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

项目摘要/摘要 该项目将评估数字众包干预是否可以减少艾滋病毒污名并促进艾滋病毒 青少年和青壮年自我测试(Aya)。在全球范围内，阿亚感染艾滋病毒的风险增加。 在东欧和中亚(EECA)，15-24岁的Aya中预计将出现新的艾滋病毒感染病例。 到2030年增长28%。在哈萨克斯坦，四分之一的艾滋病毒感染发生在阿亚人中。尽管艾滋病毒不断增长 在哈萨克斯坦的阿亚族中，这一人群的艾滋病毒检测率是全国最低的， 很大程度上是因为耻辱。然而，哈萨克斯坦几乎没有努力解决艾滋病毒的污名及其作为艾滋病毒屏障所起的作用 测试。数字技术和众包活动(即，让Aya在线团体参与解决 公共卫生挑战和共享解决方案)是可扩展的、经济高效的工具，可以增加艾滋病毒检测 在中低收入国家和其他资源有限的国家提供服务和减少艾滋病毒污名 设置。考虑到社交媒体的高使用率，众包在Aya中可能特别成功 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实现 避免与参加艾滋病中心相关的耻辱，并克服交通障碍。 研究的目标是：1)采用以社区为基础的参与式方法，让当地的阿亚人和青年参与进来 组织开发众包数字艾滋病毒污名减少和自我检测干预，以减少 在哈萨克斯坦的Aya中羞辱艾滋病毒并增加艾滋病毒检测；以及2)试点测试这种众包艾滋病毒 在初步疗效试验中减少污名和自我测试干预以评估可行性和可接受性 并对其减少艾滋病毒污名(主要结果)和增加艾滋病毒的影响进行初步估计 在哈萨克斯坦接受干预的Aya(n=168)中的检测(次要结果)与 没有做到这一点的个人。这项工作将导致综合数字众包耻辱的减少和自我 年阿亚重点人群减少HIV污名和提高HIV检测接受率的检测干预措施 哈萨克斯坦。这种干预措施可以消除艾滋病病毒的污名，减少艾滋病病毒检测的障碍 在低收入国家和国内的这一人群中增加艾滋病毒检测的接受率。

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.