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UNI Project – At risk men’s involvement in HIV treatment continuum in the Republic of Kazakhstan (2017 – 2021)

Kazakhstan has a significant need for renewed and innovative HIV prevention and treatment efforts. Kazakhstan is one of the only nine countries that saw >25% increase in HIV incidence in the first decade of this century. Besides, AIDS-related mortality has actually increased 21% between 2005-2011 in Central Asia.

Several lines of evidence point to the value and urgent need for research on at-risk men who in Kazakhstan. Men who have sex with men (MSM) are one of the key at-risk populations that bear the disproportionate brunt of the pandemic. Likewise, drug use and drug injecting are the major factors in HIV infection transmission in Kazakhstan. The UNI project seeks to engage at-risk men who use drugs to get tested for HIV and subsequently link to friendly care and treatment services.

The proposed study includes step-by-step clinical trial (intervention) in 4 cities of Kazakhstan involving 1,000-1,400 at-risk men. Intervention training program will be delivered for at-risk men on the issues of becoming experts and promoters of other at-risk men’s engagement in HIV testing, treatment and care through social networks.

Study goals:

1. Deliver and test/evaluate an intervention that will increase the number of at-risk men engaged in the HIV care continuum. This intervention will help Kazakhstan meet the UNAIDS strategy of “90-90-90” by:

  • Increasing the number of at-risk menwho get tested, and hence, detecting those who are HIV-infected (“living with HIV”)
  • Increasing the number of at risk men living with HIV on antiretroviral treatment
  • Increasing the number of at risk men living with HIV who achieve viral suppression

2. The detection and “treatment as prevention” will reduce the overall incidence and prevalence of HIV among a key population in Kazakhstan
3. Develop and evaluate resources, infrastructure, and procedures needed for intervention implementation and scale-up

Innovative approach

1. 4 weekly group sessions where participants are trained to become “peer health promoters”
2. Disseminate/diffuse HIV and health literacy, as well as information on accessing services at AIDS centers
3. Trained to become highly effective in reaching at-risk men both face-to-face  and via social media
4. Designed to enhance an evidence-based intervention to have a “multiplier effect.” The impact is multiplied because:

  • Reaches individual at-risk men plus their larger social networks of hidden and at-risk men
  • Offering STI testing is not only an incentive for at-risk men participation, but has a preventive effect because treatment of STIs is known to reduce HIV transmission

Project news

On April 23, 2017, the Global Health Research Center in Central Asia (GHRCCA) hosted an event for the partners of the UNI project at its main office in Almaty. Leaders of GHRCCA presented the project’s goals and objectives, and further discussed cooperation with the AIDS service organizations, health institutions, and other public organizations in the country.

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In April 2017, Dr. Jeremy Sugarman of the Johns Hopkins University (JHU) visited GHRCCA. Dr. Sugarman is the Harvey M. Meierhoff Professor of Biology and Medicine at JHU, and the Deputy Director for Medicine of the Johns Hopkins Berman Institute of Bioethics. He is a world-renown leader in biomedical ethics with extensive experience in applying empirical methods and scientifically based standards for bioethical issues assessment and analysis. He is also a consultant to the UNI project.

On April 20, 2017, Dr. Sugarman was invited to speak at the Kazakh National University named after Al-Farabi on “Navigating Ethical Issues in HIV Prevention Research”. The presentation was attended by KAZNU students and professors, members of research institutes, members of international organizations, as well as the representatives of the Republican AIDS Center.

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