Lower Intersecting HIV-related Stigmas to Facilitate Treatment as Prevention (LIFT)

Summary

The purpose of this study is to reduce HIV transmission risk among people who inject drugs (PWID) through a multilevel intervention known as LIFT. LIFT intervenes to build intragroup PWID support at the community-level to reduce overall drug use and stigma. LIFT also increases efficacy in navigating HIV services in the presence of structural stigma. Additionally, LIFT intervenes on abstinence-based drug use stigma at the health facility-level to improve clinic policy and staff interactions with clients.

This is an implementation study to adapt and pilot a stigma reduction intervention with persons who inject drugs (PWID) in Kyrgyzstan. The intervention includes peer-led group sessions focused on stigma reduction and providing support to increase HIV prevention efficacy. The aim will be to adapt, refine, and pilot the intervention among PWID and methadone maintenance treatment (MMT) clinic staff. Participants will be randomized to the intervention or control arms.

Conditions

• Stigma, Social
• Drug Abuse Illicit
• HIV (Human Immunodeficiency Virus)

Interventions

BEHAVIORAL

LIFT for People Who Use Drugs

LIFT intervention will include 5 peer-led participatory group sessions to reduce stigma and cultivate intragroup cohesion and support to increase HIV prevention efficacy. The intervention content will focus on 1) Naming the Problem (how intersectional stigma manifests and affects health outcomes), challenging myths that drive intersectional stigma and replacing myths with facts related to 2) Fears about drug use and internalized stigma (understanding drug dependence as a health condition), 3) Fears about MMT (understanding methadone treatment as a process, not a last resort), 4) Frears about HIV (understanding the health benefits of knowing ones HIV status and PrEP as a treatment to prevent HIV), and 5) Responding to intersectional stigma (challenging stigma and recognizing human rights and other protections for people who use drugs).

BEHAVIORAL

LIFT for MMT Providers

The LIFT intervention will be comprised of 2-day participatory trainings focused on reducing the drivers of stigma within healthcare settings and will cover the following topics: 1) Building awareness and knowledge of what drug use stigma looks like in maintenance vs. abstinence-focused MMT services, 2) Reducing HIV transmission and promoting healthier options with clients via PrEP and SSP health promotion service referrals, 3) Building stress management, empathy, and reducing social distancing in the clinic setting, and 4) Understanding institutional maintenance of stigma reduction practices and focusing on developing internal clinic policies and practices.

Sponsors & Collaborators

• Johns Hopkins University

  collaborator OTHER

• RTI International

  collaborator OTHER

• National Institute on Drug Abuse (NIDA)

  collaborator NIH

• University of California, San Diego

  lead OTHER

Principal Investigators

• Laramie Smith, PhD · University of California, San Diego

Study Design

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

TRIPLE

Model

PARALLEL

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2026-02-09

Primary Completion

2026-10-31

Completion

2026-10-31

Countries

• Kyrgyzstan

Study Locations