One of the limitations of TSS is that the findings can be limited to accessible VDTs, venue attendees, and more visible or active members of the target population. For this reason, obtaining permission from proprietors to access as many VDTs as possible is important. Lack of access to a substantial percentage of VDTs can provide biased results. Including only accessible VDTs is a concern especially when VDTs that were not easily identifiable or approachable were excluded from the sampling frame and when the target populations in the included VDTs differ from those that could have been selected at the excluded VDTs on important variables associated with the outcomes of interest. In such cases, findings can be limited to the target population who attended the VDTs listed in the sampling frame, unless data are collected and weights are developed to estimate probability of attendance across the universe of VDTs and the target population. Another limitation of TSS is the exclusion of people who do not attend any venue, for example, homeless people who do not attend any kind of outreach services or shelter accommodations. Accounting for their characteristics and how they may influence study results are important.