Facilitators and barriers to using iris scanning for identification of mobile populations at high risk of HIV in fishing communities of Lake Victoria in East Africa

Abstract The growing concern over participant identification in research, spurred on by flaws in conventional methods like name/date of birth-based identity cards, hospital cards and names, has led to adverse consequences, such as drug misadministration, co-enrolment and missed appointment visits. This study examines the facilitators and barriers associated with implementing biometric iris scanning for participant identification among mobile women and men working in the fishing communities of Lake Victoria. We aim to address challenges in participant identification and contribute to improved research practices. Twenty-four focus group discussions (FGDs) were conducted between 2021 and 2022 across Uganda, Kenya and Tanzania, involving participants aged 18 years and above. The study specifically targeted members of mobile fishing communities residing along the shores of Lake Victoria. The participating research organizations, all partners of the Lake Victoria Consortium for Health Research (LVCHR), operated at the four sites: Masaka and Entebbe in Uganda and Mwanza in Tanzania and Kisumu in Kenya. Each site covering two fishing communities. Participants had an experiential session with the iris camera/scanner, voluntarily undergoing the scanning process before participating in a subsequent FGD. Data collected from the FGDs were transcribed, coded, and subjected to inductive thematic analysis to identify themes directly emerging from the participants’ narratives. This methodology was employed to gain insights into the participants’ perceptions and experiences of the implementation of iris scanning technology in these communities. Overall, there was a broad acceptance of the biometric iris scanning technology, attributable to the comprehensive sensitization efforts among those who participated in the research, effective communication, and the provision of clear information regarding the intentions behind its introduction. However, because the participants had never been exposed to this technology before, various misconceptions, expectations, fears and concerns regarding privacy and safety emerged. These could potentially act as barriers to its adoption in the wider community looking beyond research participants. There is need to provide comprehensive sensitization and health education through communication channels tailored to the needs of specific communities, while engaging them is key in guiding sensitization procedures and improving acceptability. These approaches will help increase acceptability and reduce hesitancy and fears associated with the use of new technologies, such as the iris scanner. Competing Interest Statement The authors have declared no competing interest. Funding Statement This research was funded by international AIDS Vaccine Initiative (IAVI) with the support from donors including the United States Agency for International Development (USAID), grant number: USAID_AID_16_0000_32. A list of IAVI donors could be accessed at http://www.iavi.org. The contents of this manuscript are the responsibility of the authors. They do not reflect views of the donor (USAID) or the US Government. The funders had no role in study design, data collection, and decision to prepare the manuscript or to publish. Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Ethical approval was obtained in each country from the appropriate regulatory body: the Uganda Virus Research Institute Research Ethics Committee (UVRI REC # 605) and Uganda National Council for Science and Technology (UNCST # 4470) for Uganda KEMRI Scientific and Ethics Review Unit (SERU # 3593) for Kenya the National Health Research Ethical Committee (NatHREC # MR/53/100/637 & 659) for Tanzania and the London School of Hygiene and Tropical Medicine Ethics Committee (LSHTM # 22449 & 22639). I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Data Availability The qualitative data underlying and illustrating the findings of the study we collected and synthesized are presented within the manuscript. Anonymized transcripts are not publicly available due to ethical and legal reasons as they contain information that could potentially compromise participant privacy. Data requests may be sent to regulatory{at}mrcuganda.org.