Terlikbayeva Assel, Primbetova Sholpan, Gatanaga Ohshue S, Chang Mingway, Rozental Yelena, Nurkatova Meruert, Baisakova Zulfiya, Bilokon Yelena, Karan Shelly E, Dasgupta Anindita, Gilbert Louisa
Center of Scientific and Practical Initiatives, 38B, Shashkina Str., Almaty 050040, Kazakhstan.
School of Social Work, Columbia University, New York, NY 10027, USA.
Behav Sci (Basel). 2025 May 9;15(5):641. doi: 10.3390/bs15050641.
Key affected populations (KAPs), including women who use drugs, engage in sex work, or live with HIV, are disproportionately affected by HIV, gender-based violence, substance use, and mental health. In Kazakhstan, they face significantly higher rates of intimate partner violence (IPV), with prevalence ranging from 45% to 75% compared to the national average of 27%, alongside barriers to accessing IPV services. This community-level implementation trial with a waitlist control group evaluated the effectiveness, safety, and acceptability of a self-paced mobile health intervention (UMAI-WINGS) for women from KAPs in Kazakhstan. The study enrolled 508 women, with 306 in Almaty City (intervention) and 200 in Almaty Oblast (waitlist control). IPV rates (physical, sexual, and psychological) were assessed at baseline and 6-months post-intervention. Participants in the intervention community were significantly less likely to report psychological (-23.0%), sexual (-27.0%), and physical IPV (-29.0%) at the 6-month follow-up compared to the control group. These results demonstrate the potential of digital, community-driven interventions to reduce IPV among marginalized women and offer a scalable, evidence-based model for implementation. The success of the UMAI-WINGS underscores the value of community-based, mobile health approaches for advancing trauma-informed, survivor-centered care and closing critical service gaps for underserved populations.
关键受影响人群(KAPs),包括吸毒女性、从事性工作的女性或感染艾滋病毒的女性,在艾滋病毒、性别暴力、药物使用和心理健康方面受到的影响尤为严重。在哈萨克斯坦,她们面临着更高的亲密伴侣暴力(IPV)发生率,其发生率在45%至75%之间,而全国平均水平为27%,同时在获取IPV服务方面也存在障碍。这项采用等待名单对照组的社区层面实施试验,评估了一种针对哈萨克斯坦KAPs女性的自定进度移动健康干预措施(UMAI-WINGS)的有效性、安全性和可接受性。该研究招募了508名女性,其中306名来自阿拉木图市(干预组),200名来自阿拉木图州(等待名单对照组)。在基线和干预后6个月评估IPV发生率(身体暴力、性暴力和心理暴力)。与对照组相比,干预社区的参与者在6个月随访时报告心理IPV(-23.0%)、性IPV(-27.0%)和身体IPV(-29.0%)的可能性显著降低。这些结果表明,数字化、社区驱动的干预措施有潜力减少边缘化女性中的IPV,并提供一种可扩展的、基于证据的实施模式。UMAI-WINGS的成功凸显了基于社区的移动健康方法在推进创伤知情、以幸存者为中心的护理以及弥合弱势群体关键服务差距方面的价值。