Pilot study “Improving Antiretroviral Therapy (ART) Adherence Among People Who Inject Drugs” (2017)
The primary goal of the pilot project was to collect qualitative data on the acceptability of the core components of SMART Couples (a couple-level evidence-based antiretroviral therapy (ART) adherence intervention) through semi-structured interviews with 18 HIV-serodiscordant couples in Kazakhstan who use injection drugs; identify components that need to be adapted; and assess the perceived facilitators and barriers to participating in SMART Couples. Moreover, this pilot examined the attitudes and perceived acceptability of the use of biomarkers to measure ART Adherence. One aim was to conduct interviews with PWID and healthcare providers to examine their perceptions and attitudes towards the core components of the SMART Couples intervention and determine perceived barriers and facilitators of participating in a couple-based adherence intervention. Another aim was to assess the perceived barriers and attitudes of PWID and healthcare providers towards the use of different measures of ART adherence (self-report, pill count, electronic monitoring, dried blood spot samples, hair samples) through semi-structured interviews.
ADVANCE: Advocacy and Assessment of Naloxone in Central Asia project (2011-2013)
The project on advocacy and assessment of naloxone administration in opioid overdose was the first regional initiative covering Central Asian countries, Kazakhstan, Kyrgyzstan, and Tajikistan. The project was called ADVANCE -Advocacy and Assessment of Naloxone in Central Asia, and was funded by the Open Society Institute. The project goal was to help regional partners to build local capacity for evidence-based advocacy in the countries participating in the project. The project aimed to provide technical support to regional initiatives to expand access to naloxone among opiate users’ communities and social networks in Kazakhstan, Kyrgyzstan, and Tajikistan by providing training to local partners in advanced technologies of data collection and certification to work with human subjects. Moreover, the project was focused at expansion of partnerships with governmental agencies and donors on procurement and wide distribution of Naloxone among different medical facilities, non-governmental organizations and trust points.
ISWOP (2012-2013) – Informing Social Work Practice with Most – At – Risk – Populations (MARPs) for TB and HIV in Central Asia
This study aims to achieve the short-term goal of building skill capacity of outreach workers and nurses, who currently provide psychosocial support services to MARPs for HIV and TB. Through our research team’s expertise and experience in the region, we aim to contribute to the USAID-funded Quality Health Care Project’s long-term goal: institutionalizing functions and educational capacity for psychosocial support services; systematizing productive collaboration between NGOs serving MARPs and the health sector. Using a digital survey, we collected data and focused groups with Central Asian key informants in Kazakhstan, Kyrgyzstan, and Tajikistan. This will also include leadership and front-line staff from governmental and non-governmental agencies serving MARPs for HIV and TB regarding the knowledge and skills needed by social service providers. We will inform strategies to address barriers to engagement into care and HIV testing and care of those most at risk. Additionally, academic leadership training for social workers will be surveyed to gain expertise and to enhance uptake of constructed curriculum. Finally, population key informants will be interviewed to gain understanding of the issues that may inhibit engagement and successful utilization of healthcare services, and how social service staff might support clients and mitigate barriers.
ISWOP (2012-2013): Informing Social Work Practice with Most-At-Risk-Populations (MARPs) for TB and HIV in Central Asia
This study’s short-term goal was to build the capacity of those currently providing psychosocial support services to MARPs for HIV and TB, primarily outreach workers and nurses. We also contributed to the USAID-funded Quality Health Care Project’s long-term goal of institutionalizing functions and educational capacity for psychosocial support services and systematizing productive collaboration between NGOs serving MARPs and the health sector. Using a digital survey and focus groups of key informants in Kazakhstan, Kyrgyzstan, and Tajikistan, data was collected as follows: ascertaining from personnel of governmental and nongovernmental agencies the knowledge and skills needed by social service providers, so as to inform strategies to address barriers to engagement in care and HIV testing and care of those most at risk; acquiring expertise from academic leadership to enhance uptake of curriculum being constructed; and learning from MARPs about issues that may inhibit engagement and successful utilization of healthcare services and how social service staff might support clients and mitigate barriers.
The Preliminary Research Investigation of MSM Estimation (PRIME) (2011-2012)
PRIME was funded by the Republican AIDS Center of Kazakhstan (RAC) and conducted in conjunction with the NGO, Amulet. The overarching goals of the study were to generate preliminary estimates of the number of men who have sex with men (MSM) in Almaty, Astana, Pavlodar, and Shymkent, and to suggest research methodologies for future larger-scale estimations. The estimates generated by this study were 4.2% of the 18-59 year old male population in Almaty, 2.2% in Astana, 0.9% in Pavlodar, and 1.9% in Shymkent, which, if extrapolated to all of Kazakhstan, suggest that 3% of the 18-59 year-old men in the country are MSM (credence in this value is supported by the finding that among the 18-59 year old men in the study’s general population sample 2.5 – 3.0% were MSM depending on whether sex with another man was reported in the past 12 months or ever in the respondent’s lifetime).
Project SHARP (2009-2011)
This study, funded by the Open Society Institute, collected biological and behavioral data in order to inform the design of surveillance systems to accurately track the HIV epidemic among men who have sex with men (MSM); characterize the behaviors driving HIV transmission; target and evaluate prevention and care programs; and advocate for health resources for this population. The survey started with a qualitative formative phase to assess the diversity of social networks of MSM in the designated area followed by a structured survey with 400 MSM in Almaty using respondent driven sampling and biological testing for HIV using rapid testing. In addition to the question on the size of the participants’ social networks and HIV prevalence, key measures included a set of standardized questions on demographics, risk behaviors, health services, and human rights. This study found that about one-fifth of the 400 MSM participants tested positive for HIV.
Factors that Affect HIV Treatment Adherence among IDUs (2009-2010)
This one-year pilot project funded by a Seed Grant from the Center and the Institute for Social and Economic Research Policy (ISERP) was designed to explore factors associated with HIV treatment adherence and non-adherence among HIV-positive injecting drug users in Karaganda and Temirtau, Kazakhstan.The study completed 25 qualitative interviews with HIV positive injecting drug users and focus groups with HIV care service providers.
SHIELD Central Asia (2008-2009)
Funded by the National Institute of Drug Abuse (NIDA), Project SHIELD was a one-year project which adapted an existing HIV prevention program for injecting drug users in Osh, Kyrgyzstan. The intervention – SHIELD – is a social network, peer-driven program that addresses both sexual and drug risk behaviors, and focuses on individual behavior and group norms. Findings from immediate post-intervention demonstrated that the SHIELD intervention has a potential for wider scale-up in Central Asia to reduce drug and sexual risk among IDUs and their risk networks.Pre post repeated measure show that at immediate post test for both index and network members reported in the previous thirty days, a reduction in number of sexual partners, a decrease in having unprotected vaginal and/or anal sex, an increase in number of participants who reported reduced frequency of sharing needles and increased utilization of needle exchange programs.
Factors that Affect HIV Treatment Adherence among IDUs in Kazakhstan (2008-2009)
This one-year pilot project funded by a Seed Grant from the Center and the Institute for Social and Economic Research Policy (ISERP) was designed to examine factors associated with HIV treatment adherence and non-adherence among HIV-positive injecting drug users in Karaganda and Temirtau, Kazakhstan.
Tajikistan HIV/AIDS Prevention (2005-2007)
With support from the National Institutes of Health (NIH), the Center collaborated with the Tajikistan Ministry of Health and the Tajik HIV/AIDS Center for Prevention and Care to develop and implement HIV prevention research with sex workers in Tajikistan.
Marketplace Pilot Study (2007)
Funded by Columbia University’s Institute for Social and Economic Research and Policy (ISERP), GHRCCA and the Moore Foundation, this pilot study examined correlates of risky sexual behaviors and the prevalence of HIV, hepatitis C, and syphilis among migrant market workers in Almaty, Kazakhstan. Data was used to inform a larger study, The Silk Road Health Project.
Family-Centered HIV/AIDS Treatment and Care (2008-2009)
Funded by a Seed Grant from the Center and the Institute for Social and EconomicResearch Policy (ISERP), this project assessed the needs of women and children infected with HIV/AIDS. The Center worked with UNICEF-KZ to develop and implement a survey to assess current psycho-social programs set up to address the HIV outbreak among women and children in Shymkent. The survey and site visit provided a foundation to develop new research projects focusing on family-centered HIV/AIDS treatment and care programs for women and children.
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