Crowdsourcing to Reduce HIV Stigma Among Adolescents and Young Adults in Kazakhstan
Condition: Stigma, Social; HIV Testing
Study type: Interventional

Summary: 
      This project will assess whether a digital crowdsourced intervention can reduce HIV stigma
      and promote HIV self-testing among adolescents and young adults (AYA). NIH has emphasized the
      need for research on interventions to reduce HIV-associated stigma and its impact on the
      prevention and treatment of HIV/AIDS, particularly in low and middle income countries
      (LMICs). The proposed study has the highest public health significance: it uses a
      community-based participatory approach to engage local AYA to develop a digital crowdsourced
      HIV stigma reduction and self-testing intervention to reduce HIV stigma and increase HIV
      testing.

      Study Aim 1: To develop a crowdsourced digital HIV stigma reduction and self-testing
      intervention targeting AYA in Kazakhstan. Using a community-based participatory approach that
      engages local adolescents and young adults (AYA) and youth organizations, we will launch a
      national crowdsourcing contest in which AYA will design multimedia content to reduce HIV
      stigma in order to promote HIV testing among peers.

      Study Aim 2: To pilot test this crowdsourced HIV stigma reduction and self-testing
      intervention in a preliminary efficacy trial. We will assess the intervention's feasibility
      and acceptability and obtain preliminary estimates of its effects on decreasing HIV stigma
      (primary outcome) and increasing HIV testing (secondary outcome) among AYA in Kazakhstan who
      received the intervention compared to individuals who did not. Participants (n=168) will be
      randomized 1:1 to: 1) receive the winning multimedia crowdsourced HIV stigma reduction
      content and a link for HIV self-testing, or 2) receive standard Kazakhstan Ministry of Health
      HIV informational materials and a link for HIV self-testing.
    

Detailed description: 
      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.
    

Intervention name(s): Digital Crowdsourced Intervention to Reduce HIV Stigma among Adolescents and Young Adults
Intervention type(s): Behavioral
Intervention description(s): Adolescents and young adults will participate in a crowdsourcing contest to create digital materials to reduce HIV stigma in order to increase HIV testing. Entries will be judged by a community judging panel and expert judging panel. Winning entries will be selected for the digital intervention and presented to participants in the intervention arm.
Allocation: Randomized
Intervention model: Single Group Assignment
Intervention model description: Participants will be randomized to receive the digital crowdsourced intervention or standard of care (existing HIV informational materials). We will examine effects of the intervention on reducing HIV stigma and increasing HIV testing.
Masking: Single (Participant)
Primary purpose: Diagnostic
Keywords: HIV stigma