AEGIDA: Results of a Pilot Randomized Trial of an HIV Self-Testing Intervention for Women Who Exchange Sex and Use Substances in Kazakhstan

West B.S. Darisheva M. McCrimmon T. Chang M. Zholnerova N. Grigorchuk E. Starbird L. Terlikbayeva A. Primbetova S. Cordingley O. Baiserkin B. Kassymbekova S. Mussina Z. Rashidov I. Gilbert L. El-Bassel N. Frye V. Gulyaev P. Bekishev D. Nurkatova M. Balabekova O. Kuskulova S. Belkesheva D.
2025 Springer

AIDS and Behavior
2025

HIV self-testing (HST) is a user-controlled approach to increasing HIV testing and status knowledge, the gateway to biomedical prevention and treatment. HST is a promising option for key populations facing stigma-related barriers to testing in primary and specialty (e.g., HIV, substance use) healthcare clinics. We conducted a pilot efficacy trial of AEGIDA, a 4-session intervention designed for women who exchange sex and use substances, in Kazakhstan, where there is a growing HIV epidemic. Between November 2022 and August 2023, we used community-engaged approaches to recruit and screen 305 HIV-negative cisgender and transgender women (47% eligible). Ninety participants were enrolled and randomized in a 2:1 assignment to the active (AEGIDA) or a time-attention control (didactic self-screening information) condition with 6 months of follow-up. AEGIDA’s theoretically grounded sessions included evidence-based techniques to reduce internalized intersectional stigma and build HST skills to increase HIV testing (e.g., motivational interviewing, peer education, and cognitive restructuring). Sessions were delivered face-to-face and via videoconference, with a closed Instagram page for active condition participants to access content on demand. The intent-to-treat analysis found that participants randomized to AEGIDA were over 4 times more likely to complete a recent HIV test (1 + test in the prior three months; aOR = 4.08, 95% CI: 1.22,13.62) at 6-month follow-up compared to control participants. The intervention had no significant impact on consistent HIV testing (1 + test per three months over the six-month follow-up period; aOR = 2.02, 95%CI: 0.69–5.88). Overall, the AEGIDA intervention demonstrated feasibility and acceptability, and preliminary efficacy to increase recent HIV testing. NCT Information NCT06150937.

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Columbia School of Social Work, Columbia University, New York, NY, United States
Global Health Research Center for Central Asia (GHRCCA), Almaty, Kazakhstan
Mailman School of Public Health, Columbia University, New York, NY, United States
Amelia NGO, Taldykorgan, Kazakhstan
Community Friends NGO, Almaty, Kazakhstan
School of Nursing, University of Pennsylvania, Philadelphia, PA, United States
Dornsife School of Public Health, Drexel University, Philadelphia, PA, United States
Kazakh Scientific Center of Dermatology and Infectious Diseases, Almaty, Kazakhstan
Almaty Oblast Dermatovenerological Dispensary, Almaty, Kazakhstan

Columbia School of Social Work
Global Health Research Center for Central Asia (GHRCCA)
Mailman School of Public Health
Amelia NGO
Community Friends NGO
School of Nursing
Dornsife School of Public Health
Kazakh Scientific Center of Dermatology and Infectious Diseases
Almaty Oblast Dermatovenerological Dispensary

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