Factors associated with non-participation in a research: Observations from community engagement experiences in a home based VCT randomized controlled trial in Monze

Participation in research is crucial for success of research. It has been widely argued to be an important factor in interpreting research and implementation of the findings. In this study, factors associated with non-participation in the home based RCT VCT study in rural communities in Monze were explored.Methodology: Qualitative approaches using ethnographic methods that included observation and contextualization were employed. Triangulation was achieved using observation, in-depth interviews and focus group discussion (FGDs). Purposive sampling was used to select participants for the 8 FGDs (stratified by sex) in which each FGD consisted of 6-12 respondents. In-depth interviews were conducted with 20 key informants that were aged between 25-50 years. Data collected was transcribed replacing all identifiers with coded labels. Thematic content analysis employing iterative approaches and word processing guided the analysis. In addition for the in-depth interviews, systematic textual analysis was used to highlight quotes that support or refute identified themes.Results: Overall there were 20 in-depth interviews, 4 observations per village were conducted and 8 focus group discussions. Majority of the respondents from the FGDs were male (56.3%) aged between 25-49 years. Superstition and mistrust of the research assistants was cited consistently as a key reason for non-participation in the home based VCT RCT baseline survey by majority (97.8%) of the respondents. Many of the respondents described fears about the drawing of blood to test for HIV. Most of the key informants (15/20) cited mistrust to be the main reason of non-participation. The other factors that were identified included lack of understanding the study and benefits of participating, failure to respect culture and tradition, fear of violence by an intimate partner following HIV testing and disclosure of results, poor timing and prior negative engagements with the community.Conclusion: The findings of this study show that mistrust, superstition and lack of understanding of the study benefits were core factors associated with non participation in health research. This may underscore the need for setting specific and appropriate community engagement processes