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A Digital Citizen Science Intervention to Reduce HIV Stigma and Promote HIV Testing: A Randomized Clinical Trial among Adolescents and Young Adults in Kazakhstan

Alissa Davis , Laura Nyblade, Yihang Sun, Olga Balabekova, Sara Landers, Denis Gryazev, Joseph Tucker , Valera Gulyaev, Susan Rosenthal, Karsten Lunze, Weiming Tang , Azamat Kuskulov, Assel Terlikbayeva, Sholpan Primbetova, Mingway Chang, Alfiya Denebayeva, Aikerim Akhmetova, Ainur Absemtova, Sholpan Karzhaubayeva, Sairankul Kassymbekova, Marina Maximova, Zhannat Mussina, Gulnar Bekenova, Zhamilya Nugmanova, Zhanna Kalmatayeva, Ludmila Polyakova, Zhanneta Zhazykbaeva, Vitaliy Vinogradov, Amir Shaikezhanov, Meruyert Darisheva, Bella Orynbetova, Elena Norakidze, Mashirov Kozhahmet, Akbota Tolgenova, Aknur Imadillda, Dariga Satkhozhina, Alikhan Kartamyssov, Zhamilya Kaniyeva, Albina Aleshina, Olzhas Makhan, Aida Muravyova, Adema Rahimzanova, Arman Duisenbayev , Zhanerke Tursynbek, Nurgazy Dias, Malika Beken, Miras Murzakhan, Zhandos Brown, Daniyal Maitekov, Artur Li, Sandizaira Mergen, Dautali Mergenov, Amirali Kuanysh, Anuar Rakhimbekov, Yenlik Baisbay, Alibek Aruzhan, Zhasmina Kozhambet, Denis Grebenchishikov, Dmitriy Bekker, Sultan Kozhamberdiev, Dauren Salykov, Madina Sagimbaeva, Kamila Yussupova, Gaukhar Mergenova

Abstract

Introduction: Kazakhstan has a high HIV incidence among adolescents and young adults (AYA), and high HIV stigma contributing to low HIV testing uptake. We examined whether an AYA-developed digital crowdsourced intervention reduced HIV stigma compared to conventional public health materials among AYA in Almaty, Kazakhstan. Methods: 216 AYA (Females:116/Males:110) ages 16-24 were recruited to the online study cohort and randomized 1:1 to the intervention or control arm. AYA were exposed to the crowdsourced intervention or control materials once a week for five weeks, with equivalent exposures between arms. Outcomes included a total HIV stigma score assessed at baseline, immediately post-intervention and two months post-intervention from January to August 2023. We conducted multilevel mixed models to compare changes over time by arm and sex. Results: AYA in the intervention arm had significantly lower HIV testing stigma two months post-intervention (adjusted mean change (AMC): -0.73 [-1.07, -0.39]) than AYA in the control arm (AMC: -0.06 [-0.42, 0.30]) (p=0.032). Female AYA in the intervention arm had significantly lower total HIV stigma immediately post intervention (AMC: -4.91 [-7.25, -2.58]) and two months post-intervention (AMC: -5.16 [-7.48, -2.84]) than females in the control arm (immediately post-intervention AMC: -0.03 [-2.63, 2.57] and two-months post-intervention AMC: -0.07 [-2.70, 2.56]) (p=0.012, p=0.012). Conclusions: The AYA-developed crowdsourced intervention decreased HIV testing stigma, though this effect was moderated by sex, and decreased total HIV stigma among female AYA. Crowdsourced interventions may be a promising way to engage communities to develop interventions to decrease HIV stigma.

SH24235  Accepted 04 March 2025

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