Table 4.

Special considerations and suggestions when adapting biological behavioral surveillance surveys (BBSS) among adolescent key populations (AKP) in time location sampling (TLS) and respondent driven sampling (RDS).

Topic	Considerations and suggestions
Pre-survey assessment	An AKPa specific pre-survey assessment may include (1) meetings with and involvement from parents, guardians, or community gatekeepers to ensure AKP participate in surveys, (2) community meetings (without disclosing the full nature of the research that could result in further stigma or reprisals) to garner community acceptance of collecting information from AKP, (3) meetings with government officials, child advocates, and NGOsb working with adolescents to be fully aware of country laws and guidelines governing the involvement of children in research, and (4) research to determine if adolescent-friendly communication technologies (ie, mobile phone apps and Internet websites) or eliciting questions through cell phones and computers can enhance sampling (Note: Web-based surveys do not allow for biological data collection).
Questionnaires and other data collection forms	Materials for adolescents of higher age ranges (eg, 15-19 years) need to be adapted for those of lower age ranges (eg, 10-14 years).
	Keep questionnaires and materials short and simple, and include adolescent-appropriate language.
	Forms to be read by participants should be easy to read using language commonly used by adolescents. Some AKP are not able or do not want to read something—have the option that materials can be read to them.
	Consider the use of drawings to convey important information.
Interviews	Interviews among AKP should be short.
	Allow respondents to take breaks during an interview.
HIV and other testing	Minimize the invasiveness of HIV testingc and other testing procedures. Consider using oral swabs or finger pricks instead of venous blood.
Eligibility	Labels used by researchers to describe AKP (ie, people who inject drugs, male or female sex workers) may not be recognized by adolescents engaging in the same behaviors. Refer to the behavior, for example, selling sex in exchange for money, rather than the population group (sex workers).
Support during the survey	Have available a trained social worker or child advocate (a person or service provider with qualifications to provide information or support).
Dissemination and validation	Once data are analyzed, go back to AKP to disseminate and validate data.

^aAKP: adolescent key populations.

^bNGO: non-governmental organization.

^cHIV: human immunodeficiency virus.