Abstract: COVID-19 Disruptions to HIV Prevention and Care Are Associated with Diminished Intention to Engage in Community Peer Outreach Among Sexual and Gender Expansive People 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

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

Vitaliy Vinogradov, 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

Emily Paine, PhD, Assistant Professor, Columbia University, NY

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

Kelsey Reeder, LCSW-R, PhD Candidate, Psychotherapist, Columbia University School of Social Work, New York, NY

Jimin Sung, MA, PhD Student, Columbia University, New York, NY

Alissa Davis, PhD, Associate Professor, Columbia University, New York, 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: HIV incidence in Kazakhstan increased by 88% between 2010 and 2021. In this context, sexual and gender expansive (SGE) people are disproportionately affected by the rapidly growing epidemic and underserved in HIV prevention and care. Despite these challenges, SGE people in Kazakhstan have been reported to engage, or be willing to engage, in HIV prevention and care. However, these efforts may have been interrupted at the onset of the COVID-19 pandemic when measures to mitigate its spread, such as shelter-in-place and physical distancing, were introduced. These disruptions may also extend to vital community-level strategies of HIV prevention, such as peer outreach. In this study, we examined the relationship between COVID-19 disruptions in HIV prevention and care, as well as intention to engage in community peer outreach in a sample of SGE people in Kazakhstan.

METHODS: Data for this study came from a clinical trial of a social network-based intervention for increasing the engagement of SGE people in HIV prevention and care in three Kazakhstan cities: Almaty, Shymkent, and Astana. Participants were followed up every six months to complete an assessment of HIV risk-associated behaviors, psychosocial health conditions, sociodemographic characteristics, and peer outreach experiences and attitudes. At the onset of the COVID-19 in Kazakhstan (March 2020), a questionnaire was added to assess whether participants experienced any disrupted access to HIV testing or treatment (1=yes, 0=no). To assess peer outreach intention levels (1=higher, 0=lower), participants were also probed on their willingness and likelihood of communication with peers to encourage HIV testing or treatment within the next six months. Accounting for the nested structure of the data, we conducted a multilevel logistic regression analysis of the association between COVID-19 disruptions and peer outreach intentions. For this study, we considered data from 455 participants who remotely completed the COVID-19 disruptions questionnaire from May-October 2020.

RESULTS: In this sample, 101 participants (22%) reported experiencing COVID-19 disruptions to accessing HIV testing and treatment. 243 participants (53%) expressed higher levels of intention to engage in HIV prevention peer outreach within the next six months. In the multivariate analysis that adjusted for sociodemographic characteristics, experiencing COVID-19 disruptions was significantly associated with reduced odds of having higher levels of intention for community peer outreach (AOR=0.56, 95%CI=0.45-0.70).

CONCLUSIONS AND IMPLICATIONS: We found that COVID-19 disruptions to accessing HIV testing and treatment, as well as an intention to engage in community peer outreach were inversely related. Given the promise of peer outreach for HIV prevention and harm reduction, our findings warrant renewed efforts of protecting and mobilizing community-level interventions with Kazakhstan-based SGE people in the context of a dual pandemic.