HIV Prevention and Awareness Among People with Substance Use Disorders in Kazakhstan: A Systematic Review

Indira Karibayeva 1 2 * , Botagoz Turdaliyeva 2, Manshuk Ramazanova 3
More Detail
1 Department of Health Policy and Community Health, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, USA
2 Department of Science, Kazakh Scientific Center of Dermatology and Infectious Diseases, Almaty, Kazakhstan
3 Department of Public Health and Social Sciences, Kazakhstan Medical University “KSPH”; Almaty, Kazakhstan
* Corresponding Author
J CLIN MED KAZ, Volume 22, Issue 3, pp. 16-28. https://doi.org/10.23950/jcmk/16329
OPEN ACCESS 380 Views 190 Downloads
Download Full Text (PDF)
Author Contributions: Conceptualization, I.K.; methodology, I.K. and M.R.; validation, I.K. and B.T.; formal analysis, I.K.; investigation, I.K.; resources, I.K. and B.T.; data curation, I.K.; writing – original draft preparation, I.K. and B.T.; writing – review and editing, I.K., B.T. and M.R.; visualization, I.K.;  supervision, I.K.; project administration, I.K. and M.R.; funding acquisition, I.K. and B.T. All authors have read and agreed to the published version of the manuscript.

Data availability statement: The corresponding author can provide the data supporting the study's conclusions upon request. Due to ethical and privacy constraints, the data are not publicly accessible.

ABSTRACT

The aim of this review is to assess the available research on HIV prevention and awareness efforts among individuals with substance use disorders in Kazakhstan, in order to identify primary themes and subthemes. A systematic search of five databases was conducted using a pre-defined search strategy, according to the established guidelines. Key populations of interest: people who inject drugs, novel psychoactive substance users, youth substance use, men who have sex with men, female sex workers and migrant workers. Forty studies were included. Within the people who inject drugs cohort, research themes were categorized into four groups: Project Renaissance, Project Bridge, optimized HIV case finding and no project. Among novel psychoactive substance users, research focused on novel psychoactive substance and polydrug use, prevalence rates, associated influences, and the impact of COVID-19. Studies involving youth substance users addressed the Kazakhstani Families Together intervention and COVID-19's effects. For men who have sex with men, investigations included HIV prevention trials with themes of novel psychoactive substance and polydrug use, HIV testing, early sexual experiences, and chemsex. Research on female sex workers examined interventions like Project Nova and Aegida. For migrant workers, research included the Silk Road Health Project with the following themes: alcohol abuse, sexual risk behaviors, and limited healthcare access. Despite Kazakhstan’s initiatives in HIV prevention, research gaps remain, particularly concerning novel psychoactive substance users, overdose prevention, bio-behavioral interventions, mHealth approaches, and illicit drug use pattern analyses.
Keywords: HIV, preventive medicine, awareness, substance-related disorders, systematic review, drug users, HIV testing, sexual and gender minorities

CITATION

Karibayeva I, Turdaliyeva B, Ramazanova M. HIV Prevention and Awareness Among People with Substance Use Disorders in Kazakhstan: A Systematic Review. J CLIN MED KAZ. 2025;22(3):16-28. https://doi.org/10.23950/jcmk/16329

REFERENCES

  • UNAIDS. Fact sheet 2024 - Latest global and regional HIV statistics on the status of the AIDS epidemic. 2024 [cited 16 Sep 2024]. Available: https://www.unaids.org/sites/default/files/media_asset/UNAIDS_FactSheet_en.pdf
  • World Health Organization (WHO). HIV and AIDS. In: Fact Sheets [Internet]. 22 Jul 2024 [cited 16 Sep 2024]. Available: https://www.who.int/news-room/fact-sheets/detail/hiv-aids?gad_source=1&gclid=Cj0KCQjwrp-3BhDgARIsAEWJ6SyZBGA-LCCUZJdNg9JWjSAo5k3LwKwZVyF5tzPtFniQYXFX0A8fW98aAsbdEALw_wcB
  • UNAIDS. Country factsheets: HIV and AIDS estimates – Kazakhstan. 2024 [cited 12 Nov 2024] pp. 1–10. Available: https://www.unaids.org/en/regionscountries/countries/kazakhstan?utm_source=chatgpt.com
  • UNAIDS. Key Results in 2022–2023: Kazakhstan. 2024 [cited 13 Nov 2024] pp. 1–4. Available: https://open.unaids.org/countries/kazakhstan
  • Wu E, Terlikbayeva A, Hunt T, Primbetova S, Lee YG, Berry M. Preliminary Population Size Estimation of Men Who Have Sex with Men in Kazakhstan: Implications for HIV Testing and Surveillance. LGBT Health. 2017(2);4: 164–167. https://doi.org/10.1089/lgbt.2015.0152
  • Liberman A, Ivasiy R, Altice F, Bromberg D, Ibragimova O, Seksenova Z, Madden L, Primbetova S, Terlikbayeva A. Stalled Scale-Up of Opioid Agonist Therapies for HIV Prevention in Kazakhstan: History, Policy, and Recommendations for Change. J Illicit Econ Dev. 2023;5(2): 69–77. https://doi.org/10.31389/jied.208
  • McCrimmon T, Sundelson A, Darisheva M, Gilbert L, Hunt T, Terlikbayeva A, Primbetova S, El-Bassel N. HIV Care Continuum Services for People Who Inject Drugs in Kazakhstan During COVID-19: A Qualitative Study of Service Provider Perspectives. Glob Health Sci Pract. 2022;10(2): 1–10. https://doi.org/10.9745/ghsp-d-21-00619
  • Prilutskaya M, Yussopov O, Negay N, Altynbekov K, Tokayeva M. Prevalence of new psychoactive substances addiction: a hospital-based cross-sectional study. J Clin Med Kaz. 2020;1(55): 11–16. https://doi.org/10.23950/1812-2892-jcmk-00730
  • Prilutskaya M. Exploring Novel Psychoactive Substances Among Kazakhstan’s Youth: A Focus on Emerging Trends and Risks. Lisb Addict. 2024:1–2.
  • APCOM. National Strategic Plan on HIV/AIDS Summary Series: Kazakhstan. 2022 [cited 13 Nov 2024] pp. 1–6. Available: https://www.apcom.org/wp-content/uploads/2023/02/Country-summary-HIV-KP-snapshot-Kazakhstan_v1.pdf?utm_source=chatgpt.com
  • National Institute for Health and Care Research. PROSPERO. International prospective register of systematic reviews. In: NIHR [Internet]. 2024 [cited 27 Mar 2024]. Available: https://www.crd.york.ac.uk/prospero/
  • Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Telzlaff J, Akl E, Brennan S. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372: 1-9. https://doi.org/ 10.1136/bmj.n71
  • Mukherjee T. Structural Determinants of HIV Risk among Women Who Use Drugs in Kazakhstan. Columbia University. 2022. Available: https://www.proquest.com/openview/a3f353bd2a7347a921440af2a149271a/1?pq-origsite=gscholar&cbl=18750&diss=y
  • Vélez-Grau C, El-Bassel N, McCrimmon T, Terlikbayeva A, Primbetova S, Mergenova G, Bussey E, Choudhury A, Kalinowska K, Witte S. “I never hoped for anything … now I have other plans”: The role of microfinance in HIV intervention for women who use drugs and engage in sex work in Kazakhstan. Int Soc Work. 2022;65(4): 663–677. https://doi.org/10.1177/0020872820917737
  • Ismayilova L, Terlikbayevab A, Rozentalb Y. Computerized intervention to prevent drug use among at-risk adolescents in Central Asia: Preliminary family-level findings from a pilot mixed methods trial. Int J Drug Policy. 2019;68: 75–85. https://doi.org/10.1016/j.drugpo.2019.03.022
  • El-Bassel N, McCrimmon T, Mergenova G, Chang M, Terlikbayeva A, Primbetova S, Kuskulov A, Baiserkin B, Denebayeva A, Kurmetova K, Witte S. A cluster-randomized controlled trial of a combination HIV risk reduction and microfinance intervention for female sex workers who use drugs in Kazakhstan. J Int AIDS Soc. 2021;24(5). https://doi.org/10.1002/jia2.25682
  • Bobkov AF, Kazennova E V., Sukhanova AL, Bobkova MR, Pokrovsky VV, Zeman VV, Kovtunenko N, Erasilova I. An HIV type 1 subtype A outbreak among injecting drug users in Kazakhstan. AIDS Res Hum Retroviruses. 2004;20(10): 1134–1136. https://doi.org/10.1089/aid.2004.20.1134
  • 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. J Prev Interv Community. 2010;38(2): 162–176. https://doi.org/10.1080/10852351003640914
  • El-Bassel N, Gilbert L, Terlikbayeva A, Beyrer C, Wu E, Chang M, Hunt T, Ismayilova L, Shaw S, Primbetova S, Rozental Y, Zhussupov B, Tukeyev M. Effects of a couple-based intervention to reduce risks for HIV, HCV, and STIs among drug-involved heterosexual couples in Kazakhstan: A randomized controlled trial. J Acquir Immune Defic Syndr. 2014;67(2): 196–206. https://doi.org/10.1097/qai.0000000000000277
  • El-Bassel N, Gilbert L, Terlikbayeva A, Beyrer C, Wu E, Shaw SA, Ma X, Chang M, Hunt T, Ismayilova L, Primbetova S, Rozental Y, Zhussupov B. HIV risks among injecting and non-injecting female partners of men who inject drugs in Almaty, Kazakhstan: implications for HIV prevention, research, and policy. Int J Drug Policy. 2014;25(6): 1195–1203. https://doi.org/10.1016/j.drugpo.2013.11.009
  • Famouri ML, Shaw SA, Terlikbayeva A, Gilbert L, Hunt T, Rozental Y, El-Bassel N. Partner notification among HCV-positive couples who inject drugs. J Subst Use. 2016;21(1): 78–84. https://doi.org/10.3109/14659891.2014.960015
  • Shaw SA, El-Bassel N, Gilbert L, Terlikbayeva A, Hunt T, Primbetova S, Rozental Y, Chang M. Depression among people who inject drugs and their intimate partners in Kazakhstan. Community Ment Health J. 2015;52(8): 1047–1057. https://doi.org/10.1007/s10597-015-9883-3
  • Davis A, McCrimmon T, Dasgupta A, Gilbert L, Terlikbayeva A, Hunt T, Primbetova S, Wu E, Darisheva M, El-Bassel N. Individual, social, and structural factors affecting antiretroviral therapy adherence among HIV-positive people who inject drugs in Kazakhstan. Int J Drug Policy. 2018;62: 43–50. https://doi.org/10.1016/j.drugpo.2018.08.014
  • El-Bassel N, Gilbert L, Terlikbayeva A, Wu E, Beyrer C, Shaw S, Hunt T, Ma X, Chang M, Ismayilova L, Tukeyev M, Zhussupov B, Rozental Y. HIV among injection drug users and their intimate partners in Almaty, Kazakhstan. AIDS Behav. 2013;17(7): 2490–2500. https://doi.org/10.1007/s10461-013-0484-2
  • Gilbert L, Hunt T, Primbetova S, Terlikbayeva A, Chang M, Wu E, McCrimmon T, El-Bassel N. Reducing Opioid Overdose in Kazakhstan: A randomized controlled trial of a couple-based integrated HIV/HCV and overdose prevention intervention “Renaissance.” Int J Drug Policy. 2018;54: 105–115. https://doi.org/10.1016/j.drugpo.2018.01.004
  • Jiwatram-Negrón T, Michalopoulos LM, El-Bassel N. The syndemic effect of injection drug use, intimate partner violence, and HIV on mental health among drug-involved women in Kazakhstan. Glob Soc Welf. 2018;5(2): 71–80. https://doi.org/10.1007/s40609-018-0112-1
  • Marotta PL, Gilbert L, Terlikbayeva A, Wu E, El-Bassel N. Differences by sex in associations between injection drug risks and drug crime conviction among people who inject drugs in Almaty, Kazakhstan. Int J Drug Policy. 2018;60: 96–106. https://doi.org/10.1016/j.drugpo.2018.07.014
  • Marotta PL, Terlikbayeva A, Gilbert L, Hunt T, Mandavia A, Wu E, El-assel N. Intimate relationships and patterns of drug and sexual risk behaviors among people who inject drugs in Kazakhstan: A latent class analysis. Drug Alcohol Depend. 2018;192: 294–302. https://doi.org/10.1016/j.drugalcdep.2018.07.046
  • Shaw SA, Terlikbayeva A, Famouri L, Hunt T, Gilbert L, Rozental Y, Primbetova S, Chang M, Ma X, El-Bassel N. HIV testing and access to HIV medical care among people who inject drugs and their intimate partners in Kazakhstan. J Subst Use. 2016;22(1): 53-63. https://doi.org/10.3109/14659891.2016.1143046
  • Davis A, Sarsembayeva L, Gulyaev V, Primbetova S, Terlikbayeva A, Mergenova G, Remien R. If You Build It, Will They Use It? Preferences for Antiretroviral Therapy (ART) Adherence Monitoring Among People Who Inject Drugs (PWID) in Kazakhstan. AIDS Behav. 2019;23(12): 3294–3305. https://doi.org/10.1007/s10461-019-02421-y
  • Stringer KL, Mukherjee T, McCrimmon T, Terlikbayeva A, Primbetovac S, Darisheva M, Hunt T, Gilbert L, El-Bassel N. Attitudes towards people living with HIV and people who inject drugs: A mixed method study of stigmas within harm reduction programs in Kazakhstan. Int J Drug Policy. 2019;68: 27–36. https://doi.org/10.1016/j.drugpo.2019.02.007
  • Marotta PL, Terlikbayeva A, Gilbert L, Davis A, Wu E, Metsch L, Feaster D, El-Bassel N. Dyadic analysis of criminal justice involvement and hiv risks among couples who inject drugs and their intimate partners in Almaty, Kazakhstan. Int J Drug Policy. 2020;87: 102950. https://doi.org/10.1016/j.drugpo.2020.102950
  • El-Bassel N, McCrimmon T, Wu E, Chang M, Terlikbayeva A, Hunt T, Darisheva M, Primbetova S, Davis A, Metsch L, Feaster D, Baiserkin B, Abishev A, Denebayeva A, Sagimbayev B, Kurmetova K, Mashirov K, Gilbert L. Effectiveness of an Intervention to Improve HIV Service Delivery for People Who Inject Drugs in Kazakhstan: A Cluster Trial. JAMA Netw Open. 2022;5(12): e2244734–e2244744. https://doi.org/10.1001/jamanetworkopen.2022.44734
  • McCrimmon T, Sundelson A, Darisheva M, Gilbert L, Hunt T, Terlikbayeva A, Primbetova S, El-Bassel N. HIV Care Continuum Services for People Who Inject Drugs in Kazakhstan During COVID-19: A Qualitative Study of Service Provider Perspectives. Glob Health Sci Pract. 2022;10(2): e2100619–e2100629. https://doi.org/10.9745/ghsp-d-21-00619
  • Primbetova S, Darisheva M, Gatanaga O, Gilbert L, Davis A, Wu E, Hunt T, Terlikbayeva A, McCrimmon T, Dasgupta A, Cordingley O, El-Bassel N. Nurses and Outreach Workers’ Stigmatizing Attitudes in Needle Syringe Programs in Kazakhstan. Res Soc Work Pract. 2022;33(3): 305–312. https://doi.org/10.1177/10497315221137109
  • Denisiuk O, Pavlo S, Batyrbekova A, Dudnik R, Denebayeva A, Zhandybayeva A, Kuznetsova Y, Tetyana D. Social Network Strategy improves access to HIV testing and harm reduction programs for PWID and their partners in Kazakhstan. J Infect Dev Ctries. 2023;17(3): 397–403. https://doi.org/10.3855/jidc.16611
  • Neuenschwander P, Altice FL, Remien RH, Mergenova G, Sarsembayeva L, Rozental E, Gulyayev V, Davis A. A qualitative dyad analysis of barriers and facilitators of antiretroviral therapy (ART) adherence among people who inject drugs (PWID) with HIV in Kazakhstan. AIDS Care. 2025; 37(1):151-160. https://doi.org/10.1080/09540121.2024.2414078
  • Prilutskaya M, Bersani FS, Corazza O, Molchanov S. Impact of synthetic cannabinoids on the duration of opioid-related withdrawal and craving among patients of addiction clinics in Kazakhstan: A prospective case-control study. Hum Psychopharmacol. 2017;32(3): 1–9. https://doi.org/10.1002/hup.2618
  • Akkuzinova K, Inoue K, Toleuov E, Moldagaliyev T, Seksenbayev N, Jamedinova U, Ospanova N, Dyussupov A. Differences in the Rates of Diagnoses of Mental and Behavioral Disorders Due to Psychoactive Substance Use by Sex and Age during Pre-Pandemic and COVID-19 Pandemic Periods in Kazakhstan. Healthcare (Basel). 2024;12(20): 1–18. https://doi.org/10.3390/healthcare12202012
  • Ismayilova L, Terlikbayeva A. Building Competencies to Prevent Youth Substance Use in Kazakhstan: Mixed Methods Findings From a Pilot Family-Focused Multimedia Trial. J Adolesc Health. 2018;63(3): 301–312. https://doi.org/10.1016/j.jadohealth.2018.04.005
  • Konstantinov V, Berdenova S, Satkangulova G, Reznik A, Isralowitz R. COVID-19 Impact on Kazakhstan University Student Fear, Mental Health, and Substance Use. Int J Ment Health Addict. 2020;20(2): 888–894. https://doi.org/10.1007/s11469-020-00412-y
  • Lee YG, Zhakupova G, Vinogradov V, Paine EA, Laughney CI, Reeder K, Davis A, Hunt T, Mergenova G, Primbetova S, Terlikbayeva A, Wu E. Polydrug Use, Sexual Risk, and HIV Testing Among Cisgender Gay, Bisexual, and Other Men and Transgender and Nonbinary Individuals Who Have Sex With Men in Kazakhstan. AIDS Educ Prev. 2022;34(5): 413–426. https://doi.org/10.1521/aeap.2022.34.5.413
  • Laughney CI, Lee YG, Mergenova G, Vinogradov V, Zhakupova G, Paine EA, Primbetova S, Terlikbayeva A, Wu E. Earlier sexual debut as a risk factor for substance use among men who have sex with men (MSM) in Kazakhstan. Glob Soc Welf. 2024;11(3): 225–232. https://doi.org/10.1007/s40609-023-00298-3
  • Lunchenkov N, Cherchenko N, Altynbekov K, Terlikbayeva A, Primbetova S, Gryazev D, German E, Batyrgaliev U, Steinert J. “A way to liberate myself”: A qualitative study of perceived benefits and risks of chemsex among gay, bisexual, and other men who have sex with men in Almaty, Kazakhstan. Drug Alcohol Depend. 2024;264: 112464–112474. https://doi.org/10.1016/j.drugalcdep.2024.112464
  • Mergenova G, El-Bassel N, McCrimmon T, Terlikbayeva A, Primbetova S, Riedel M, Kuskulov A, Velez-Grau C, Witte S. Project Nova: A Combination HIV Prevention and Microfinance Intervention for Women Who Engage in Sex Work and Use Drugs in Kazakhstan. AIDS Behav. 2019;23(1): 1–14. https://doi.org/10.1007/S10461-018-2268-1
  • El-Bassel N, Norcini Pala A, Mukherjee TI, McCrimmon T, Mergenova G, Terlikbayeva A, Primbetova S, Witte S. Association of Violence Against Female Sex Workers Who Use Drugs With Nonfatal Drug Overdose in Kazakhstan. JAMA Netw Open. 2020;3(10): e2020802–e2020812. https://doi.org/10.1001/jamanetworkopen.2020.20802
  • Vélez-Grau C, El-Bassel N, McCrimmon T, Chang M, Terlikbayeva A, Primbetova S, Mergenova G, Witte S. Suicidal ideation among women who engage in sex work and have a history of drug use in Kazakhstan. Ment Health Prev. 2021;23: 200208–200218. https://doi.org/10.1016/j.mhp.2021.200208
  • Mukherjee TI, Pala AN, Terlikbayeva A, Davis A, Howard AA, McCrimmon T, Mergenova G, Primbetova S, Witte S, El-Bassel N. Social and structural determinants of health associated with police violence victimization: A latent class analysis of female sex workers who use drugs in Kazakhstan. Int J Drug Policy. 2022;106. https://doi.org/10.1016/j.drugpo.2022.103750
  • Cordingley O, McCrimmon T, West BS, Darisheva M, Primbetova S, Terlikbaeva A, Gilbert L, El-Bassel N, Frye V. Preferences for an HIV Self-Testing Program Among Women who Engage in sex Work and use Drugs in Kazakhstan, Central Asia. Res Soc Work Pract. 2023;33(3): 296–304. https://doi.org/10.1177/10497315221128594
  • Mukherjee TI, Terlikbayeva A, McCrimmon T, Primbetova S, Mergenova G, Benjamin S, Witte S, El-Bassel N. Association of gender-based violence with sexual and drug-related HIV risk among female sex workers who use drugs in Kazakhstan. Int J STD AIDS. 2023;34(10): 666–676. https://doi.org/10.1177/09564624231170902
  • Witte SS, Pala AN, Mukherjee TI, Yang LS, McCrimmon T, Mergenova G, Terlikbayeva A, Primbetova S, El-Bassel N. Reducing Partner Violence Against Women who Exchange Sex and use Drugs through a Combination Microfinance and HIV Risk Reduction Intervention: A Cluster Randomized Trial. AIDS Behav. 2023;27(12): 4084–4093. https://doi.org/10.1007/s10461-023-04122-z
  • Yang LS, Witte SS, Vélez-Grau C, McCrimmon T, Terlikbayeva A, Primbetova S, Mergenova G, El-Bassel N. The Financial Lives and Capabilities of Women Engaged in Sex Work: Can Paradoxical Autonomy Inform Intervention Strategies? Glob J Health Sci. 2021;13(6): 69–80. https://doi.org/10.5539/gjhs.v13n6p69
  • McCrimmon T, Frye V, Darisheva M, Starbird L, Cordingley O, Terlikbayeva A, Primbetova S, Gilbert L, El-Bassel N, West B. “Protected Means Armed”: Perspectives on Pre-Exposure Prophylaxis (PrEP) Among Women Who Engage in Sex Work and Use Drugs in Kazakhstan. AIDS Educ Prev. 2023;35(5): 347–361. https://doi.org/10.1521/aeap.2023.35.5.347
  • Ismayilova L, Lee HN, Shaw S, El-Bassel N, Gilbert L, Terlikbayeva A, Rozental Y. Mental Health and Migration: Depression, Alcohol Abuse, and Access to Health Care among Migrants in Central Asia. J Immigr Minor Health. 2014;16(6): 1138–1148. https://doi.org/10.1007/s10903-013-9942-1
  • El-Bassel N, Marotta PL. Alcohol and Sexual Risk Behaviors Among Male Central Asian Labor Migrants and Non-migrants in Kazakhstan: Implications for HIV Prevention. AIDS Behav. 2017;21(Suppl 2): 183–193. https://doi.org/10.1007/s10461-017-1918-z
  • Vélez-Grau C, El-Bassel N, McCrimmon T, Terlikbayeva A, Primbetova S, Mergenova G, Bussey E, Choudhury A, Kalinowska K, Witte S. “I never hoped for anything … now I have other plans”: The role of microfinance in HIV intervention for women who use drugs and engage in sex work in Kazakhstan. Int Soc Work. 2022;65(4): 663–677. https://doi.org/10.1177/0020872820917737
  • El-Bassel N, Gilbert L, Shaw SA, Mergenova G, Terlikbayeva A, Primbetova S, Ma X, Chang M, Ismayilova L, Hunt T, West B, Wu E, Beyrer C. The Silk Road Health Project: How Mobility and Migration Status Influence HIV Risks among Male Migrant Workers in Central Asia. PLoS One. 2016;11(3): e0151278–e0151288. https://doi.org/10.1371/journal.pone.0151278
  • Pikirenia U, Kudabekov M, Bakirova Z, Boltaev A. Opioid Agonist Maintenance Treatment in Central Asia. HIV and Hepatitis C in Central Asia and China. Baden-Baden: Nomos Verlagsgesellschaft mbH & Co. KG; 2024.
  • LaMonaca K, Dumchev K, Dvoriak S, Azbel L, Morozova O, Altice FL. HIV, Drug Injection, and Harm Reduction Trends in Eastern Europe and Central Asia: Implications for International and Domestic Policy. Curr Psychiatry Rep. 2019;21(7): 1–11. https://doi.org/10.1007/s11920-019-1038-8/figures/1
  • Higgins K, O’Neill N, O’Hara L, Jordan JA, McCann M, O’Neill T, Clarke M, O’Neill T, Kelly G, Campbell A. New psychoactives within polydrug use trajectories—evidence from a mixed-method longitudinal study. Addiction. 2021;116(9): 2454–2462. https://doi.org/10.1111/add.15422
  • Braunewell E, Stanton AM, Fitch C, McKetchnie SM, Westphal L, Hart TA, O’Cleirigh C. Cognitive Behavioral Therapy for Trauma and Self-Care to Treat Posttraumatic Stress Symptoms and Support HIV Care Engagement Among Men With HIV Who Have Sex With Men: A Case Series. Cogn Behav Pract. 2024. https://doi.org/10.1016/j.cbpra.2023.12.013
  • Di Maio S, Villinger K, Knoll N, Scholz U, Stadler G, Gawrilow C, Berli C. Compendium of dyadic intervention techniques (DITs) to change health behaviours: a systematic review. Health Psychol Rev. 2024;18(3): 538–573. https://doi.org/10.1080/17437199.2024.2307534
  • Boltaev AA, El-Bassel N, Deryabina AP, Terlikbaeva A, Gilbert L, Hunt T, Primbetova S, Strathdee S. Scaling up HIV prevention efforts targeting people who inject drugs in Central Asia: A review of key challenges and ways forward. Drug Alcohol Depend. 2013;132(Suppl1): S41–S47. https://doi.org/10.1016/j.drugalcdep.2013.07.033
  • Li Y, McCarten-Gibbs M. Kazakhstan’s first community-based pre-exposure prophylaxis program allows for flexibility and option. In: EpiC Blog [Internet]. 24 May 2023 [cited 12 Oct 2024]. Available: https://epicproject.blog/kazakhstans-first-community-based-pre-exposure-prophylaxis-program-allows-for-flexibility-and-options/?utm_source=chatgpt.com
  • Zhuang X, Moshi MA, Quinones O, Trenholm RA, Chang C-L, Cordes D, Vanderford B, Vo V, Gerritty D, Oh E. Drug Use Patterns in Wastewater and Socioeconomic and Demographic Indicators. JAMA Netw Open. 2024;7(9): e2432682–e2432682. https://doi.org/10.1001/jamanetworkopen.2024.32682