ECOM is beginning a new, important phase of its work in the field of HIV prevention, which focuses on studying the perception and potential of lencapavir for pre-exposure prophylaxis (PrEP) among key populations and healthcare professionals in Kazakhstan.
This project will be the first comprehensive, qualitative study on the implementation of long-acting injectable PrEP in Central Asia. Its findings will help better understand how to make HIV prevention more accessible, sustainable, and user-friendly.
ECOM, the Eurasian Coalition on Health, Rights, Gender, and Sexual Diversity, received a grant from the WEEPI Foundation to conduct a study on the use of lencapavir for pre-exposure prophylaxis (PrEP) in Central Asia. Over the course of 12 months, the team will study the acceptability and feasibility for Kazakhstan of a long-acting PrEP regimen, namely lencapavir injections administered twice a year.
Responding to key challenges in HIV prevention
The country continues to experience a concentrated HIV epidemic: approximately 35,000 people are living with the virus, with up to 3,000 new cases recorded annually, primarily among men who have sex with men, people who inject drugs, and sex workers. Although oral PrEP was made available through pilot programs in 2021, its implementation has been hampered by adherence issues, stigma, and systemic barriers.
Lencapavir, an innovative HIV-1 capsid inhibitor administered subcutaneously only twice a year, has the potential to significantly transform prevention practices. The long-acting format reduces dependence on daily pills, mitigates social risks, and simplifies service delivery. However, until now, high-quality research on the perception of long-acting injectable PrEP has been virtually absent in the region.
Study with the participation of the community
The team will conduct in-depth interviews and focus groups with 40–50 representatives of key populations and 20–25 healthcare professionals in Almaty and Astana. The study aims to identify preferences, concerns, barriers, and factors that would facilitate the implementation of lencapavir-based PrEP.
“We now have the opportunity to hear from users and specialists before lencapavir is introduced into prevention programs,” notes the study’s leader, Dr. Nikolai Lunchenkov. “An early understanding of barriers and resources will enable Kazakhstan to develop effective implementation strategies and become a regional leader in modern HIV prevention.”
The advisory board, which will include community representatives, will be involved in all stages, from the adaptation of tools to discussion of the results.
Partnerships and regional leadership
Kazakhstan remains one of the most active countries in the region in implementing PrEP and demonstrates openness to innovation. ECOM has a long history of collaboration with Kazakhstani partners, the WHO, and the Kazakh Scientific Center for Dermatology and Infectious Diseases (KSCDID).
The project is being implemented in partnership with the KSCDID, the Global Fund implementation team in Kazakhstan, and the Technical University of Munich (TUM).
The Technical University of Munich provides methodological support and academic supervision, strengthening the research’s scientific foundation and enhancing the project’s international character. Project coordination is led by Elena German, a specialist with over 20 years of experience in the field of HIV in the region.
Practical results
The study is aimed at four main objectives:
- User perspectives: studying the knowledge, expectations, preferences, and concerns of key populations in relation to twice-yearly injections of lencapavir as long-acting PrEP.
- Position of medical workers: analyzing the views of specialists on the implementation of lencapavir-based PrEP in the existing healthcare system, including training needs.
- Contextual factors: assessing the social, cultural and structural conditions impacting the implementation of long-acting PrEP.
- Recommendations on implementation: developing data-driven service delivery models and strategies to overcome barriers.
Impact on the healthcare system
The results of the study will help partners develop protocols and training materials before lencapavir becomes available in Kazakhstan, thereby avoiding delays typical of the implementation of oral PrEP. At the policy level, the recommendations can be reflected in national guidelines and strategic documents.
Regionally, the project will be the first large-scale, qualitative study of perceptions of lencapavir-based PrEP in Central Asia and will serve as a basis for sharing experiences between countries.
The study is being conducted with financial support from the WEEPI Foundation.
