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Last updated: 2nd April 2025

1.1 People who use drugs, HIV and HCV

• There are an estimated 79,900 people who inject drugs in Kazakhstan.

• The estimated HIV prevalence among people who inject drugs is 7.6%.

• The Hepatitis C (anti-HCV) prevalence among people who inject drugs is 58.6%, and Hepatitis B (anti-HBsAg) prevalence is 8.3%.

1.2 HIV Prevention and Harm Reduction Coverage

• The coverage of opioid agonist therapy (OAT) among people who inject drugs is 7.8%.

• Antiretroviral therapy coverage among people who inject drugs is 65.5%.

• The coverage of the HIV prevention program is 74.2%.

• The percentage of safe injecting practices is 69%, and 138 needles and syringes are distributed per

  person who injects drugs

The government is the main funder of HIV prevention services for people who inject drugs. The government-funded prevention program aims to cover 62% (50,106) of the total population of people who inject drugs by 2026 in all planned 20 districts.
The Global Fund coverage for the same period is estimated at 8%, covering three districts — these districts are home to 25% of the total PWID population and have high HIV prevalence levels.

The government of Kazakhstan is funding the procurement of syringes and condoms for people who inject drugs across the country to ensure necessary coverage. It is also funding outreach workers based in AIDS Centers.

OAT medication procurement has transitioned to government funding. In November 2024, the government made its first methadone purchase — 2,000 bottles for 400 patients for 10 months. The Global Fund no longer covers OAT procurement. Meanwhile, PEPFAR (CDC) is supporting capacity building of the OAT programme.

In 2024, NGOs were working on HIV social contracting in 11 regions. In 2025, all 20 regions will offer options for social contracting.

• With a total allocation of $3.7 million for September 2024–2025, PEPFAR accounts for 2% of HIV response funding, while the Global Fund contributes 3%. Programs supported through USAID operate in 2 of 20 regions (Pavlodar, East Kazakhstan (Abai, Ust-Kamenogorsk)), complemented by a CDC-funded initiative aimed at strengthening the health system.

  Budget distribution:

  • HIV testing – 24%

  • Prevention – 16%

  • Clinical care – 27%

  • Health systems – 33%

  KPs outreach targets in numbers (6,000) for 2025 fiscal year:

  • 3,740 self-testing outreach targets in Ust-Kamenogorsk

  • 2,304 self-testing outreach target in Pavlodar

  • Case-finding target: 282 in 2 regions

• The work of 4 NGOs (3 already working and 1 being planned to be supported) on testing, linkage & adherence (MSM/Community Friends) in 2 regions was supported through PEPFAR and also Kazakhstan Union of PLHIV on CLM (SAPA project) and ICAP Columbia University.

• CDC-funded programmes continue operations (ICAP as implementer) applying the condition of the Temporary Restricting Order (TRO) and Limited Waiver to Pause. The CDC office is not operating.

• The key populations, in particular people who use drugs and men having sex with men, are mostly affected by US funding cuts in 2 regions.

• The discontinuation of outreach services for key populations — previously led by 3 HIV-serving NGOs in 2 of 20 regions — affects areas home to up to 20% (14,000) of the total PUD size estimation and 9% (6,500) of the MSM population.

  As these services focused on case detection (testing) and linkage to care, their suspension is likely to hinder national progress on:

  • New case detection (the first 95),

  • Treatment adherence (the second 95),

  • PrEP scale-up.

  Medications for PrEP are fully procured by the government, while Global Fund, PEPFAR, and state-funded outreach workers provide services related to PrEP demand and distribution. PEPFAR (USAID) contributed 13% to the 1st 95% in those 2 regions.

• Measures being taken so far: Domestic resources will be used to sustain outreach services in the two affected regions, enabling AIDS centers to contract outreach workers.

  This measure accounts for the funding pause, which will transition into termination after a 90-day freeze. There is also a dialogue with the Global Fund on uptake of some services — funding can be done after the 90-day pause with more clarity on the final decision.