Focus on the growing AIDS threat

With more than 25 million people, Uzbekistan is the most populous of the five Central Asian states. Although officially there are only about 2,000 reported HIV-positive cases, independent assessments put the number as high as 20,000, indicating the possibility of a large-scale epidemic in the country. Thirty-three-year-old Qadir Maqsodov’s life has changed since he started work as a volunteer at the Republican AIDS Centre (RAC) in the capital, Tashkent. He contracted HIV through needles as a drug addict and was on the verge of collapse when he first consulted the centre two years ago. After receiving six months of counselling and treatment, he started helping others at the centre. "Their attitude is excellent and they treat me really well," he told IRIN in the course of describing how it felt to be working as an HIV-positive individual. The centre provides commercial sex workers (CSWs) and drug addicts with condoms and syringes, in addition to providing them with anonymous testing facilities, counselling and treatment. "Thanks to this project, I have not been using drugs for the last one and a half years," Maqsodov said. He lectures people on HIV/AIDS awareness - especially the most vulnerable groups of drug addicts and youngsters - by drawing on his personal example of fighting back the disease."I want others to learn from my example," he said. Alina Jahidjanova, a 19-year-old former CSW, also works as a volunteer at the centre. Although, she is not HIV positive, a sexually transmitted infection a year ago forced her to visit the centre. The incident changed her life, and she decided to join the fight against the mounting threat of HIV/AIDS. "It is a huge problem, and if we do not pay attention it will increase dramatically," she told IRIN. "Most of the young people and CSWs know little or nothing about the disease." Setting herself as a role model, she educates prostitutes on the dangers of HIV. While prostitution is illegal in Uzbekistan, some 10,000 to 15,000 CSWs are said to be working in Tashkent alone. "I want all prostitutes to emulate my example," she said. Maqsodov and Jahidjanova are only two of the thousands living with or threatened by HIV in the country. From the first HIV case registered in 1987, among foreign students from Africa and Asia, Uzbekistan today has some 1,750 officially registered HIV-positive cases. "Over the past four years there has been a 35-fold increase in HIV cases," Aziz Khudayeberdiev, the UNAIDS national programme officer in Uzbekistan, told IRIN, adding that there had only been 51 registered cases in 1998. "Until 1999, HIV was mainly transmitted sexually, now the disease is mostly contracted through injecting drug use," he said. Some 53 percent of HIV-positive people contracted the disease by way of needle sharing. "There are 27,000 registered drug users in the country, but independent assessments put the figure at 12,000 for Tashkent alone," he added. However, The UN Office for Drug Control and Crime Prevention recently estimated that there were 90,000 drug users in the country. According to the agency, HIV spreads so quickly that once it is introduced into a particular drug-using population, 40 to 60 percent of it will contract the disease within two to three years. About 85 percent of those infected are men. Only 10 children younger than 14 years were reported infected. Most of the infected people are aged between 15 and 30 years. "After its concentration among intravenous drug users, HIV is spreading to the general public through heterosexual contacts," Khudayeberdiev explained. "This indicates a potential for a large-scale sexually transmitted HIV/AIDS epidemic in Uzbekistan," he said, adding that most of the country's people were young, with the national average standing at 24. Despite the introduction of new legislation in 2000 on improving the institutional environment to the level at which it could address the needs of risk groups, implementation is yet to be seen. Khudayeberdiev maintained that although the government was responsible for providing medicines, these were not available everywhere. "The government is not open and transparent on the issue," he said, stressing the discrepancy between the official and independent statistics on HIV/AIDS, and the lack of resources to confront the challenge. But Boris Sergeyich who heads the RAC is optimistic. "Our aim is to stop the spread of the AIDS epidemic," he told IRIN, saying thousands of drug addicts and CSWs were benefiting from RAC's services. All 12 major regions had RAC outposts. Moreover, 220 trust points offering confidential HIV blood tests, needle-exchange facilities and free contraceptives, as well as information material on how to prevent HIV transmission, were distributed throughout the country. "There are problems related to lack of specialists and interactive outreach methodology, information and education materials," Khudayeberdiev said, adding that a strategic plan on a national response to HIV/AIDS initiated by the UN theme group and supported by UNAIDS had been finalised in June and now awaited government approval. The integrated plan aims support Uzbekistan in assisting and caring for people living with HIV/AIDS while ensuring the implementation of the UN General Assembly's declaration of commitment on HIV/AIDS in the country. Meanwhile, Maqsodov is going ahead with his struggle against HIV/AIDS. Although physically weakened by the infection, his morale and ambitions remain high. "I hope they can find a medicine that can treat this dreadful disease," he said.