Project Orleu: Reducing Intersectional and HIV Stigma Among Health Care Providers and High Risk Women Who Use Drugs in Kazakhstan

NCT06932796 | Completed

• 2 other identifiers: AAAU3129R01TW012405
• Study Type: interventional
• Target: 83
• Locations: 1 country
• Sites: 1

Brief Summary

Suboptimal linkage to and retention in HIV prevention and care is prevalent among high-risk women who use or inject drugs in both the US and globally, including high HIV incidence contexts like Kazakhstan; addressing HIV and intersectional stigma, especially from health care providers (HCP) within clinics, is necessary to increase engagement in the HIV care and prevention continuum. To address this challenge and increase HIV prevention and care, the proposed study will involve the design and assessment of the acceptability, feasibility, and usability of a three component, multi-level participatory intervention to promote stigma resistance/coping and reduce anticipated/internalized stigma among high-risk women who use drugs as well as to reduce enacted stigma among HCP in Kazakhstan, Central Asia. Results of this study will generate information in order to power a future preliminary effectiveness trial and will be unique in utilizing multilevel anti-stigma approaches for both high risk women who use drugs and HCP, all of which will have important implications for advancing HIV prevention and care engagement among highly stigmatized populations in diverse settings.

Conditions

Stigma, Social

Keywords

Intersectional Stigma; HIV; Linkage to Prevention and Care; Service Delivery; Women; Drug Use; Sex Work

Outcome Measures

Primary Outcomes (1)

• Provider HIV Enacted Stigma Measure

  This 4-item measure is adapted from the "Measuring HIV Stigma and Discrimination among Health Facility Staff" questionnaire enacted stigma sub-scale. Across the 4 items, Likert-responses range from 1 (never observed) to 4 (always observed).

  6 months

Secondary Outcomes (2)

• Total Number of PrEP Prescriptions Issued to Clients

  6 months

• Total Number of Clients

  6 Months

Study Arms (1)

Provider Training and Clinic Messaging

EXPERIMENTAL

Providers receive a 5-session stigma-free clinic training and anti-stigma messaging campaign materials to display in clinic.

Behavioral: Health Care Provider Stigma Training and Clinic-Based Messaging Campaign

Interventions

Health Care Provider Stigma Training and Clinic-Based Messaging Campaign BEHAVIORAL

Providers in 10 HIV clinics participated in a 5 session anti-stigma health facility training focused on: 1) raising awareness about stigma and discrimination at the facility; and 2) changing attitudes and behaviors towards women who use drugs and/or trade sex; and 3) building a stigma-free clinic. Each of these clinics also received anti-stigma messaging materials (i.e., pamphlets, posters) to display in their clinics over a 6 month period. Providers received text-based message twice a month during this time to reinforce skills learned during trainings and to empower providers to be stigma change agents. Providers completed pre/post survey assessments.

Provider Training and Clinic Messaging

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Providers (e.g., physicians, nurses, clinic directors, epidemiologists, outreach workers)
• Aged 18 years or older
• Currently employed part or full-time at an AIDS Center friendly clinic (city clinics focused on the provision of HIV and sexual health care).

You may not qualify if:

• \- Providers who are less than 18 years of age and/or do not work at an AIDS center friendly clinic.

Sponsors & Collaborators

• Columbia University: lead
• Fogarty International Center of the National Institute of Health: collaborator
• University of Pennsylvania: collaborator

Study Sites (1)

Global Health Research Center for Central Asia

Almaty, Kazakhstan

Location

MeSH Terms

Conditions

Social Stigma; Sex Work

Condition Hierarchy (Ancestors)

Social Behavior; Behavior; Sexual Behavior

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor

Model Details: Pre/Post Design

Study Record Dates

• First Submitted: April 10, 2025
• First Posted: April 17, 2025
• Study Start: August 15, 2024
• Primary Completion: May 15, 2025
• Study Completion: May 15, 2025
• Last Updated: July 20, 2025

Record last verified: 2025-07

Data Sharing

• IPD Sharing: Will not share

Locations

KA (1)