Abstract: HIV Risk Prevention Behaviors and PrEP Willingness Among Cisgender Men and Trans Individuals Who Have Sex with Men in Kazakhstan (Society for Social Work and Research 29th Annual Conference)

Schedule:

Thursday, January 16, 2025

Jefferson A, Level 4 (Sheraton Grand Seattle)

* noted as presenting author

Caitlin Laughney, PhD, MSW, Postdoctoral Research Fellow, Columbia University, New York, NY

Yong Gun Lee, PhD, Assistant Professor, The University of Hong Kong (HKU), Hong Kong, Hong Kong

Gaukhar Mergenova, MD, MS, Project Director, Columbia University Global Health Research Center of Central Asia (GHRCCA), Almaty, Kazakhstan

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

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

Elwin Wu, PhD, Professor of Social Work, Columbia University School of Social Work, New York, NY

BACKGROUND AND PURPOSE: Despite the importance of pre-exposure prophylaxis (PrEP) in ending the HIV epidemic, scarce research exists about HIV risk prevention behaviors and willingness to use PrEP among sexual and gender expansive (SGE) populations in Kazakhstan. This study aims to explore HIV risk prevention behaviors and willingness to use PrEP among SGE people in Kazakhstan who are HIV-negative or uncertain about their HIV status.

METHODS: A secondary analysis was conducted using a NIDA-funded data set of 629 cisgender men and trans individuals who have sex with men (MSM and TSM) in Kazakhstan.

RESULTS: Few MSM and TSM reported using PrEP in the past 90 days (5%), and the most frequently reported HIV prevention behavior in the past 90 days was avoidance of ejaculation during anal sex (i.e., “pulling out”) (86%). In a subsample of HIV-negative participants (n=75), nearly half (45%) of MSM and TSM reported that they definitely would use PrEP as needed (i.e., PrEP “on-demand”). Approximately a third of MSM and TSM reported that they probably would use once-daily PrEP (29%) and that they were uncertain if they would use long-acting injectable (LAI) PrEP (36%).

CONCLUSIONS AND IMPLICATIONS: MSM and TSM in Kazakhstan report low rates of recent PrEP use and high rates of less effective HIV-prevention behaviors (e.g., “pulling out”). However, MSM and TSM in Kazakhstan reported high rates of willingness to use PrEP—particularly PrEP “on-demand.” Future research needs to explore and address potential barriers to PrEP use among SGM populations in Kazakhstan at increased risk of HIV, including lack of PrEP awareness, acceptability, and availability due to factors such as homophobic stigma and limited pharmaceutical infrastructure in the region.