Data for the papers came from an on-going clinical trial of a social network-based intervention for promoting linkage to HIV care among SGD persons in Kazakhstan's three major cities: Almaty, Nur-Sultan (formerly Astana), and Shymkent. Participants could enroll in the trial if they were 18 years old or older, identified as men at any time, reported non-coerced sex with a man within the past 12 months, reported binge drinking and/or illicit substance use within the past 90 days, and lived in a study city. Every six months, participants completed structured interviews assessing HIV risk, substance use, psychosocial health conditions, peer outreach experiences, and sociodemographic characteristics. In March 2020, Kazakhstan saw its first COVID-19 cases, prompting an emergency national response to mitigate the spread of COVID-19 by restricting travel and gatherings; thus, the trial suspended in-person activities. At this time, we developed a questionnaire to assess experiences of disruptions to receiving HIV testing and treatment caused by COVID-19 mitigation measures. The papers considered data from 455 participants who completed the COVID-19 questionnaire during the first six months of its administration (May-October 2020).
Paper ONE characterizes the extent to which this national sample of SGD persons experienced hindrance in their ability to receive HIV testing and treatment due to COVID-19 and mitigation measures. Findings reveal elevated likelihoods of experiencing COVID-19 disruptions in HIV-related services among transgender/gender non-conforming individuals, those reliant on others for housing, and engaged in illicit use of certain substances. Paper TWO describes the association of COVID-19 disruptions with psychological distress. Findings support the negative mental health consequences of the COVID-19 pandemic as demonstrated through a synergistic expansion of disruptions with levels of depression, anxiety, and stress. Paper THREE investigates COVID-19 disruptions among those exposed to sexual/gender-based victimization/discrimination, finding evidence that COVID-19 has compounded vulnerabilities among MSM and TSM in Kazakhstan navigating a hostile climate for LGBTQ people. Paper FOUR examines the association of COVID-19 disruptions with HIV prevention peer outreach. Findings suggest a potential threat of COVID-19 disruptions to community-level strategies of HIV prevention. The symposium will conclude with discussion on implications for social work practice and research with Kazakhstan-based SGD persons grappling with compounded vulnerabilities observed in the context of the dual pandemic of HIV and COVID-19.