Sexual and gender minority stigma, and associations with perceived barriers to HIV testing and HIV testing behaviors among adolescents and young adults in Kazakhstan

BACKGROUND: Kazakhstan is experiencing a rising HIV epidemic, with adolescents and young adults (AYA) accounting for nearly one-quarter of new infections. However, HIV testing rates remain low, partly due to stigma, especially sexual and gender minority (SGM) stigma. METHODS: We examined the prevalence and associations between SGM stigma, perceived barriers to HIV testing, and testing behaviors among 216 AYA in Almaty, Kazakhstan. The analysis used baseline survey data from enrolled RCT participants. RESULTS: Results showed that male and heterosexual AYA reported significantly higher SGM stigma than female or SGM AYA. Regression analyses found that higher SGM stigma was associated with greater perceived barriers to HIV testing (β = 0.72, P < 0.001), but not with HIV testing uptake. CONCLUSIONS: These findings suggest that SGM stigma contributes to perceived barriers that discourage HIV testing. Given that current HIV stigma interventions may not adequately address gendered or sexual identity-related stigma, targeted strategies that address the intersection of SGM and HIV stigma among AYA, especially among males, are timely needed.