HIV Stigma, Homophobia, Sexual and Gender Minority Community Connectedness and HIV Testing Among Gay, Bisexual, and Other Men and Transgender People Who Have Sex with Men in Kazakhstan

Abstract

Although HIV incidence is rising among gay, bisexual, and other men (MSM) and transgender people who have sex with men (TSM) in Kazakhstan, whether stigmatizing attitudes and connectedness are associated with HIV testing in this region is not known. We analyzed data from one-time interviews with 304 adult MSM and TSM conducted 2018–2019 in three cities in Kazakhstan. Logistic regression determined whether HIV stigma, internalized homophobia, sexual and gender minority (SGM) connectedness predicted HIV testing (within the lifetime, past year, and past 6 months) before and after adjustment for sociodemographic characteristics. 80% of participants reported ever receiving an HIV test. Gay-identified participants reported less HIV stigma and internalized homophobia as well as greater connectedness relative to those with bisexual or other identities. In adjusted models, those who had ever tested reported lower HIV stigma (aOR 0.83, 95% CI 0.76–0.91, P <.001) and higher connectedness (aOR 1.17, 95% CI 1.06–1.29, P =.003) than those who had not; those who had ever tested reported lower internalized homophobia in the unadjusted model only (OR 0.95, 95% CI 0.91–0.99, P =.01). Similar differences and trends were found in models examining testing in the past year and past 6 months. Addressing stigmatizing attitudes and connectedness may improve uptake of HIV testing among MSM and TSM in Kazakhstan.