Evidence map›Paper›PMID 40892800›Full record

ArticlePloS one2025

"I think they are infected because of their ignorance and lack of responsibility": A mixed-methods study on HIV-related stigma in the healthcare system in Kazakhstan.

Balnur Iskakova, Elizabeth J King, Recai Murat Yucel, Jack DeHovitz, Zhamilya Nugmanova

Abstract read
In one paragraph

Article in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Balnur IskakovaDepartment of Epidemiology, School of Public Health, Kazakh National Medical University named after S.D, Asfendiyarov, Almaty, Kazakhstan.ORCID https://orcid.org/0000-0002-5862-5375
Elizabeth J KingDepartment of Health Behavior and Health Equity, School of Public Health, University of Michigan, Ann Arbor, Michigan, United States of America.
Recai Murat YucelDepartment of Epidemiology and Biostatistics, Temple University College of Public Health, Philadelphia, Pennsylvania, United States of America.
Jack DeHovitzSUNY Downstate Health Sciences University, Brooklyn, New York, United States of America.ORCID https://orcid.org/0000-0001-7307-0614
Zhamilya NugmanovaDepartment of Epidemiology, School of Public Health, Kazakh National Medical University named after S.D, Asfendiyarov, Almaty, Kazakhstan.

Funding

Research Training for Substance Use Mediated HIV Epidemic in Kazakhstan/Aging SupplementD43TW010046 · FIC · SUNY DOWNSTATE MEDICAL CENTER · PI Jack A DeHovitz, Zhamilya Nugmanova · 2016 to 2026
$3.4M
FIC NIH HHS D43 TW010046
6 · The paper itself

Abstract

backgroundHIV-related stigma among healthcare providers remains a significant barrier to effective HIV care and treatment. This study aimed to assess HIV-related stigma and associated factors among healthcare providers in primary healthcare clinics (PHCs) in Almaty, Kazakhstan.

methodsA mixed-methods design was employed, involving quantitative surveys and qualitative in-depth interviews. Eight PHCs were randomly selected, and 448 healthcare providers participated in the survey. The cross-sectional surveys took place at the PHCs between May 2, 2019, and July 2, 2019. The sample size was predetermined statistically with a 2.5% precision using a 95% confidence level. For the qualitative component, 10 participants were chosen for in-depth interviews. Descriptive statistics, bivariate analysis, and multivariable logistic regression models were performed for quantitative data analysis. Qualitative data were analyzed through manual thematic analysis.

resultsThe study revealed high levels of HIV-related stigma, with 87% of respondents agreeing with at least one stigmatizing statement about people living with HIV (PLHIV). Fear of HIV infection was also prevalent, with 85% of healthcare providers expressing some level of concern about contracting HIV during medical procedures. Logistic regression analysis indicated that longer years of work in healthcare were protective against stigmatizing opinions (Adjusted Odds Ratio (AOR)=0.25; 95% Confidence Interval (95%CI)=0.09,0.67; p = 0.006), while not having seen a patient living with HIV in the last 12 months was associated with higher stigma (AOR = 3.31; 95%CI = 1.73, 6.31; p < 0.001). Qualitative interviews corroborated these findings and highlighted differential attitudes towards PLHIV based on modes of transmission, with particularly negative views towards sex workers and individuals with non-traditional sexual orientations.

conclusionsThe study demonstrates significant HIV-related stigma among healthcare providers in Almaty PHCs, influenced by a lack of exposure to PLHIV and specific socio-demographic factors. These findings underscore the need for targeted interventions to reduce stigma and enhance HIV care in Kazakhstan.

Indexed as

Health PersonnelHIV InfectionsSocial StigmaAdultAttitude of Health PersonnelCross-Sectional StudiesDelivery of Health CareFemaleHealth Knowledge, Attitudes, PracticeHumansKazakhstanMaleMiddle AgedSurveys and Questionnaires

Identifiers

PMID40892800
PMCPMC12404490

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LicenceCC BY
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.