Polydrug Use, Sexual Risk, and HIV Testing Among Cisgender Gay, Bisexual, and Other Men and Transgender and Nonbinary Individuals Who Have Sex With Men in Kazakhstan

Abstract

This study examined substance use and sexual risk correlates of HIV testing among cisgender gay, bisexual, and other men (MSM) and transgender and nonbinary individuals (TSM) who have sex with men in Kazakhstan. We analyzed baseline data from an HIV prevention trial collected prior to intervention deployment (N = 304). Multivariable logistic regression analyses revealed that lifetime HIV testing was positively associated with poly-drug use (AOR = 4.4, 95% CI [2.0, 9.9]) and negatively with sexual risk (AOR = 0.4, 95% CI [0.2, 1.0]). Similarly, recent HIV testing was positively associated with polydrug use (AOR = 2.7, 95% CI [1.4, 5.2]) and negatively with sexual risk (AOR = 0.5, 95% CI [0.3, 0.9]). Current HIV testing was negatively associated with sexual risk (AOR = 0.6, 95% CI [0.3. 0.9]). Findings support the value of integrating drug treatment with HIV testing among MSM and TSM in Kazakhstan.

Earlier Sexual Debut and Anti-Gay Victimization Among Men Who Have Sex With Men (MSM) in Kazakhstan

“…Briefly, the clinical trial utilized a stepped-wedge design across three geographically disparate cities—Almaty, Nur-Sultan (formerly Astana), and Shymkent—to test the intervention. These cities were chosen based primarily on the following: (a) having high prevalence and incidence of HIV in the country; (b) preliminary work mapping venues and locations indicating an ability to reach MSM from a combination of traditional brick-and-mortar venues and digital social networking and dating services (Lee et al, 2022; Paine et al, 2021); and (c) being geographically disparate to minimize contamination given the parent study’s stepped-wedge randomized trial. The study utilized a combination of convenience, venue-based, and snowball (via referral from study participants) sampling (Lee et al, 2022; Paine et al, 2021) to recruit individuals who met the following eligibility criteria: ≥18 years old; identifying as male at any point in life or being assigned male at birth; having consensual sex with another man in the past 12 months; engaging in binge drinking, illicit drug use, or both in the past 90 days; and residing in one of the three study cities.…”

Social Impacts of Multi-City HIV Research Participation Among Sexual and Gender Expansive Individuals in Kazakhstan

“…Alcohol and drug use assessment relied on the same measures used in previous studies. 14,16,17 Briefly, participants self-reported lifetime use of alcohol, marijuana, heroin and other opioids, stimulants, cocaine, hallucinogens or psychedelics, inhalants, and club drugs. Participants reporting any prior use of alcohol were asked about incidents of binge drinking, operationalized as "consuming five or more alcohol beverages within a two-hour period".…”

“…14,15 Furthermore, SGE individuals contend with multiple behavioral risks associated with HIV that urge attention. 16–18…”

“…14,15 Furthermore, SGE individuals contend with multiple behavioral risks associated with HIV that urge attention. [16][17][18] Persistent stigma and discrimination pose ethical and practical challenges for research needed to help develop locally effective means of decreasing HIV incidence. For instance, HIV research participation may elicit and, in turn, be deterred by presumption of infection status, unwanted attention or isolation, and other negative attitudes toward participants.…”