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Purpose: This paper examines differences in attitudes, stigma, and discrimination towards people living with HIV (PLWH) in needle and syringe programs (NSPs) in Kazakhstan to help inform HIV care interventions in these settings. Method: We collected data on HIV/AIDS attitudes using a modified Health Policy Project Standardized Brief Questionnaire with two subscales: attitudes within the health facility environment in a facility caring for PLWH, and opinions about PLWH. Results: Outreach workers were significantly more likely than nurses to report health professionals disparaging PLWH, and having stigmatizing attitudes towards PLWH. Outreach workers LWH were significantly more likely to report HIV discrimination in the NSP, and male staff was significantly more likely to have negative opinions of PLWH. Conclusions: Assessing different staff attitudes of nurses versus outreach workers, male versus female staff, and HIV positive versus negative staff and conducting follow-up training may decrease stigma and improve attendance at harm reduction programs. [ABSTRACT FROM AUTHOR]