HST for Female Sex Workers/Drug Users in Kazakhstan

Summary

The goal of this behavioral intervention clinical trial is to assess acceptability, feasibility, and preliminary efficacy of a 4-session intervention to increase consistent HIV testing and linkage to care and prevention among HIV uninfected (assessed via on-site testing) female sex workers who use drugs in Kazakhstan.

The main question it aims to answer are:

1. is the intervention acceptable and feasible
2. do participants randomized to the intervention arm report: 1) past 3-month testing; 2) frequent testing (2+ test over 6 mos.); 3) linkage to HIV care and ART initiation, if positive, or intention to uptake PrEP, if negative, as compared with control arm participants. Secondary outcomes include incident, biologically-confirmed STIs and stigma-related factors. Follow-up period is six months.

All participants will be HIV-negative upon study enrollment as assessed via rapid HIV test.

Participants randomized to the intervention arm will be engaged in a 4-session intervention that offers training and education in HIV self-testing, peer education on HIV self-testing, internalized stigma coping and resistance via basic cognitive restructuring, and provision of HIV self-test kits and reminders every three months. Researchers will compare participants randomized to the intervention arm to participants randomized to the time- and attention-control arm to evaluate impact of the intervention on the outcomes described above.

Conditions

• HIV Testing
• Intention

Interventions

BEHAVIORAL

AEGIDA intervention arm

The intervention arm has 4 sessions facilitated one-on-one by trained staff and lasting \~40 minutes. The first session focuses on establishing rapport, assessing HIV risk, and educating/training participants on HIV self-testing/PEP/PrEP. The second session on peer education/training, barriers to and facilitators of testing, and supporting peers in receiving reactive and/or indeterminate HIV test results, as well as self-care. The third session on stigma and discrimination and techniques to cope with and resist stigma. The final session is a culminating one focused on reviewing key skills and health promotion planning conducted in first three sessions. The intervention arm applies anti-intersectional stigma, empowerment, and harm reduction approaches. All participants will receive/have access to HIV self-test kits every three months.

BEHAVIORAL

AEGIDA control arm

The control arm has 4 sessions via one-on-one facilitation by a trained facilitator and lasting \~40 minutes. It includes basic information on self-screening for common adverse health conditions among women in Kazakhstan, including STIs and HIV, as well as information on testing and risk reduction. All participants will receive/have access to HIV self-test kits every three months.

Sponsors & Collaborators

• Columbia University

  collaborator OTHER

• City University of New York

  lead OTHER

Study Design

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

18 Years

Sex

FEMALE

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2022-11-15

Primary Completion

2024-04-01

Completion

2024-08-31

Countries

• Kazakhstan

Study Locations