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Substance Use

National Online Survey of People Who Use Drugs: Challenges and Potential Solutions Winston Luhur* Winston Luhur Cristina Chin Czarina Navos Behrends

The majority of surveys of people who inject drugs (PWID) are limited in reach and access to the full population of PWID, both in geography and diversity, due to limitations of reaching this hidden population through usual recruitment methods. People of color, LGBTQIA+ people, people residing in rural areas and/or harm reduction deprived areas, and people who rarely connect with harm reduction services are the least surveyed and understood PWID populations. Online-based recruitment and surveys may be a pathway to reach these hidden populations of PWID. As the use of technology and internet access becomes more ubiquitous, research using online-based recruitment and survey techniques are growing in the field of substance use. While there is great promise for using these methods to obtain larger and more diverse samples of PWID, the methods for implementing online methods for recruitment and survey administration are not well established in the field of substance use and pose various challenges, including determining best practices for online recruitment in order to maximize data validity, prevent fraudulent responses, and minimize sampling biases. With the HOME (Harm reduction services Offered through Mail-delivery Expansion) study, we aim to determine the acceptability and use of mail-based harm reduction services for PWID across the United States, with an emphasis on PWID who are not connected to existing harm reduction services. We will describe the successes and challenges of recruiting PWID using online approaches in the HOME study, such as successful advertising approaches and the optimal online settings for recruitment that reaches diverse populations of PWID. Best practices for detecting fraud and maximizing data validity as well as issues of bias throughout the data collection process will be detailed using our initial sample. These strategies will inform subsequent large-scale, nationwide efforts that aim to use this methodology in the future.