Factors associated with being on antiretroviral treatment among people living with HIV in Almaty, Kazakhstan

Like other countries in the region of Eastern Europe and Central Asia, Kazakhstan has seen an increase in the number of new HIV cases in recent years. HIV treatment coverage among people living with HIV (PLHIV) in Kazakhstan is suboptimal; however, the country has committed to reaching the 90-90-90 goals for HIV diagnosis and treatment. Kazakhstan has recently committed to the "test and treat" approach, and provides antiretroviral treatment (ART) to all PLHIV. Using registry data from the City AIDS Center, we used logistic regression models to assess the factors associated with uptake of ART and its correlates among 2687 adult PLHIV in Almaty, Kazakhstan. 67.8% were on treatment. PLHIV are more likely to be on ART if diagnosed in the later clinical stages [aOR = 2.45, 95% CI (1.85, 3.25)], diagnosed after the country's change in treatment approach [aOR = 1.97, 95% CI (1.42, 2.72)], and acquired HIV via sexual transmission vs. injection drug use [aOR = 1.72, 95%CI (1.25, 2.35)]. Our findings highlight which subpopulations are most in need of interventions to promote ART in Kazakhstan, and also serve as an example for other countries in Central Asia for thinking about what factors are important to consider in improving HIV treatment coverage.