Validity and Reliability of the Turkish version of the Wender-Reimherr Adult Attention Deficit Disorder Scale.

The COVID-19 pandemic and mitigation measures significantly disrupted HIV service use among sexual and gender expansive (SGE) populations. An online survey administered with cisgender men who have sex with men (MSM) across 20 countries at the outset of the pandemic showed that more than half of the respondents reported perceived disruptions to HIV self-testing and PrEP, nearly 40% reported disruptions to in-person HIV testing, and approximately 20% of those living with HIV reported disruptions to HIV treatment services (). Similarly, an online survey involving transgender and nonbinary people living with HIV globally showed substantial declines in access to HIV treatment services during the pandemic (). Research further indicated that disruptions to HIV service use could exacerbate HIV vulnerabilities and morbidities for people at risk for and living with HIV (; ). These findings urge renewed efforts to promote and sustain HIV service use among SGE people, while anticipating and addressing largescale disruptions. Peer-led approaches have been central to HIV preventive efforts in SGE communities. In these approaches, peers, referring to individuals with shared identities, interests, or both as recipients, are enlisted to lead or aid intervention delivery within their networks (). Reviews of the state-of-the-art research on peer-led interventions involving SGE people have highlighted the successes of various peer-led interventions in promoting risk reduction, HIV testing, PrEP uptake and adherence, and HIV care continuum engagement (; ; ). Interpersonal communication is the hallmark of peer-led intervention delivery, facilitating a wide range of activities, such as information exchange, role modeling, and social support, that promote behavior change aligned with HIV prevention (; ). However, the impact of COVID-19 disruptions has been far reaching across HIV prevention efforts and may have extended to peer communication about HIV. Disruptions to peer HIV communication could contribute to less awareness or social support regarding HIV and available services, thus undermining HIV preventive efforts. Little is known about how COVID-19 disruptions affected peer HIV communication among SGE people, particularly in low- and middle-income countries, such as Kazakhstan, with growing HIV epidemics. The number of new HIV infections in Kazakhstan increased by 88% between 2010 and 2021, and the HIV epidemic has disproportionately affected SGE populations (). As of 2023, the HIV prevalence rate among MSM was estimated to be 8.8%, the highest of all key populations in Kazakhstan (). Meanwhile, the COVID-19 mitigation measures led government-sponsored AIDS Centers to restrict or pause delivery of HIV services (). Our prior study in Kazakhstan showed that one in five people who are MSM and transgender and nonbinary individuals who have sex with men (TSM) reported disruptions to HIV service use at the outset of the COVID-19 pandemic (). Whether or how COVID-19 disruptions affected peer HIV communication among MSM and TSM in Kazakhstan has not been examined. In this study, we investigated the association between COVID-19 disruptions to HIV service use and intention of peer HIV communication among MSM and TSM in Kazakhstan.