Session: Research without Borders: International and Community Collaborative Research for Social Impact Among Sexual and Gender Expansive People in Kazakhstan (Society for Social Work and Research 29th Annual Conference)

The global declining trend in HIV transmission has led to aspirations of "ending the HIV epidemic." However, Kazakhstan experienced an 88% increase in HIV incidence between 2010 and 2021 and disproportionately affected sexual and gender expansive (SGE) people, including men* who have sex with men (MSM) and those under the LGBTQ+ umbrella. This points to an urgent need to address HIV among SGE people in Kazakhstan. The four papers in the symposium aim to shed light on critical questions surrounding HIV risk and prevention methods (e.g., HIV testing, pre-exposure prophylaxis [PrEP], risk reduction) among SGE people in Kazakhstan stemming from collaboration of researchers across countries and collaboration between scientists and community members.

The research was a NIDA-funded multi-site/city stepped-wedge trial of a crowdsourcing and peer-actuated network intervention for increasing the number of queer and trans people in the HIV care continuum in Kazakhstan (ClinicalTrials.gov: NCT02786615). Community members prompted the trial itself, and the communities were engaged in all aspects of the study, including terminology used in the study, recruitment procedures, and safety measures. In addition, the intervention also founded on crowdsourcing expertise from members of the community as an active, key component of the intervention. MSM were recruited from LGBTQ+-oriented online and offline venues. Eligibility criteria included: being 18 years or older, having identified as male at any time across their life, reporting consensual sex with a man* within the past 12 months, reporting illicit drug use or binge drinking within the past 90 days, and residing in a study city. Eligible and interested participants provided informed consent and completed behavioral assessments and biological assays.

Paper One focused on trans and gender expansive study participants, finding high rates of HIV and other STIs, and low rates of HIV status awareness. Paper Two characterized HIV risk reduction behaviors and PrEP use attitudes among 629 MSM. Findings indicate adoption of a wide array of risk reduction behaviors, low rates of PrEP use, and high PrEP willingness. Paper Three examined the link between COVID-19-induced disruptions to HIV testing and treatment and attitudes towards HIV prevention peer outreach among 455 MSM on/after the onset of the COVID-19 pandemic. Findings suggest a potential threat of COVID-19 disruptions to community peer outreach. Paper Four presents hypothesis testing of the trial's primary outcome of HIV testing. Findings demonstrate the intervention was efficacious in promoting HIV testing throughout the community (i.e., even among those who did not directly receive the intervention).

Taken together, findings underscore the urgency of addressing sexual health among a sample of SGE people in Kazakhstan and support the power of community mobilization and empowerment in achieving success. The symposium will conclude with discussion on implications for social work practice and community collaborative intervention research.

*'Man/Men' refers to anyone who was assigned male at birth (AMAB) and/or identified as a man/male at some point in their life; altogether, this includes cismen; transmen; and transwomen, nonbinary, genderqueer, etc. who were AMAB.