Crowdsourcing to Reduce HIV Stigma Among Adolescents and Young Adults in Kazakhstan

Not Applicable

Completed

Conditions: HIV Testing
Stigma, Social

Interventions: Behavioral: Digital Crowdsourced Intervention to Reduce HIV Stigma among Adolescents and Young Adults

Registration Number: NCT05107401

Lead Sponsor: Columbia University

Brief Summary: This project will assess whether a digital crowdsourced intervention can reduce HIV stigma and promote HIV self-testing among adolescents and young adults (AYA). NIH has emphasized the need for research on interventions to reduce HIV-associated stigma and its impact on the prevention and treatment of HIV/AIDS, particularly in low and middle income countries (LMICs). The proposed study has the highest public health significance: it uses a community-based participatory approach to engage local AYA to develop a digital crowdsourced HIV stigma reduction and self-testing intervention to reduce HIV stigma and increase HIV testing.

Study Aim 1: To develop a crowdsourced digital HIV stigma reduction and self-testing intervention targeting AYA in Kazakhstan. Using a community-based participatory approach that engages local adolescents and young adults (AYA) and youth organizations, we will launch a national crowdsourcing contest in which AYA will design multimedia content to reduce HIV stigma in order to promote HIV testing among peers.

Study Aim 2: To pilot test this crowdsourced HIV stigma reduction and self-testing intervention in a preliminary efficacy trial. We will assess the intervention's feasibility and acceptability and obtain preliminary estimates of its effects on decreasing HIV stigma (primary outcome) and increasing HIV testing (secondary outcome) among AYA in Kazakhstan who received the intervention compared to individuals who did not. Participants (n=168) will be randomized 1:1 to: 1) receive the winning multimedia crowdsourced HIV stigma reduction content and a link for HIV self-testing, or 2) receive standard Kazakhstan Ministry of Health HIV informational materials and a link for HIV self-testing.

Detailed Description: This project will assess whether a digital crowdsourced intervention can reduce HIV stigma and promote HIV self-testing among adolescents and young adults (AYA). Globally AYA are at increased risk for HIV acquisition. In Eastern Europe and Central Asia (EECA), new HIV infections among 15-24 year old AYA are expected to increase 28% by 2030. In Kazakhstan, one in four HIV infections occur among AYA. Despite the growing HIV burden among AYA in Kazakhstan, this population has some of the lowest HIV testing rates in the country, largely due to stigma. Yet few efforts in Kazakhstan address HIV stigma and the role it plays as a barrier to HIV testing. Digital technologies and crowdsourcing campaigns (i.e., engaging groups of AYA online to address public health challenges and share solutions) are scalable, cost-effective tools that can increase HIV testing services and reduce HIV stigma in low and middle income countries (LMICs) and other resource- constrained settings. Crowdsourcing may be particularly successful among AYA, given their high levels of social media use and technological literacy. Complementing the crowdsourcing approach, mailing HIV rapid test kits can enable AYA to avoid the stigma associated with attending the AIDS Center and overcome transportation barriers.

Recruitment & Eligibility

Status: COMPLETED

Sex: All

Target Recruitment: 216

Inclusion Criteria

Age 16-24
Report previous sex with another individual
Reside in Kazakhstan

Exclusion Criteria

Not willing to provide consent or not able to understand study procedures

Study & Design

Study Type: INTERVENTIONAL

Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
Crowdsourced Intervention	Digital Crowdsourced Intervention to Reduce HIV Stigma among Adolescents and Young Adults	The digital crowdsourced intervention will be presented to participants in the intervention arm.

Primary Outcome Measures

Name	Time	Method
Mean Score Change in Total HIV Stigma Scale	Baseline and 3 months	The scale/questionnaire is comprised of 17 items on a 5-point Likert scale (score range from 17-85). Higher scores indicate higher levels of stigma. Outcome will be assessed in mean score change from baseline to 3 months follow-up.

Secondary Outcome Measures

Name	Time	Method
Mean Change in Perceived HIV Test Stigma	Baseline and 3 months	This is a subscale of the Total HIV Stigma scale. It contains 2 items, each on a 1-5 point Likert scale, with a range of 5-10. Higher values indicate higher levels of HIV stigma.
Mean Change in Perceived HIV Healthcare Stigma Subscale	Baseline and 3 months	This is a subscale of the Total HIV Stigma Scale. It contains two items, each on a 1-5 point Likert scale, with a range of 5-10. Higher values indicate higher levels of HIV healthcare stigma.
Mean Change in Fear & Judgement HIV Stigma Sub-scale	Baseline and 3 months	This is a subscale of the Total HIV Stigma Scale. It consists of 5 items, each on a 1-5 point Likert scale, with a range of 5-25. Higher values indicate higher levels of fear \& judgement HIV stigma.
Mean Change in Perceived Community HIV Stigma Subscale	Baseline and 3 months	This is a subscale of the Total HIV Stigma Scale. It consists of 8 items, each on a 1-5 point Likert-scale, with a range of 6-40. Higher values indicate higher levels of perceived community HIV stigma.
Uptake of HIV Self-test	After baseline and by the 3 month follow-up period	The number of participants who ordered an HIV self-test kit after baseline and by the 3-month follow-up. It is a dichotomous outcome (yes/no).