Understanding Risk Factors for HIV and Creating Innovative Prevention Interventions in Kazakhstan:
The Renaissance and Marketplace Projects

Led by Drs. Nabila El-Bassel, Louisa Gilbert, and Anne Malin of Columbia University and the Global Health Research Center of Central Asia
Co-Investigators: Dr. Chris Beyrer and Mark Berry

Grave concern exists among international health leaders in respect to the current HIV epidemic in Central Asia, a region where the prevalence of HIV is continuing to rise.  In Kazakhstan, the existence of heavy drug-trafficking, availability of low-cost heroin, and mobile populations of migrant workers and traders place groups such as sex workers, injecting drug users (IDUs), and migrant vendors at the greatest risk of infection, while cities, such as Almaty, that are involved in heavy trading activity tend to have higher levels of HIV infection as well.

CPHHR investigators, Dr. Chris Beyrer and Mark Berry, have been invited to collaborate with Dr. Nabila El-Bassel and researchers from Columbia University’s Global Health Research Center of Central Asia (GHRCCA) to further examine the risk factors and societal influences on HIV and sexually transmitted infection (STI) epidemics in Kazakhstan.  The Marketplace Study, conducted in 2008 – 2012 in the Barakholka Market of Almaty, focuses on HIV and STI rates among migrant male market vendors.  This study is conducted in two phases; the first phase includes qualitative interviews among 60 randomly selected vendors to understand the context of sexual risk, while the second phase is a longitudinal assessment of HIV/STI incidence among 2,000 randomly selected vendors.  This study is supported by the National Institue of Mental Health (NIMH).

Dr. Beyrer is also collaborating with the GHRCCA's Project Renaissance, conducted in 2008-2013 in Chu, Kazakhstan, that was developed in response to the lack of behavioral interventions available to the particularly vulnerable IDU population.  The study is enrolling IDUs and their intimate partners (a total of 400 couples) to test the efficacy of a couples-based HIV/STI prevention intervention.  The project also aims to increase condom use and reduce unsafe injection practices among the IDUs. This project is supported by the National Institue on Drug Abuse (NIDA).  Click on the link to see Dr. El-Bassel's award announcement. 

The long-term objective of these studies are to augment the knowledge of HIV and STI transmission factors and risky behaviors, as well as inform local officials and organizations so more appropriate and efficacious HIV and STI prevention and treatment programs can be made available to vulnerable populations in Central Asia. 

Publication:
Gilbert L, El-Bassel N, Terlikbayeva A, Rozental Y, Chang M, Brisson A, Wu E, Bakpayev M. Couple-Based HIV Prevention for Injecting Drug Users in Kazakhstan: A Pilot Intervention Study.Journal of Prevention & Intervention in the Community, 2010; 38: 2, 162 — 176.