By Derek T. Dangerfield II, PhD
In public health and social science, inclusive and equitable research practices are crucial for ensuring that all communities benefit from scientific progress. One area that demands increased attention in research is the role of incentives in health equity research. Offering equitable incentives in research with Black gay, bisexual, and other Black sexual minority men (SMM) involves a matter of fairness and is essential for promoting trust, fostering engagement, and producing data that is truly representative of their unique experiences.
Black SMM have faced significant discrimination and exclusion across multiple domains, including healthcare, legal protections, and social support systems. Due to the legacy of unethical medical experiments, such as the infamous Tuskegee Syphilis Study, coupled with daily experiences of marginalization, communities of color also experience mistrust in the healthcare system, which extends to research participation. For Black SMM, these barriers are compounded by homophobia, racism, and HIV stigma, which further isolates them from opportunities to meaningfully engage with research. Despite knowledge of this, many studies focus on a one-size-fits-all incentive approaches that overlooks the cultural, social, and economic realities of this group. Instead, studies typically offer small standard monetary incentives or gift cards, which may fail to address the deeper, systemic barriers that prevent meaningful participation and promote fairness.
Offering appropriate incentives can help reduce these barriers. Moreover, incentives should be designed with flexibility in mind. While financial rewards are often a standard incentive, non-monetary incentives like access to healthcare services, free counseling, or career development opportunities can have long-term benefits. Research teams need to engage with the communities they hope to study to understand which forms of compensation are most meaningful and accessible.
For any research initiative to be successful, it must minimize barriers to participation. What’s often missing is a culturally responsive approach that recognizes the unique needs and experiences of Black SMM. Offering appropriate compensation, whether financial or otherwise, respects their time, knowledge, and the risk they may take in participating in research. Fair incentives also send a message that the research process values their contribution equally to others, creating an environment where Black gay and bisexual men can feel confident that their involvement will benefit both themselves and their communities. Equitable incentives lead to higher participation rates, which help generate robust, comprehensive data. This, in turn, allows researchers to develop insights that are more representative of the diverse experiences of Black gay and bisexual men. By ensuring that research includes and values their voices, we can produce findings that lead to better health outcomes, more relevant studies, and policies that genuinely address community needs. Additionally, offering equitable incentives signals a broader commitment to addressing the health disparities that disproportionately affect Black SMM. It tells participants that the research isn’t just about gathering data, but about driving systemic change that could improve their health, wellbeing, and quality of life.
An equitable research approach must go beyond just inclusion; it must actively address the systemic barriers that Black gay and bisexual men face. This means acknowledging their heightened exposure to poverty, discrimination, mental health challenges, and inadequate healthcare access. The incentives offered must reflect an understanding of these conditions. For example, transportation stipends, mental health resources, or connecting participants with local healthcare services can be transformative, especially in studies where health risks are involved.
Research is not just about collecting data; it’s about building relationships with the communities involved. When Black gay and bisexual men feel that their participation is respected and valued through equitable incentives, they are more likely to engage with research in the future. This helps foster sustainable partnerships between researchers and these communities, which can contribute to long-term improvements in public health and social equity.