Transportation as a Barrier to AIDS Center Visits among People Who Inject Drugs Living with HIV/AIDS in Kazakhstan Open Access

Kiselova, Sophia (Spring 2020)

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Background: The Republic of Kazakhstan faces ongoing public health challenges with addressing human immunodeficiency virus (HIV) among people who inject drugs (PWID). Social and structural factors may be important barriers to medical care among PWID. Transportation is a known barrier to HIV services in low- and middle- income countries. No studies have explored the relationship between access to transportation and utilization of HIV services among people who inject drugs living with HIV/AIDS (PLWHA-PWID) in Kazakhstan.

Methods: Data from a survey of PLWHA-PWID (N=616) living in four Kazakhstan cities and their AIDS center clinic records were used to construct a generalized linear model examining the association between self-reported access to transportation for medical care (exposure) and the number of AIDS center visits (outcome).

Results: Mean number of AIDS Center visits was 1.56 (SD = 1.51) with 29.20% of participants not visiting the AIDS Center at all. 40.75% of participants reported not having transportation to medical care. Transportation did not show significance in bivariate (OR = 0.89, 95% CI 0.76 - 1.04) or multivariate analyses (OR = 0.87, 95% CI 0.74 – 1.03).

Conclusions: We found no evidence of association between access to transportation to medical care and AIDS Center attendance among PLHWA-PWID in Kazakhstan cities. Further research is needed to understand how transportation may affect access to other HIV-related care among PLWHA-PWID in Kazakhstan.

Keywords: HIV; PLWHA; PWID; built environment; transportation; Kazakhstan

Table of Contents

Background 1

Methods 3

Results 7

Discussion 9

Conclusion 11

References 13

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