Reducing HIV Stigma to Increase HIV Testing among Adolescents and Young Adults in Kazakhstan Using a Crowdsourcing Approach

使用众包方法减少艾滋病毒耻辱，增加哈萨克斯坦青少年和年轻人的艾滋病毒检测

• 批准号: 10302018
• 负责人: Alissa Davis
• 金额: $ 26.6万
• 依托单位: COLUMBIA UNIV NEW YORK MORNINGSIDE
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-16 至 2023-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10302018
• 关键词: AIDS prevention; AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Address; Adolescent and Young Adult; Area; Attention; Behavior; Caring; Central Asia; China; Cities; Communities; Complement; Continuity of Patient Care; Country; Development; Diagnostic Reagent Kits; Disclosure; Eastern Europe; Fright; Geography; HIV; HIV Infections; Health; Hepatitis B; Human immunodeficiency virus test; Incidence; Individual; Intervention; Kazakhstan; Letters; Link; Location; Methods; Multimedia; NIH Office of AIDS Research; Outcome; Participant; Play; Population; Prevalence; Prevention; Prevention strategy; Preventive; Public Health; Randomized; Research; Research Priority; Resources; Risk; Risk Behaviors; Role; Sex Behavior; Social Behavior; Stigmatization; Technology; Testing; Transportation; United States National Institutes of Health; Work; Youth; acceptability and feasibility; base; comparison intervention; cost effective; crowdsourcing; design; digital; efficacy trial; experience; governmental health organization; health disparity; improved; interest; literacy; low and middle-income countries; men who have sex with men; multidisciplinary; peer; prevent; primary outcome; rapid test; rapid testing; secondary outcome; self testing; sex; sexual risk behavior; social; social media; social stigma; substance use; testing services; testing uptake; tool; treatment strategy; uptake; young adult

PROJECT SUMMARY/ABSTRACT This project will assess whether a digital crowdsourced intervention can reduce HIV stigma and promote HIV self-testing among adolescents and young adults (AYA). Globally AYA are at increased risk for HIV acquisition. In Eastern Europe and Central Asia (EECA), new HIV infections among 15-24 year old AYA are expected to increase 28% by 2030. In Kazakhstan, one in four HIV infections occur among AYA. Despite the growing HIV burden among AYA in Kazakhstan, this population has some of the lowest HIV testing rates in the country, largely due to stigma. Yet few efforts in Kazakhstan address HIV stigma and the role it plays as a barrier to HIV testing. Digital technologies and crowdsourcing campaigns (i.e., engaging groups of AYA online to address public health challenges and share solutions) are scalable, cost-effective tools that can increase HIV testing services and reduce HIV stigma in low and middle income countries (LMICs) and other resource-constrained settings. Crowdsourcing may be particularly successful among AYA, given their high levels of social media use and technological literacy. Complementing the crowdsourcing approach, mailing HIV rapid test kits can enable AYA to avoid the stigma associated with attending the AIDS Center and overcome transportation barriers. Study aims are: 1) use a community-based participatory approach that engages local AYA and youth organizations to develop a crowdsourced digital HIV stigma reduction and self-testing intervention to reduce HIV stigma and increase HIV testing among AYA in Kazakhstan; and 2) to pilot test this crowdsourced HIV stigma reduction and self-testing intervention in a preliminary efficacy trial to assess feasibility and acceptability and obtain preliminary estimates of its effects on decreasing HIV stigma (primary outcome) and increasing HIV testing (secondary outcome) among AYA (n=168) in Kazakhstan who received the intervention compared to individuals who did not. This work will result in an integrated digital crowdsourced stigma reduction and self- testing intervention to reduce HIV stigma and improve HIV testing uptake among the key population of AYA in Kazakhstan. Such an intervention addressing HIV stigma and reducing barriers to HIV testing for AYA could increase HIV testing uptake among this population in LMICs and domestically.

项目概要/摘要 该项目将评估数字众包干预是否可以减少艾滋病毒耻辱并促进艾滋病毒传播 青少年和年轻人的自我测试（AYA）。在全球范围内，AYA 感染艾滋病毒的风险增加。 在东欧和中亚 (EECA)，15-24 岁 AYA 中新发艾滋病毒感染者预计将 到 2030 年将增加 28%。在哈萨克斯坦，四分之一的艾滋病毒感染者发生在 AYA 中。尽管艾滋病毒日益增多 哈萨克斯坦 AYA 的负担，该人群的艾滋病毒检测率是该国最低的， 很大程度上是由于耻辱。然而，哈萨克斯坦在解决艾滋病毒耻辱及其作为艾滋病毒障碍所发挥的作用方面所做的努力很少 测试。数字技术和众包活动（即，让 AYA 团体在线参与解决 公共卫生挑战和分享解决方案）是可扩展的、具有成本效益的工具，可以增加艾滋病毒检测 服务并减少中低收入国家 (LMIC) 和其他资源有限的国家的艾滋病毒耻辱 设置。鉴于 AYA 社交媒体的高使用率，众包可能在 AYA 中特别成功 和技术素养。作为众包方法的补充，邮寄艾滋病毒快速检测试剂盒可以使 AYA 旨在避免因前往艾滋病中心而带来的耻辱并克服交通障碍。 研究目标是： 1) 采用以社区为基础的参与方法，让当地 AYA 和青少年参与进来 组织开发众包数字艾滋病毒耻辱减少和自我测试干预措施，以减少 哈萨克斯坦 AYA 中的艾滋病毒耻辱和增加艾滋病毒检测； 2) 试点测试这种众包艾滋病毒 在初步功效试验中减少耻辱和自我测试干预，以评估可行性和可接受性 并获得其对减少艾滋病毒耻辱（主要结果）和增加艾滋病毒的影响的初步估计 在接受干预的哈萨克斯坦 AYA (n=168) 中进行测试（次要结果） 没有这样做的人。这项工作将导致集成的数字众包耻辱减少和自我保护 检测干预措施，以减少艾滋病毒耻辱并提高 AYA 重点人群的艾滋病毒检测率 哈萨克斯坦。这种干预措施可以解决艾滋病毒耻辱问题并减少 AYA 艾滋病毒检测的障碍 提高中低收入国家和国内这一人群的艾滋病毒检测率。