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Advancing methods in internet-based HIV research: European MSM Internet Study (EMIS) in 38 countries

International Academy of Sex Research annual meeting, Lisbon (Portugal), July 8-11th, 2012 (Invited Plenary)

Speakers: Peter Weatherburn, Axel J. Schmidt, Ford Hickson, David Reid, Rigmor Berg, Harm Hospers, Ulrich Marcus and the EMIS Network

Background: While some European countries have well established systems for behavioural and biological HIV surveillance among men who have sex with men (MSM), others have not commenced behavioural monitoring, and those systems that exist have incommensurate study design and measures. EMIS aimed to develop a pan-European internet-based survey on HIV-related male homosexual behaviours and prevention needs to both increase research capacity and to move towards harmonisation of existing systems.

Methods/Design: Six Associated Partners recruited another 77 Collaborating Partners from academia, public health and civil society across 35 countries. Partners’ existing surveys were collected and collated, producing a meta-survey which was discussed by all potential partners through rotating round-tables at a two day summit. Survey development continued iteratively through user piloting and partner feedback until the English language content was agreed. Transfer to an online survey application was followed by further testing before on-screen translation into 24 other languages, final testing and sign-off. The project’s visual identity and promotional materials were developed in close collaboration with national leads, tailoring products to match country specific needs while maintaining an overall project identity. Five international gay dating websites were contracted to send instant messages to their members with other survey promotion occurring via banners on 232 other websites. Daily real-time monitoring of responses allowed targeted spending of the advertising budget to maximise coverage of responses. Fieldwork occurred during June-August 2010. Over 184,469 responses were submitted of which 94.4% were eligible. Partners in 38 countries were handed back a national database of 100 or more respondents for national analysis and outputting, while the Associated Partners proceeded on comparisons among 174,000 respondents in 38 countries.

Discussion: EMIS demonstrated the feasibility of multi-country third-generation behavioural surveillance (ie. encompassing prevention needs) with limited public funding. Meaningful involvement of a large number of collaborators in the survey design, its visual identity and in promotional strategies ensured unprecedented coverage and scale of recruitment. Flexible planning was essential and a patchwork of recruitment was required across a range of commercial and community partners. Careful design, piloting and presentation ensured the survey was acceptable and had both perceived authority and community benefit.

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