Compounding vulnerabilities: victimization and discrimination is associated with COVID-19 disruptions to HIV-related care among gay, bisexual, and other men and transgender and nonbinary people who have sex with men in Kazakhstan

Paine E.A. Lee Y.G. Mergenova G. Vinogradov V. Laughney C.I. Davis A. Terlikbayeva A. Primbetova S. Hunt T. Wu E.
2023 Routledge

AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
2023 #35 Issue 5 651 - 657 pp.

Gay, bisexual, and other men and transgender and nonbinary people who have sex with men (MSM and TSM) are disproportionately impacted by the HIV epidemic in Kazakhstan. MSM and TSM in Kazakhstan also face high levels of discrimination and victimization, known barriers to engagement in HIV prevention and care. We examined data from surveys with 455 MSM and TSM collected May -- October 2020 to determine whether access to HIV testing and treatment was disproportionately limited among those exposed to victimization and discrimination during the early COVID-19 pandemic. Odds of reporting COVID-19 disruptions to HIV-related care access were significantly higher (OR: 1.96; 95% CI: 1.25–3.06; P =.003) among those who experienced recent sexual or gender-based victimization, and recent discrimination (OR: 2.93; 95% CI: 1.65–5.23; P <.001), compared to those who did not experience victimization or discrimination, respectively. Odds of reporting disruptions among those who experienced both victimization and discrimination were significantly higher (OR: 3.59; 95% CI: 1.88–6.86; P <.001) compared to those who experienced neither. Associations remained significant after adjustment for potentially confounding factors. Findings suggest the COVID-19 pandemic is compounding vulnerability among MSM and TSM in Kazakhstan–highlighting need for intervention efforts targeting the most marginalized groups.

COVID , discrimination , HIV testing , HIV treatment , Kazakhstan , MSM , stigma , transgender , victimization

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Department of Psychiatry, Columbia University, New York, NY, United States
HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, New York, NY, United States
Columbia University School of Social Work, New York, NY, United States
Global Health Research Center of Central Asia, Almaty, Kazakhstan

Department of Psychiatry
HIV Center for Clinical and Behavioral Studies
Columbia University School of Social Work
Global Health Research Center of Central Asia

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