The project is funded by the FOGARTY International Center/National Institutes of Health (NIH), and in partnership with the Kazakh Scientific Center for Dermatology and Infectious Diseases, Almaty AIDS Center, and local NGOs. The project aims to reduce intersectional and HIV-related stigma among healthcare providers and women at risk for HIV prevention. It involves developing and evaluating an innovative, multilevel anti-stigma intervention for healthcare providers using evidence-based approaches. The intervention will be piloted in Almaty, with the outcome being crowdsourced materials on stigma reduction for future training of medical professionals in Kazakhstan.
Aegida Project – “Assessment of the intervention to develop HIV self-testing skills and reduce stigma among women at risk in Kazakhstan” (2021 – 2023)
This project Aegida, funded by the U.S. National Institute on Drug Abuse (NIDA), is a pilot randomized control trial (RCT) of women engaged in commercial sex work and drug use in Kazakhstan. The project’s goal is to increase regular HIV testing, enable early detection of new HIV/STI cases, and reduce HIV stigma among at-risk women. The intervention aims to support HIV self-testing and stigma reduction, with a control arm focusing on HIV risk reduction and disease prevention. The project is being implemented in Almaty, supported by the Kazakh Scientific Center for Dermatology and Infectious Diseases, and the Center for AIDS Prevention and Control in Almaty.
Publications:
“Protected Means Armed”: Perspectives on Pre-Exposure Prophylaxis (PrEP) Among Women Who Engage in Sex Work and Use Drugs in Kazakhstan (https://pubmed.ncbi.nlm.nih.gov/37843909/);
Preferences for an HIV Self-Testing Program Among Women who Engage in sex Work and use Drugs in Kazakhstan, Central Asia (https://pubmed.ncbi.nlm.nih.gov/37426726/);
NOVA project – Evaluating a Microfinance Intervention for High Risk Women in Kazakhstan (2014 – 2019)
Project NOVA was a randomized control trial (RCT) funded by the National Institute on Drug Abuse (NIDA), focusing on women engaged in commercial sex work in Kazakhstan. The study assessed the effectiveness of a comprehensive microfinance intervention, including financial literacy and vocational training, against a control group receiving only the HIV risk reduction component. The intervention aimed to reduce new cases of HIV, STIs, and hepatitis C, as well as risks associated with sexual behavior and drug use among women in Almaty and Karaganda regions.
Publications:
Witte, S. S., Pala, A. N., Mukherjee, T. I., Yang, L. S., McCrimmon, T., Mergenova, G., … & El-Bassel, N. (2023). Reducing partner violence against women who exchange sex and use drugs through a combination microfinance and HIV risk reduction intervention: a cluster randomized trial. AIDS and behavior, 27(12), 4084-4093. (https://pubmed.ncbi.nlm.nih.gov/37389675/);
Vélez-Grau, C., El-Bassel, N., McCrimmon, T., Terlikbayeva, A., Primbetova, S., Mergenova, G., … & Witte, S. S. (2022). ‘I never hoped for anything… now I have other plans’: The role of microfinance in HIV intervention for women who use drugs and engage in sex work in Kazakhstan. International social work, 65(4), 663-677. (https://pubmed.ncbi.nlm.nih.gov/38031578/);
Mukherjee, T. I., Pala, A. N., Terlikbayeva, A., Davis, A., Howard, A. A., McCrimmon, T., … & El-Bassel, N. (2022). Social and structural determinants of health associated with police violence victimization: A latent class analysis of female sex workers who use drugs in Kazakhstan. International Journal of Drug Policy, 106, 103750. (https://pubmed.ncbi.nlm.nih.gov/35667193/);
Vélez-Grau, C., El-Bassel, N., McCrimmon, T., Chang, M., Terlikbayeva, A., Primbetova, S., … & Witte, S. S. (2021). Suicidal ideation among women who engage in sex work and have a history of drug use in Kazakhstan. Mental health & prevention, 23, 200208. (https://pubmed.ncbi.nlm.nih.gov/38031555/);
El‐Bassel, N., McCrimmon, T., Mergenova, G., Chang, M., Terlikbayeva, A., Primbetova, S., … & Witte, S. S. (2021). A cluster‐randomized controlled trial of a combination HIV risk reduction and microfinance intervention for female sex workers who use drugs in Kazakhstan. Journal of the International AIDS Society, 24(5), e25682. (https://pubmed.ncbi.nlm.nih.gov/33955170/);
Yang, L. S., Witte, S. S., Vélez-Grau, C., McCrimmon, T., Terlikbayeva, A., Primbetova, S., … & El-Bassel, N. (2021). The financial lives and capabilities of women engaged in sex work: Can paradoxical autonomy inform intervention strategies?. Global journal of health science, 13(6), 69. (https://pubmed.ncbi.nlm.nih.gov/37163144/).
Smart Couples project – Couple-based antiretroviral therapy (ART) adherence intervention for people who inject drugs in Kazakhstan (2019 – 2023)
Funding: National Institute of Drug Abuse (NIDA)
Grant amount: 180’652 USD
The project goal: To develop a couples-based intervention to improve HIV medication adherence among HIV-positive people who inject drugs, which should increase viral suppression and reduce transmission of HIV.
Project Description: The project developed a couple’s program to improve adherence to HIV treatment among HIV-positive people who inject drugs. The program included social support skills training, use of electronic pill boxes and an integrated smartphone app to improve adherence to ART to increase viral suppression and reduce HIV transmission. The study evaluated the effectiveness of the intervention and its potential to improve ART adherence among people living with HIV who inject drugs. 128 participants were included in the study, 64 were enrolled in the intervention in Almaty.
Theproject results: The dyad-based intervention significantly increased self-reported ART adherence among PWID with partners with HIV, indicating the importance of considering dyad-level factors in interventions.
Publications:
Implementation of a Dyad-Based Intervention to Improve Antiretroviral Therapy Adherence Among HIV-Positive People Who Inject Drugs in Kazakhstan: A Randomized Trial (https://pubmed.ncbi.nlm.nih.gov/37576461/);
If You Build It, Will They Use It? Preferences for Antiretroviral Therapy (ART) Adherence Monitoring Among People Who Inject Drugs (PWID) in Kazakhstan (https://pubmed.ncbi.nlm.nih.gov/30741397/).
Neuenschwander P, Altice FL, Remien RH, Mergenova G, Sarsembayeva L, Rozental E, Gulyayev V, Davis A. A qualitative dyad analysis of barriers and facilitators of antiretroviral therapy (ART) adherence among people who inject drugs (PWID) with HIV in Kazakhstan. AIDS Care. 2024 Oct 15:1-10. doi: 10.1080/09540121.2024.2414078. Epub ahead of print. PMID: 39404196.
Web site for participants (rus-kaz): https://orleu.ghrcca.org/
Project NOVA was a randomized control trial (RCT) funded by the National Institute on Drug Abuse (NIDA), focusing on women engaged in commercial sex work in Kazakhstan. The study assessed the effectiveness of a comprehensive microfinance intervention, including financial literacy and vocational training, against a control group receiving only the HIV risk reduction component. The intervention aimed to reduce new cases of HIV, STIs, and hepatitis C, as well as risks associated with sexual behavior and drug use among women in Almaty and Karaganda regions.
Smart Couples project – Couple-based antiretroviral therapy (ART) adherence intervention for people who inject drugs in Kazakhstan (2019 – 2023)