Drug Use, HIV
Conditions
Brief summary
This study is a mixed-methods pilot designed to evaluate the feasibility, acceptability, and appropriateness of a brief digital micro-intervention aimed at reducing stigma-related barriers to pre-exposure prophylaxis (PrEP) engagement among people who use drugs (PWUD) in Kazakhstan. Participants will complete baseline and post-intervention surveys and receive structured informational content via Telegram or WhatsApp over approximately 2-3 weeks. The intervention focuses on addressing anticipated stigma, confidentiality concerns, and misinformation that may prevent PWUD from seeking PrEP services. No clinical procedures, medication provision, or biological specimen collection are involved.
Detailed description
The proposed study has three aims: 1. To refine a brief, stigma-informed digital micro-intervention designed to address structural and anticipated barriers to PrEP uptake among people who use drugs (PWUD) in Kazakhstan. 2. To assess the feasibility, acceptability, and appropriateness of delivering this intervention through secure digital platforms (e.g., Telegram or WhatsApp). 3. To evaluate preliminary changes in PrEP-related knowledge, perceived stigma- related barriers, and readiness to seek PrEP services following exposure to the intervention.
Interventions
BEHAVIORALDgital micro-intervention
Intervention will include 6-10 brief modules delivered asynchronously consisting of text-based content with optional simple visuals. There is no requirement for participant response. Messages will avoid explicit labeling referencing HIV or drug use in preview text and be written using neutral language. Participants are allowed to discontinue receipt at any time.
Sponsors
Yale University
National Institute of Mental Health (NIMH)
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Intervention model description
Adults in Kazakhstan who report recent drug use and who are not currently using pre-exposure prophylaxis (PrEP). Participants will be recruited through established community-based harm-reduction organizations that serve people who use drugs (PWUD).
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Self-reported drug use within the past six months * HIV-negative or unknown HIV status (self-reported) * Not currently taking PrEP * Able to provide informed consent * Have access to a personal mobile phone capable of receiving Telegram or WhatsApp messages
Exclusion criteria
* Are unable to provide informed consent * Do not have access to a mobile device for digital message delivery * Are currently enrolled in another PrEP behavioral intervention study
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Mean Score Acceptability of Intervention Measure (AIM) | Baseline and Post intervention (Week 4) | Acceptability of the intervention will be assessed using the Acceptability of Intervention Measure (AIM). It has 4-items scored on a 5-point Likert scale summed to achieve a total score. Total score range of 0-20. Higher scores indicate more acceptability. |
| Mean Score Intervention Appropriateness Measure (IAM) | Baseline and Post intervention (Week 4) | The Intervention Appropriateness Measure (IAM) is a 4-item, 5-point Likert scale ( 1=Completely Disagree to 5=Completely Agree) used to evaluate the perceived fit, relevance, or compatibility of an intervention or implementation strategy. Total score range 0-20. Higher scores indicate better appropriateness. |
| Mean Score Feasibility of Intervention Measure (FIM) | Baseline and Post intervention (Week 4) | Feasibility of intervention measured using Feasibility of Intervention Measure (FIM)- a 4-item instrument to assess perceived intervention feasibility. Total score 1-5 with higher scores indicating greater feasibility. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in PrEP knowledge | Baseline and Post intervention (Week 4) | Measured by a structured survey. Total score range 1-10. Higher scores indicate increased knowledge. |
| Change in perceived stigma-related barriers | Baseline and Post intervention (Week 4) | Measured by a structured survey. Total score range 8-40. Higher scores indicate more barriers. |
| Change in readiness to seek PrEP | Baseline and Post intervention (Week 4) | Measured by Likert scale survey items. Total score range 1-5. Higher scores indicate increased readiness. |
| Mean number of clicks or links accessed | Baseline and Post intervention (Week 4) | Mean number of clicks or links accessed among participants that used the intervention |
| Mean number of messages delivered | Baseline and Post intervention (Week 4) | Mean number of confirmed messages delivered |
Countries
Kazakhstan
Contacts
CONTACTAssel Terlikbayeva, MD, MS, MPH
CONTACTDavid Oliveros, MPH
PRINCIPAL_INVESTIGATORFrederick L Altice, MD
Yale University
Outcome results
None listed