Participatory geographic mapping and activity space diaries: innovative data collection methods for understanding environmental risk exposures among female sex workers in a low-to middle-income country.

BACKGROUND: A common approach for measuring place-based exposure is to use geographically-defined administrative boundaries and to link neighborhood characteristics at this level. This approach, however, may not be feasible in low-to middle-income countries where neighborhood-level data are limited or unavailable, and administrative boundaries are often unstandardized and not proportional to population size. Furthermore, such traditional approaches may not be appropriate for marginalized populations whose environments can be more difficult to study. In this paper, we describe two innovative and feasible methods to generate geospatial data to characterize and assess the role of risk environments on drug use among female sex workers living with HIV in the Dominican Republic. METHODS: Participatory geographic mapping and daily activity space travel diaries were employed. RESULTS: The methods presented in this study were feasible to implement, acceptable by study participants, and yielded rich geospatial data to analyze the impact of contextual factors on risk behaviors of female sex workers in a low-to middle-income country. CONCLUSION: Participatory geographic mapping and activity space diaries are two alternative methods for collecting geospatial data among hard-to-reach populations in resource constrained settings. Moreover, the methods are interactive and educational, allowing study participants to take an active role in the data collection process and potentially allowing for a deeper understanding of place-based effects on health and behavior.