Numerous investigators from SIG and the Global Health Research Center of Central Asia (GHRCCA) will be presenting at the Twentieth European AIDS Conference of the European AIDS Clinical Society (EACS), which will be held in Paris, France, from October 15 to 18, 2025. The conference, held every two years, provides an opportunity for healthcare professionals, scientists, and other community members to share knowledge, forge collaborations, and inspire each other through their work.
The SIG and GHRCCA presentations largely address sex exchange in Kazakhstan, focusing in on specific topics such as mental health, attitudes toward PrEP, and HIV research participation. The details of selected presentations are available below.
Victoria Frye, SIG Co-Director
Title: Did the AEGIDA Intervention Reduce Sexual Behaviors Associated with HIV Acquisition among Women who Exchange Sex and/or Use Substances in Kazakhstan?
AEGIDA is a socio-behavioral HIV prevention intervention designed to support consistent HIV testing via self-testing training among women in Kazakhstan who exchange sex and use substances. The primary outcome was HIV testing, with secondary outcomes including sexual behaviors that increase likelihood of HIV acquisition. In this poster, we report results of a modified intent-to-treat analysis of these behavioral outcomes. We found that, at baseline, 83% of participants in each arm reported condomless vaginal sex with any partner; at 6-month follow-up, 70% of participants in the active arm did, compared to 96% of participants in the control arm. Thus, participants randomized to AEGIDA were significantly less likely to report condomless vaginal sex with any partner (aOR= 0.10; 95% CI: 0.10,0.84; p<.04) at 6-month follow-up compared to control participants. The intervention had no significant impact on condomless sex with paying partners. We conclude that, in addition to increasing likelihood of recent HIV testing, the AEGIDA intervention reduced likelihood of condomless vaginal sex with main partners, which is important to STI, as well HIV, acquisition and transmission.
Sholpan Primbetova, GHRCCA Deputy Regional Director
Poster title: Trauma-Informed HIV Research Participation and Declines in Partner Violence Among Women Who Exchange Sex and Use Substances (WESUS) in Kazakhstan (AEGIDA)
This study demonstrates that trauma-informed HIV interventions like AEGIDA can do more than reduce HIV risk—they can actively lower women’s exposure to gender-based violence (GBV), offering hope for healthier and safer futures for some of Kazakhstan’s most vulnerable women. This research addresses one of the most urgent health and human rights challenges in Kazakhstan and Central Asia: the overlapping crises of gender-based violence and HIV risk among women who exchange sex and use substances (WESUS). Violence not only increases direct HIV exposure but also erodes trust in health systems, discourages testing, and undermines engagement with essential services.
The study evaluated AEGIDA, a trauma-informed, four-session intervention combining motivational interviewing, cognitive restructuring, peer education, and trauma-sensitive care. Conducted with 90 participants across 2022–2023, the research found that both the intervention and control groups reported reductions in violence over six months. Notably, non-paying partner abuse significantly declined in the control arm, and decreases in physical, psychological, and sexual abuse were observed across groups.
A key insight is that trauma-informed and respectful research settings themselves can contribute to violence reduction, suggesting that even the process of engaging women in safe, supportive environments creates protective effects. The findings highlight the potential of brief, behavioral HIV interventions not only to improve safer sex self-efficacy and treatment adherence but also to reduce exposure to GBV. The study concludes that scaling up GBV-sensitive HIV interventions is essential for long-term sustainability, and future research should further explore the mechanisms through which violence reduction occurs.
Assel Terlikbayeva, GHRCCA Regional Director
Poster title: Internalized stigma and mental health symptoms among females who engage in sex work and use drugs in Kazakhstan: baseline insights from the AEGIDA study (AEGIDA)
This research provides rare evidence from Central Asia, highlighting how internalized sex-work stigma fuels depression and anxiety among women who exchange sex and use drugs. By centering mental health in HIV and harm-reduction programming, Kazakhstan can lead in building stigma-free, trauma-informed approaches with global relevance.
Poster title: Negative beliefs about methadone and barriers to opioid agonist therapy in Kazakhstan: findings from a multi-city respondent-driven sampling (RDS) study (ExMAT study: Expanding methadone-assisted therapies across Central Asia)
This multi-city study of 450 people who use opioids in Kazakhstan reveals that stigma and negative beliefs about methadone remain a critical barrier to methadone-assisted therapy (MAT) enrollment. Despite MAT’s proven role in HIV prevention, uptake is alarmingly low, with only 10% ever attempting to enroll. The findings underscore the urgent need for client-centered education and culturally tailored approaches to expand treatment and strengthen HIV prevention in the region.
Tara McCrimmon, T32 Predoctoral Fellow
Poster title: Attitudes towards PrEP among women engaged in sex work who use drugs in Kazakhstan (AEGIDA)
Poster title: Provider willingness to discuss and prescribe PrEP with women at risk of HIV in Kazakhstan (PrEP for Women training)
Pre-exposure prophylaxis (PrEP) for HIV prevention has been available globally for over a decade, but was only introduced in Kazakhstan in 2021. Globally, women often have lower uptake of PrEP than men, and a similar pattern may be emerging in Kazakhstan, since initial dissemination efforts mainly targeted MSM populations. Marginalized women, such as those engaged in sex work or drug use, may face even higher barriers to PrEP access due to lower awareness, social or provider stigma, and structural challenges in accessing care.
These two posters explores this issue from complementary perspectives: The first poster looks at what factors are associated with positive attitudes toward PrEP among women in the Aegida study (HIV-negative women who exchange sex and use drugs), while the second looks at what factors are associated with medical providers likelihood of discussing and prescribing PrEP with women clients. Together, these findings highlight key barriers to accessing PrEP in traditional medical institutions, and emphasize the essential roles of trusted NGOs to act as community liaisons in supporting PrEP uptake among marginalized groups of women.
In December, predoctoral fellow Tara McCrimmon and former Columbia School of Social Work MSW student Olivia Cordingley (currently pursuing a PhD at Drexel) will have a viewpoint piece published in Health & Human Rights responding to a new law in Kazakhstan that imposes stricter penalties on trafficking. Due to the language used, there is a risk that sex workers could be violating it if they advertised their services, and potentially even NGOs if they design programming for sex workers. In other countries, similar laws have lead to increased policing that drives sex work deeper underground, further isolating and endangering women who exchange sex for money. The piece will mainly be focused on concrete actions NGOs and medical workers should take to be able to continue providing services to these women without finding themselves in legal trouble. The law, and the piece, show how the environment around sex work is increasingly challenging and legally fraught, limiting the access of women who exchange sex for money to all services, not just HIV prevention and treatment.