Development and pilot of a drug use and HIV stigma reduction training for Tajik migrants who work in Moscow: The SRI-AVLOD intervention.

Tajik labor migrants who inject drugs while working in Moscow are subject to the negative effects of stigma within the diaspora community in Russia. They are also at risk of acquiring HIV, which further compounds their stigmatization. An intersectional intervention to reduce both drug-related and HIV-related stigma within the Tajik diaspora community is needed to prevent adverse social and health effects among its members who inject drugs. We conducted a series of focus groups and interviews with Tajik migrant workers and health workers who treat migrants in Moscow to inform the development of a five-session anti-discrimination training for Tajik community leaders. The training sessions are designed to educate leaders about substance use disorder and HIV and prepare them to act as change agents in reducing stigma toward both disorders within the Moscow Tajik diaspora community. We pilot tested the Stigma Reduction Intervention Approach Via Leaders of Diaspora (SRI-AVLOD) for cultural acceptability and feasibility with two groups of traditional migrant community (avlod) leaders while residing in Tajikistan before returning to Moscow for work. Measures of drug use and HIV-related stigma were administered prior to the first and after the final training session. We collected participant feedback on the acceptability and feasibility of the intervention and conducted a brief follow-up interview post-training to assess participants' experience in delivering the anti-stigma messages to their community. Participant ratings indicated high acceptability and satisfaction with the training. Measures of stigmatizing attitudes among the avlod leaders were significantly reduced following the intervention. In follow-up interviews, participants reported that they delivered the anti-stigma message to an average of 16 people. The SRI-AVLOD intervention proved feasible and acceptable to Tajik community leaders and was judged to have considerable potential for effective diffusion within the migrant diaspora community.