Kelsey Reeder, LCSW-R,
PhD Candidate, Psychotherapist, Columbia University School of Social Work, New York, NY
Yong Gun Lee, PhD, Assistant Professor, The University of Hong Kong (HKU), Hong Kong, Hong Kong
Jimin Sung, MA, PhD Student, Columbia University, New York, NY
Vitaliy Vinogradov, Project Director, Columbia University Global Health Research Center of Central Asia (GHRCCA), Almaty, Kazakhstan
Gulnara Zhakupova, MSW, Project Director, Columbia University Global Health Research Center of Central Asia (GHRCCA), Almaty, Kazakhstan
Gaukhar Mergenova, MD, MS, Project Director, Columbia University Global Health Research Center of Central Asia (GHRCCA), Almaty, Kazakhstan
Alissa Davis, PhD, Associate Professor, Columbia University, New York, NY
Emily Paine, PhD, Assistant Professor, Columbia University, NY
Sholpan Primbetova, MS, MPharm, Deputy Regional Director, Columbia University Global Health Research Center of Central Asia (GHRCCA), Almaty, Kazakhstan
Assel Terlikbayeva, MD, Regional Director, Columbia University Global Health Research Center of Central Asia (GHRCCA), Almaty, Kazakhstan
Sultana Káli, Research Assistant & Intervention Specialist, Columbia University Global Health Research Center of Central Asia (GHRCCA), Kazakhstan
Timothy Hunt, PhD, Associate Director, Columbia University School of Social Work, New York, NY
Elwin Wu, PhD, Professor of Social Work, Columbia University School of Social Work, New York, NY
BACKGROUND AND PURPOSE: Trans (used as an umbrella term for those identifying with a gender different from the gender they were assigned at birth, [i.e. transgender, nonbinary, genderqueer, etc.]) individuals around the world are at higher risk for contracting HIV and sexually transmitted infections (STIs), yet combinations of stigma, accessibility challenges, and a lack of trans-specific, trans-affirming interventions perpetuate rates of infection. Due to the severe paucity of data on trans communities’ experience with HIV in Central Asia, this study describes HIV infections (both known and newly detected) and STIs among trans individuals who have sex with men (TSM) in a multi-city Kazakhstan study.
METHODS: This study utilized behavioral and biological assay data collected in a NIDA-funded clinical trial of a behavioral HIV preventive intervention for substance among TSM across three Kazakhstan cities (Almaty, Astana, and Shymkent). We specifically focus on HIV infection, as well as three other STIs (chlamydia, gonorrhea, and syphilis), among 68 TSM individuals who participated in the trial from August 2018 to March 2022.
RESULTS: Findings reveal that while the majority (69%) of TSM participants have undergone HIV testing in their lifetime—with 32% having completed an HIV test in the prior 6 months—over a third (37%) of participants did not know their current HIV status. Fourteen (21%) of the sample were confirmed to be living with HIV, and 11 (79%) of these confirmed infections were reportedly unknown prior to testing. STI testing found that 47% of the TSM sample tested positive for chlamydia, gonorrhea, or syphilis, with almost 10% testing positive for more than one of these STIs.
CONCLUSIONS AND IMPLICATIONS: Findings from this study demonstrate high rates of HIV and STIs among TSM in this study sample in Kazakhstan, as well as a discrepancy between HIV status awareness and confirmed HIV diagnosis (with higher rates of confirmed HIV diagnosis). Additionally, HIV testing rates fall short of the 90-90-90 and 95-95-95 UNAIDS targets for 2020 and 2030, respectively. These results underscore the need for additional research, interventions, and services to address HIV and other STIs and increase testing—concomitantly redressing the conditions leading to marginalization—among TSM in Kazakhstan.
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