Preliminary results of AmanBol: HIV self-testing program for MSM and transgender persons in Kazakhstan

BACKGROUND: Over 60% of new HIV infections in 2018 are estimated to occur among men who have sex with men (MSM) (Kazakhstan's National AIDS Center (NAC)). MSM and transgender persons remain among the least covered groups by HIV testing and treatment programs with only 7.8% HIV testing coverage for MSM (NAC, 2020) across Kazakhstan due to persisting discrimination and stigma.
DESCRIPTION: Funded by Elton John AIDS Foundation (EJAF) and implemented by GHRCCA, AmanBol (2019'2021) is the first HIV self-testing (HIVST) program in the region, dedicated to providing service for MSM and transgender persons in Kazakhstan. AmanBol aims to provide 10,320 HIV self-tests in 3 years for MSM and transgender persons by using web-based solutions such as social networks and automation to gain access to the community. The main services provided include delivering HIV self-tests, providing online support, and publishing articles on sexual and mental health on the website. The programme collaborates with the available post, taxi, local, and national LGBT NGOs/initiatives for confidential, safe, and targeted service.
LESSONS LEARNED: Since the project started in 2019, 7,315 tests were delivered, 5,048 feedback responses received, 165 positive results reported, 93 clients linked to care, website viewed 266,000 times. Calculations are based on self-reports by the participants and Google analytics.
One of the biggest achievements was to gain access to marginalized MSM and transgender communities using social media and creating demand for HIVST by providing information and using marketing tools. With a 5-person team, the project was able to test an equivalent of 11% of the estimated MSM population.
This was possible due to the following components:

• Effective and optimized SMM;
• User-friendly interface and language;
• Applying marketing and remarketing tools;
• Automation of database by using CRM;
• Automation of communication using Messagebird and Telegram;
• Proactively requesting feedback from the participants;
• Creating trustworthy experience by securing any personal data;

Optimizing operational processes and outsourcing them as much as possible.
CONCLUSIONS: The EJAF-funded Amanbol pilot HIVST project showed feasibility and acceptability of HIV self-testing among MSM and transgender persons in Kazakhstan and might be replicated for other Central Asian countries through NGOs.