SHIELD Central Asia: HIV Prevention with Injection Drug Users in Kyrgyzstan

[unreadable] DESCRIPTION (provided by applicant): Central Asia is experiencing one of the fastest growing HIV epidemics in the world. The emerging epidemic is injection drug-associated and despite ongoing prevention efforts, HIV continues to increase among this population. In this 12-month study, we bring an evidence-based SHIELD (Self-Help in Eliminating Life-Threatening Diseases) HIV behavioral prevention intervention for injection drug users to Central Asia. The collaborative US investigator -Central Asian research team selected the network- oriented peer outreach SHIELD intervention as it can be sustained in a low-resource setting, addresses both drug and sexual risk HIV transmission routes, and has the ability to access hidden IDU who are not connected to current prevention programs. The study will be conducted in the Southern Kyrgyzstan city of Osh, where 14% of the IDU are HIV+ and 50% are infected with HCV. To adapt the intervention we use qualitative research (focus groups) with 12 IDU and a Community Advisory Board to refine the intervention to the Kyrgyzstani culture and context. The revised intervention is then piloted for feasibility and preliminary outcomes with 60 participants in a pre-post design. The information learned in this study will inform an R01 study to test the efficacy of the intervention through a RCT with a larger sample size. [unreadable] [unreadable] [unreadable]