Project Summary
Labor migration is a major contributor to fueling the global AIDS epidemic and also the movement of HIV
across country borders and populations. Migrants who inject drugs while in a host country are at especially
high risk. Tajikistan, a small country in Central Asia, exports more than a million temporary labor migrants
annually, many of whom inject drugs. These migrants are highly subject to the negative effects of intersectional
stigma within Russia's cultural and socio-economic environment due to being both a migrant worker and a
person who injects drugs (PWID). In addition, they are subject to extensive censure and marginalization from
their non-drug-using Tajik peers in the close-knit diaspora communities in which they reside, especially if they
acquire HIV. The adverse effects of stigmatization on those who experience it are well documented. The
intersection of stigmatized identities as migrants and people who inject drugs (PWID), along with stigma
associated with HIV infection, contributes to HIV risk behavior, poses as a barrier to accessing HIV testing and
other prevention/treatment services, and results in poorer health outcomes for those living with HIV.
The proposed study will investigate the character of stigma in the Moscow Tajik migrant community,
and the effects of multiple intersecting forms of stigma on the health and well-being of Tajik labor migrants who
inject drugs while living in Moscow (Aim 1). We will use the insight and findings gained through this formative
research to develop an innovative intervention specifically designed to counter the negative effects of drug-
related stigma within the Tajik migrant community that can affect HIV risk behavior and prevention among Tajik
migrants in Moscow who inject drugs (Aim 2). The Stigma Reduction Intervention Approach Via Leaders of
Diaspora (SRI-AVLOD) intervention will draw on the strengths of close-knit Tajik diaspora communities in
which new norms and behaviors can be effectively diffused and promoted within and across migrant social
networks if endorsed by leaders whom they trust. SRI-AVLOD is designed to recruit and train Tajik diaspora
community leaders as agents of change and open up conversation within the Moscow Tajik community about
the effects of drug and HIV-related stigma, to reduce stigmatizing beliefs and actions that negatively affect HIV
risk behavior and prevention among community members who inject drugs. After developing a working
prototype, we will deliver the intervention to small groups of Tajik migrant community leaders to assess its
feasibility and acceptability, and need for further modifications (Aim 3).
In future work we will deliver and test the efficacy of the SRI-AVLOD model in changing drug-related
stigma and stigmatizing beliefs, behavior, and consequences at all levels (community, leadership, PWID)
within the Tajik diaspora community and its positive effects in reducing HIV risk behavior and increasing the
adoption of HIV prevention methods and services among its Tajik members who inject drugs.