Defeating the stigma around HIV and AIDS in Kyrgyzstan
27 November 2007
According to UN estimates there are up to 10,000 people living with HIV/AIDS
in Kyrgyzstan, a country of five million. However, only 1,286 have been
officially recorded. Although the number of new cases is growing rapidly,
society doesn't accept there's a problem, and fails to treat infected individuals
with respect or dignity. The stigma surrounding the disease prevents people
from getting tested, and forces those who are infected to isolate themselves from
services such as needle exchanges, condoms, and drug and sexually transmitted
DFID is currently funding a £5.4 million programme in
Kyrgyzstan and other Central Asian countries to change attitudes and increase
the uptake of HIV services. Working both with governments and non-governmental
organisations (NGO), it uses educational initiatives and counselling sessions to
abolish stigma, while pushing to get essential healthcare to those who need it.
No place for prejudice in hospitals
Overturning negative attitudes and ending discrimination
can be a major challenge. Despite their professional codes of conduct and
ethics, some hospitals and medical staff continue to show fear and hostility
towards people living with HIV and AIDS.
Sergey Uzhalovskii, one of the few in Kyrgyzstan who has
admitted he is HIV-positive, contracted the virus by sharing used needles while
injecting drugs. During hospital treatment, he and his family encountered
prejudice among staff. When his wife was
delivering her first child, the doctors and nurses panicked, and when the child was receiving antiretroviral (ARV)
treatment, Sergey and his wife had to control this process themselves, as the doctors
measured the dosage incorrectly. The doctors also had to be constantly reminded
to give the child medication.
Sergey believes that, if no one talks about the disease,
the stigma will never be overcome and more and more people will suffer
unnecessarily. It is crucial that a supportive environment is created in
Kyrgyzstan for those living with HIV and AIDS. One way of doing this would be to
spur a national and community-wide discussion on relationships, sex and
sexuality, risk, and cultural practices that may increase the likelihood of HIV
transmission. Unless attitudes are altered across society, fear and
discrimination cannot be defeated, and national policies will not change.
Creating a supportive environment
DFID's programme funds activities that will help achieve
a supportive environment. Through a range of NGOs it funds personal and group
counselling sessions, and peer education meetings, in which ex-drug users share
their experiences with current users. Through self-help groups it also provides
a place where reformed and current users can meet to support each other in
tackling addiction and getting treatment.
To change attitudes within public institutions, the
programme also carries out training, "round-table" discussions, and direct
collaboration with staff. Codes of conducts are developed and service standards
are agreed upon. With these tools in place, public service providers such as
doctors and nurses have a clearer sense of how to treat people living with HIV.
They can then pass these lessons on to their communities, and inspire fresh
attitudes and ways of behaving.
And there are strong signs that the long-standing stigmas and discrimination
are being eroded. Sergey now has one more child, and he
admits to seeing a definite change amongst medical personnel. When he goes to
hospital, he is met by staff who are more supportive and understanding than
before. He is less an object of fear, and more an individual deserving of
UNAIDS reported in December 2006 that Eastern Europe and Central Asia have some of
the fastest growing AIDS rates in the world. The number of people living
with HIV in 2006 was over one-fifth (21%) higher than in 2004 – the most
striking increase in the world.
- Kyrgyzstan, Uzbekistan and Tajikistan have experienced a 25-fold increase in
HIV cases over the last five years. The number of people living with HIV in
these countries is estimated to have tripled between 2003 and 2005.
- DFID's funds a four-year (2005-9) £5.4 million regional Central Asia HIV and AIDS
Programme (CARHAP) in Kyrgyzstan, Tajikistan and Uzbekistan, which focuses on
scaling up harm reduction services. The three countries have recognised
intravenous drug use as the main route of HIV transmission in the region.
- In Kyrgyzstan there are eight NGOs
providing harm reduction services to vulnerable groups, and six
projects operate in prisons.
- Knowledge of HIV is low and the stigma
attached to it is high. Vulnerable populations such as injecting
drug users, sex workers and ex-prisoners experience stigmatization
and marginalization in their communities. People living with HIV are the most stigmatized group of people
and prefer not to disclose their status. Discrimination pushes them to
underground", making them unreachable for preventive interventions and even more
dangerous to themselves and the general population.
- CARHAP is working to reduce the stigma and discrimination to the degree that vulnerable groups are able to access HIV/AIDS prevention services and
participate in the implementation of these services.
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