Sexual and gender minority stigma, and associations with perceived barriers to HIV testing and HIV testing behaviors among adolescents and young adults in Kazakhstan

Wen H. Sun Y. Landers S. Mergenova G. Balabekova O. Gryazev D. Davis A.
April 2026 CSIRO Publishing

Sexual Health
2026 #23 Issue 2

Background: Kazakhstan is experiencing a rising HIV epidemic, with adolescents and young adults (AYA) accounting for nearly one-quarter of new infections. However, HIV testing rates remain low, partly due to stigma, especially sexual and gender minority (SGM) stigma. Methods: We examined the prevalence and associations between SGM stigma, perceived barriers to HIV testing, and testing behaviors among 216 AYA in Almaty, Kazakhstan. The analysis used baseline survey data from enrolled RCT participants. Results: Results showed that male and heterosexual AYA reported significantly higher SGM stigma than female or SGM AYA. Regression analyses found that higher SGM stigma was associated with greater perceived barriers to HIV testing (β = 0.72, P < 0.001), but not with HIV testing uptake. Conclusions: These findings suggest that SGM stigma contributes to perceived barriers that discourage HIV testing. Given that current HIV stigma interventions may not adequately address gendered or sexual identity-related stigma, targeted strategies that address the intersection of SGM and HIV stigma among AYA, especially among males, are timely needed.

adolescent and young adult , central Asia , health service , HIV stigma , HIV testing , intersectionality , perceived barriers , sexual and gender minority stigma

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School of Social Work, Columbia University, New York City, NY, United States
Warren Alpert Medical School, Brown University, Providence, RI, United States
Global Health Research Center of Central Asia, Almaty, Kazakhstan
Asfendiyarov Kazakh National Medical University, Department of Epidemiology, Almaty, Kazakhstan

School of Social Work
Warren Alpert Medical School
Global Health Research Center of Central Asia
Asfendiyarov Kazakh National Medical University

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