A digital citizen science intervention to reduce HIV stigma and promote HIV testing: a randomized clinical trial among adolescents and young adults in Kazakhstan
Davis A. Nyblade L. Sun Y. Balabekova O. Landers S.E. Gryazev D. Tucker J.D. Gulyaev V. Rosenthal S.L. Lunze K. Tang W. Kuskulov A. Terlikbayeva A. Primbetova S. Chang M. Denebayeva A.Y. Akhmetova A.U. Absemetova A. Karzhaubayeva S. Kassymbekova S. Maximova M. Mussina Z. Bekenova G. Nugmanova Z. Kalmatayeva Z. Polyakova L. Zhazykbaeva Z.K. Vinogradov V. Shaikezhanov A. Darisheva M. Orynbetova B. Norakidze E. Kozhakhmet M. Tolegenova A. Imadillda A. Satkhozhina D. Kartamyssov A. Kanieva Z. Aleshina A. Makhan O. Muravyova A. Rahimzanova A. Duisenbayev A. Tursynbek Z. Dias N. Beken M. Murzakhan M. Brown Z.A. Maitekov D. Li A. Mergen S. Mergenov D. Kuanysh A. Rakhimbekov A. Baisbay Y. Aruzhan A. Kozhambet Z. Grebenchishikov D. Bekker D. Kozhamberdiev S. Salykov D. Sagimbayeva M. Yussupova K. Mergenova G.
27 March 2025CSIRO Publishing
Sexual Health
2025#22Issue 2
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.
adolescents and young adults , citizen science , crowdsourcing , digital intervention , HIV , Kazakhstan , stigma , testing
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School of Social Work, Columbia University, New York, NY, United States
RTI International, Washington, DC, United States
Global Health Research Center of Central Asia, Almaty, Kazakhstan
Institute for Global Health and Infectious Diseases, University of North Carolina-Chapel Hill, Chapel Hill, NC, United States
Clinical Research Department, Faculty of Infectious and Tropical Diseases,, London School of Hygiene and Tropical Medicine, London, United Kingdom
Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons,, New York, NY, United States
Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States
Section of General Internal Medicine, Department of Medicine, Boston Medical Center, Boston, MA, United States
Chobanian and Avedisian School of Medicine, Boston University, Boston, MA, United States
Almaty City AIDS Center, Almaty, Kazakhstan
National Volunteer Network, Almaty, Kazakhstan
Almaty City Center for Human Reproduction, Youth and Family Health Department, Almaty, Kazakhstan
Kazakh Scientific Center of Dermatology and Infectious Diseases, Almaty, Kazakhstan
Kazakhstan Association for Sexual and Reproductive Health, Almaty, Kazakhstan
Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
Teenergizer, Almaty, Kazakhstan
Protection of Children from AIDS Charitable Public Foundation, Shymkent, Kazakhstan
Internews, Almaty, Kazakhstan
Narxoz University, Almaty, Kazakhstan
Shymkent City AIDS Center, Shymkent, Kazakhstan
Nazarbayev University, Astana, Kazakhstan
School of Social Work
RTI International
Global Health Research Center of Central Asia
Institute for Global Health and Infectious Diseases
Clinical Research Department
Department of Pediatrics
Department of Psychiatry
Section of General Internal Medicine
Chobanian and Avedisian School of Medicine
Almaty City AIDS Center
National Volunteer Network
Almaty City Center for Human Reproduction
Kazakh Scientific Center of Dermatology and Infectious Diseases
Kazakhstan Association for Sexual and Reproductive Health
Asfendiyarov Kazakh National Medical University
Teenergizer
Protection of Children from AIDS Charitable Public Foundation
Internews
Narxoz University
Shymkent City AIDS Center
Nazarbayev University
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