","year":"2011","unstructured":"Shaghaghi A, Bhopal RS, Sheikh A. Approaches to Recruiting \u201cHard-To-Reach\u201d Populations into Re-search: A Review of the Literature. Heal Promot Perspect [Internet]. 2011;1(2):86\u201394. https:\/\/doi.org\/10.5681\/hpp.2011.009.","journal-title":"Heal Promot Perspect [Internet]"},{"issue":"3","key":"1752_CR13","doi-asserted-by":"publisher","first-page":"e37","DOI":"10.2196\/resprot.3342","volume":"17","author":"AC Hernandez-Romieu","year":"2014","unstructured":"Hernandez-Romieu AC, Sullivan PS, Sanchez TH, Kelley CF, Peterson JL, Del Rio C, et al. The comparability of men who have sex with men recruited from venue-time-space sampling and Facebook: a cohort study. JMIR Res Protoc [Internet]. 2014 Jul;17(3):e37. https:\/\/doi.org\/10.2196\/resprot.3342.","journal-title":"JMIR Res Protoc [Internet]"},{"key":"1752_CR14","doi-asserted-by":"publisher","unstructured":"Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Heal Care [Internet]. 2007 Sep 16;19(6):349\u201357. https:\/\/doi.org\/10.1093\/intqhc\/mzm042.","DOI":"10.1093\/intqhc\/mzm042"},{"issue":"3","key":"1752_CR15","doi-asserted-by":"publisher","first-page":"398","DOI":"10.1111\/nhs.12048","volume":"15","author":"M Vaismoradi","year":"2013","unstructured":"Vaismoradi M, Turunen H, Bondas T. Content analysis and thematic analysis: Implications for conducting a qualitative descriptive study. Nurs Health Sci [Internet]. 2013 Sep;15(3):398\u2013405. https:\/\/doi.org\/10.1111\/nhs.12048.","journal-title":"Nurs Health Sci [Internet]"},{"key":"1752_CR16","volume-title":"web application for managing, analyzing, and presenting qualitative and mixed method research data","author":"Dedoose","year":"2019","unstructured":"Dedoose. web application for managing, analyzing, and presenting qualitative and mixed method research data. Los Angeles: SocioCultural Research Consultants LLC; 2019."},{"key":"1752_CR17","doi-asserted-by":"publisher","first-page":"1","DOI":"10.17169\/fqs-9.1.363","volume-title":"The Practice of Qualitative Research","author":"S Biber","year":"2010","unstructured":"Biber S, Leavy P. The Practice of Qualitative Research. 2nd ed. Los Angeles: SAGE Publications Inc; 2010. 1\u2013424 p. https:\/\/doi.org\/10.17169\/fqs-9.1.363.","edition":"2"},{"key":"1752_CR18","doi-asserted-by":"publisher","unstructured":"Guest G, Bunce A, Johnson L. How Many Interviews Are Enough? Field methods [Internet]. 2006 Feb 21;18(1):59\u201382. https:\/\/doi.org\/10.1177\/1525822X05279903.","DOI":"10.1177\/1525822X05279903"},{"key":"1752_CR19","doi-asserted-by":"publisher","unstructured":"Guest G, Namey E, McKenna K. How Many Focus Groups Are Enough? Building an Evidence Base for Nonprobability Sample Sizes. Field methods [Internet]. 2017 Feb 24;29(1):3\u201322. https:\/\/doi.org\/10.1177\/1525822X16639015.","DOI":"10.1177\/1525822X16639015"},{"key":"1752_CR20","doi-asserted-by":"publisher","unstructured":"Bonvicini KA. LGBT healthcare disparities: What progress have we made? Patient Educ Couns [Internet]. 2017 Dec;100(12):2357\u201361. https:\/\/doi.org\/10.1016\/j.pec.2017.06.003.","DOI":"10.1016\/j.pec.2017.06.003"},{"issue":"6","key":"1752_CR21","doi-asserted-by":"publisher","first-page":"1114","DOI":"10.2105\/AJPH.2014.302448","volume":"105","author":"J Khalili","year":"2015","unstructured":"Khalili J, Leung LB, Diamant AL. Finding the Perfect Doctor: Identifying Lesbian, Gay, Bisexual, and Transgender\u2013Competent Physicians. Am J Public Health [Internet]. 2015 Jun;105(6):1114\u20139. https:\/\/doi.org\/10.2105\/AJPH.2014.302448.","journal-title":"Am J Public Health [Internet]"},{"key":"1752_CR22","doi-asserted-by":"publisher","DOI":"10.1097\/00042560-199806010-00009","author":"RA Jenkins","year":"1998","unstructured":"Jenkins RA, Chinaworapong S, Morgan PA, Ruangyuttikarn C, Sontirat A, Chiu J, et al. Motivation, recruitment, and screening of volunteers for a phase I\/II HIV preventive vaccine trial in Thailand. J Acquir Immune Defic Syndr Hum Retrovirol [Internet]. 1998 Jun 1;18(2):171\u20137. https:\/\/doi.org\/10.1097\/00042560-199806010-00009."},{"key":"1752_CR23","volume-title":"A woman\u2019s disease: the history of cervical cancer","author":"I Lowy","year":"2011","unstructured":"Lowy I. A woman\u2019s disease: the history of cervical cancer. Oxford: Oxford University Press; 2011."},{"key":"1752_CR24","unstructured":"Denso Wave Incorporated. QR Code Generator [Internet]. 2018 [cited 2018 Jan 9]. Available from: https:\/\/www.qr-code-generator.com\/."},{"key":"1752_CR25","doi-asserted-by":"publisher","unstructured":"Kutner BA, Simoni JM, Aunon FM, Creegan E, Bal\u00e1n IC. How Stigma Toward Anal Sexuality Promotes Concealment and Impedes Health-Seeking Behavior in the U.S. Among Cisgender Men Who Have Sex with Men. Arch Sex Behav [Internet]. 2021 https:\/\/doi.org\/10.1007\/s10508-019-01595-9.","DOI":"10.1007\/s10508-019-01595-9"},{"key":"1752_CR26","doi-asserted-by":"publisher","unstructured":"Ravenhill JP, de Visser RO. \u201cIt Takes a Man to Put Me on the Bottom\u201d: Gay Men\u2019s Experiences of Masculinity and Anal Intercourse. J Sex Res [Internet]. 2018 Oct 13;55(8):1033\u201347. https:\/\/doi.org\/10.1080\/00224499.2017.1403547.","DOI":"10.1080\/00224499.2017.1403547"},{"key":"1752_CR27","doi-asserted-by":"publisher","unstructured":"Dangerfield DT, Smith LR, Williams J, Unger J, Bluthenthal R. Sexual Positioning Among Men Who Have Sex With Men: A Narrative Review. Arch Sex Behav [Internet]. 2017 May 13;46(4):869\u201384. https:\/\/doi.org\/10.1007\/s10508-016-0738-y.","DOI":"10.1007\/s10508-016-0738-y"},{"key":"1752_CR28","unstructured":"University of California San Francisco (UCSF). Anal HPV. Healthy Aging [Internet]. AHHA Study. 2018 [cited 2020 Dec 2]. Available from: www.ahhastudy.org."},{"issue":"1","key":"1752_CR29","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1097\/00002480-200101000-00002","volume":"47","author":"BJ Seelig","year":"2001","unstructured":"Seelig BJ, Dobelle WH. Altruism and the volunteer: psychological benefits from participating as a research subject. ASAIO J [Internet]. 2001 Feb;47(1):3\u20135. https:\/\/doi.org\/10.1097\/00002480-200101000-00002.","journal-title":"ASAIO J [Internet]"},{"issue":"4","key":"1752_CR30","doi-asserted-by":"publisher","first-page":"299","DOI":"10.1177\/1556264616679537","volume":"11","author":"LJ Chin","year":"2016","unstructured":"Chin LJ, Berenson JA, Klitzman RL. Typologies of Altruistic and Financial Motivations for Research Participation. J Empir Res Hum Res Ethics [Internet]. 2016 Oct;11(4):299\u2013310. https:\/\/doi.org\/10.1177\/1556264616679537.","journal-title":"J Empir Res Hum Res Ethics [Internet]"},{"key":"1752_CR31","doi-asserted-by":"publisher","unstructured":"Zanni MV, Fitch K, Rivard C, Sanchez L, Douglas PS, Grinspoon S, et al. Follow YOUR Heart: development of an evidence-based campaign empowering older women with HIV to participate in a large-scale cardiovascular disease prevention trial. HIV Clin Trials [Internet]. 2017 Mar 4;18(2):83\u201391. https:\/\/doi.org\/10.1080\/15284336.2017.1297551.","DOI":"10.1080\/15284336.2017.1297551"},{"key":"1752_CR32","doi-asserted-by":"publisher","unstructured":"Nyasani DK, Mutua GN, Sajabi RM, Ng\u2019ang\u2019a JW, Gachie JN, Maina AM, et al. Reported willingness to participate in a hypothetical HIV vaccine trial and its translation to actual participation among healthy adults-Experience from Kenya. PLoS One [Internet]. 2018;13(11):e0206656. https:\/\/doi.org\/10.1371\/journal.pone.0206656.","DOI":"10.1371\/journal.pone.0206656"}],"container-title":["BMC Medical Research Methodology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12874-022-01752-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12874-022-01752-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12874-022-01752-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,11,18]],"date-time":"2022-11-18T20:07:39Z","timestamp":1668802059000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcmedresmethodol.biomedcentral.com\/articles\/10.1186\/s12874-022-01752-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,18]]},"references-count":32,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["1752"],"URL":"https:\/\/doi.org\/10.1186\/s12874-022-01752-0","relation":{"references":[{"id-type":"uri","id":"","asserted-by":"subject"}]},"ISSN":["1471-2288"],"issn-type":[{"value":"1471-2288","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,18]]},"assertion":[{"value":"14 August 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 July 2022","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 October 2022","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 November 2022","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All methods for this study were approved by the University of California, San Francisco (UCSF) Institutional Review Board before initiation of study procedures. All procedures performed in studies involving human participants were in accordance with the ethical standards of the UCSF Human Research Protection Program and Institutional Review Board number: 16-18966 and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors have no relevant financial or non-financial interests to disclose.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"296"}}