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RESEARCH ARTICLE
Contents Vol 22(2)

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 https://orcid.org/0000-0003-2084-9741 A * , Laura Nyblade B , Yihang Sun A , Olga Balabekova C , Sara E. Landers A , Denis Gryazev C , Joseph D. Tucker https://orcid.org/0000-0003-2804-1181 D E , Valera Gulyaev C , Susan L. Rosenthal F G , Karsten Lunze H I , Weiming Tang https://orcid.org/0000-0002-9026-707X D , Azamat Kuskulov A , Assel Terlikbayeva A C , Sholpan Primbetova A C , Mingway Chang A , Alfiya Y. Denebayeva J , Aikerim Utegulovna Akhmetova J , Ainur Absemetova K , Sholpan Karzhaubayeva L , Sairankul Kassymbekova M , Marina Maximova M , Zhannat Mussina M , Gulnar Bekenova N , Zhamilya Nugmanova O , Zhanna Kalmatayeva O , Ludmila Polyakova P , Zhanneta Kanaevna Zhazykbaeva Q , Vitaliy Vinogradov C , Amir Shaikezhanov C , Meruyert Darisheva C , Bella Orynbetova R , Elena Norakidze S , Mashirov Kozhakhmet T , Akbota Tolegenova U , Aknur Imadillda C # , Dariga Satkhozhina C # , Alikhan Kartamyssov C # , Zhamilya Kanieva C # , Albina Aleshina C # , Olzhas Makhan C # , Aida Muravyova C # , Adema Rahimzanova C # , Arman Duisenbayev https://orcid.org/0009-0000-0588-0586 C # , Zhanerke Tursynbek C # , Nurgazy Dias C # , Malika Beken C # , Miras Murzakhan C # , Zhandos Ali Brown C # , Daniyal Maitekov C # , Artur Li C # , Sandizaira Mergen C # , Dautali Mergenov C # , Amirali Kuanysh C # , Anuar Rakhimbekov C # , Yenlik Baisbay C # , Alibek Aruzhan C # , Zhasmina Kozhambet C # , Denis Grebenchishikov C # , Dmitriy Bekker C # , Sultan Kozhamberdiev C # , Dauren Salykov C # , Madina Sagimbayeva C # , Kamila Yussupova C # and Gaukhar Mergenova C
+ Author Affiliations
- Author Affiliations

A School of Social Work, Columbia University, New York, NY, USA.

B RTI International, Washington, DC, USA.

C Global Health Research Center of Central Asia, Almaty, Kazakhstan.

D Institute for Global Health and Infectious Diseases, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA.

E Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.

F Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA.

G Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA.

H Section of General Internal Medicine, Department of Medicine, Boston Medical Center, Boston, MA, USA.

I Chobanian and Avedisian School of Medicine, Boston University, Boston, MA, USA.

J Almaty City AIDS Center, Almaty, Kazakhstan.

K National Volunteer Network, Almaty, Kazakhstan.

L Almaty City Center for Human Reproduction, Youth and Family Health Department, Almaty, Kazakhstan.

M Kazakh Scientific Center of Dermatology and Infectious Diseases, Almaty, Kazakhstan.

N Kazakhstan Association for Sexual and Reproductive Health, Almaty, Kazakhstan.

O Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan.

P Teenergizer, Almaty, Kazakhstan.

Q ‘Protection of Children from AIDS’ Charitable Public Foundation, Shymkent, Kazakhstan.

R Internews, Almaty, Kazakhstan.

S Narxoz University, Almaty, Kazakhstan.

T Shymkent City AIDS Center, Shymkent, Kazakhstan.

U Nazarbayev University, Astana, Kazakhstan.

* Correspondence to: ad3324@columbia.edu

# These authors contributed equally to this paper

Handling Editor: Chunyan Li

Sexual Health 22, SH24235 https://doi.org/10.1071/SH24235
Submitted: 8 December 2024  Accepted: 4 March 2025  Published: 27 March 2025

© 2025 The Author(s) (or their employer(s)). Published by CSIRO Publishing

Abstract

Background

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 with conventional public health materials among AYA in Almaty, Kazakhstan.

Methods

A total of 216 AYA (females:116/males:110) aged 16–24 years 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 5 weeks, with equivalent exposures between arms. Outcomes included a total HIV stigma score assessed at baseline, immediately post-intervention and 2 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 2 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 2 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 2-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, although 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.

Keywords: adolescents and young adults, citizen science, crowdsourcing, digital intervention, HIV, Kazakhstan, stigma, testing.

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