Developing effective HIV education in Central Asia: a cross-sectional study among Kazakh medical students.

Introduction: The HIV epidemic continues to expand in Central Asia, bridging from injecting drug users to the general population, largely through heterosexual transmission. This study describes medical students' attitudes and behaviours regarding HIV and sexual practices in response to recently introduced HIV curriculum.

Methodology: Medical students in Almaty, Kazakhstan, were invited to participate in a cross-sectional survey between April and November, 2013. The survey assessed participant's risk behaviours (e.g., injecting drug use, condom use), concerns related to HIV infection risk (e.g., medical care exposures, personal behaviours), and ability to identify HIV-positive individuals without asking their status. Bivariate analyses (Chi-square test or Fisher's exact test) and multivariate analysis (log-binomial regression) were conducted.

Results: Of 647 medical students, the majority were female (82.2%) and single (92.8%) with a median age of 21-22 years. Sexual activity was reported by 176 (27.2%); males were substantially more likely to report sexual activity (74.8% males vs. 16.9% females, p <.0001). The majority of sexually active medical students (65.6% and 68.3% males and females, respectively) believe they can determine if their partner is HIV-positive without asking or seeking a laboratory test. This proportion is much higher (92.6%) among married or cohabitating women. No association between perceived ability to ascertain HIV status and condom use was identified.

Conclusions: The medical students in our study had a relatively naïve perception of HIV risk, and their knowledge of risk did not translate to appropriate precautionary behaviours. Much work remains if the epidemic in Central Asia is to be contained.