Brokering: a process for establishing long-term and stable links with gay male communities for research and public health education.

The success of efforts to prevent continued transmission of the human immunodeficiency virus (HIV) and to increase compliance with HIV prophylactic interventions among homosexual and bisexual men will depend in part on health care professionals' understanding of and ability to establish linkages with these men. In order to recruit men into a research project and an educational program, staff at the Pitt Men's Study, an epidemiological investigation of HIV infection, developed a process described here as "brokering," which was based on community organizing and marketing principles. Brokering is a dynamic process by which researchers and public health professionals exchange goods and services with formal and informal leaders of the gay community in order to establish strong, long-term linkages. To date, this process yielded 2,989 homosexual and bisexual recruits into the study, which began in 1983. After 8 years, 79% of those still alive continue to return for follow-up. While recruitment techniques will need to vary from city to city, the importance of establishing linkages with the local indigenous leadership remains of major importance.