A digital citizen science intervention to reduce HIV stigma and promote HIV testing: a randomized clinical trial among adolescents and young adults in Kazakhstan
Background Kazakhstan has a high HIV incidence among adolescents and young adults (AYA), and high HIV stigma contributing to low HIV testing uptake. We examined whether an AYA-developed digital crowdsourced intervention reduced HIV stigma compared with conventional public health materials among AYA in Almaty, Kazakhstan. Methods A total of 216 AYA (females:116/males:110) aged 16-24 years were recruited to the online study cohort and randomized 1:1 to the intervention or control arm. AYA were exposed to the crowdsourced intervention or control materials once a week for 5weeks, with equivalent exposures between arms. Outcomes included a total HIV stigma score assessed at baseline, immediately post-intervention and 2months post-intervention from January to August 2023. We conducted multilevel mixed models to compare changes over time by arm and sex. Results AYA in the intervention arm had significantly lower HIV testing stigma 2months post-intervention (adjusted mean change (AMC): -0.73 (-1.07, -0.39)) than AYA in the control arm (AMC: -0.06 (-0.42, 0.30); P =0.032). Female AYA in the intervention arm had significantly lower total HIV stigma immediately post-intervention (AMC: -4.91 (-7.25, -2.58)) and 2months post-intervention (AMC: -5.16 (-7.48, -2.84)) than females in the control arm (immediately post-intervention AMC: -0.03 (-2.63, 2.57) and 2-months post-intervention AMC: -0.07 (-2.70, 2.56); P =0.012, P =0.012). Conclusions The AYA-developed crowdsourced intervention decreased HIV testing stigma, although this effect was moderated by sex, and decreased total HIV stigma among female AYA. Crowdsourced interventions may be a promising way to engage communities to develop interventions to decrease HIV stigma.
Authors
- Zhamilya Nugmanova
- Vitaliy Vinogradov (ORCID: https://orcid.org/0009-0008-3839-7337)
- Laura Nyblade (ORCID: https://orcid.org/0000-0001-8067-4192)
- Denis Gryazev
- Akbota Tolegenova (ORCID: https://orcid.org/0000-0001-8121-3259)
- Alissa Davis (ORCID: https://orcid.org/0000-0003-2084-9741)
- Dmitriy Bekker
- Meruyert Darisheva
- Amirali Kuanysh
- Gaukhar Mergenova (ORCID: https://orcid.org/0000-0003-4702-1944)
- M. Yu. Maximova (ORCID: https://orcid.org/0000-0002-7682-6672)
- Susan L. Rosenthal (ORCID: https://orcid.org/0000-0002-8119-725X)
- Sholpan Primbetova (ORCID: https://orcid.org/0000-0002-7633-7764)
- A. M. Li
- Ainur Akhmetova (ORCID: https://orcid.org/0000-0002-5557-3338)
- Azamat Kuskulov
- Weiming Tang (ORCID: https://orcid.org/0000-0002-9026-707X)
- L. A. Polyakova
- Valera Gulyaev
- Zhandos Ali Brown
- Sholpan Karzhaubayeva
- Nathalia Dias
- Assel Terlikbayeva (ORCID: https://orcid.org/0000-0002-4067-1998)
- Joseph D. Tucker (ORCID: https://orcid.org/0000-0003-2804-1181)
- Karsten Lunze (ORCID: https://orcid.org/0000-0001-8495-0350)
- Alfiya Denebayeva
- Mingway Chang (ORCID: https://orcid.org/0000-0002-6816-7187)
- Arman Duisenbayev (ORCID: https://orcid.org/0009-0000-0588-0586)
- A. G. Aleshina
- Olga Balabekova
- Zhannat Mussina
- Yihang Sun
- Zhanna Kalmatayeva
- Sara E. Landers (ORCID: https://orcid.org/0000-0002-2418-1366)
- Ainur Absemetova
- Sairankul Kassymbekova
- Gulnar Bekenova
- Zhanneta Kanaevna Zhazykbaeva
- Amir Shaikezhanov
- Bella Orynbetova
- Elena Norakidze
- Mashirov Kozhakhmet
- Aknur Imadillda
- Dariga Satkhozhina
- Alikhan Kartamyssov
- Zhamilya Kanieva
- Olzhas Makhan
- Aida Muravyova
- Adema Rahimzanova
- Zhanerke Tursynbek
- Malika Beken
- Miras Murzakhan
- Daniyal Maitekov
- Sandizaira Mergen
- Dautali Mergenov
- Anuar Rakhimbekov
- Yenlik Baisbay
- Alibek Aruzhan
- Zhasmina Kozhambet
- Denis Grebenchishikov
- Sultan Kozhamberdiev
- Dauren Salykov
- Madina Sagimbayeva
- Kamila Yussupova
Institutions
- Almaty Management University (KZ)
- Boston University (US)
- University of North Carolina at Chapel Hill (US)
- University of London (GB)
- Boston Medical Center (US)
- Kazakh National Medical University (KZ)
- Narxoz University (KZ)
- International Life Sciences Institute (US)
- London School of Hygiene & Tropical Medicine (GB)
- South Kazakhstan Medical Academy (KZ)
- Kazakh Institute of Oncology and Radiology (KZ)
- Kazakh University Ways of Communications (KZ)
- Kazakhstan Medical University (KZ)
- Global Health Research Center of Central Asia (KZ)
- Kazakhstan Association on Sexual and Reproductive Health (KZ)
- Human Growth Foundation (US)
- Center for Human Reproduction (US)
- Nazarbayev University (KZ)
- Columbia University (US)
Publication Details
- Journal
- Sexual Health
- Published
- 2025-03-26
- DOI
- https://doi.org/10.1071/sh24235
- Citations
- 3
- Primary Topic
- HIV/AIDS Research and Interventions
- Type
- article
- Field-Weighted Citation Impact
- 4.19
Funders
- National Institute on Drug Abuse
- National Institute of Allergy and Infectious Diseases
- Fogarty International Center
- Eunice Kennedy Shriver National Institute of Child Health and Human Development