LAUSR

Key Points Question Is a 3-component intervention (Bridge) that promotes client recruitment, HIV testing, and linkage to HIV treatment associated with improved engagement along the HIV care continuum among people who inject drugs (PWID) served by needle and syringe programs (NSPs) in Kazakhstan? Findings A stepped-wedge cluster trial of 1225 PWID served by 24 NSPs demonstrated that implementation of the Bridge intervention was associated with significant increases in the number of PWID clients served (by 2.37 times) and tested for HIV (by 3.98 times) over a 4-year study period from 2017 to 2020. The Bridge intervention was not associated with a significant increase in the number of clients referred to HIV care from NSPs. Meaning These findings suggest that an integrated intervention that addresses multiple components of the HIV care continuum shows potential to improve engagement and retention in HIV testing, treatment, and care for PWID served by NSPs in Kazakhstan.