Living with HIV/AIDS

Life is not easy for an HIV-positive person in Tajikistan given the negative approach to infected people and the stigma attached to the disease prevalent in the country. IRIN was able to meet a person living with the diseases in the Tajik city of Khujand, capital of Sogd province, some 350 km north of Dushanbe. Zukhro, 24, who has been an injecting drug user for five years doesn't know who she contracted the virus from. She doesn't have a regular job and is engaged in sex work to pay for her narcotics habit. She needs three injections a day, requiring her to make at least US $11 in the same period to keep her going. The young woman comes from a troubled family. Her mother is an alcoholic and she hasn't seen her father since she was a young child. Her two brothers are drug addicts as well. Last year her elder brother was sentenced to nine years imprisonment for selling drugs. Zukhro said that her acquaintances and neighbours knew that she was a drug addict and a sex worker, but their attitude to those issues was quite tolerant. However, nobody knows that she is HIV-positive, even her relatives. “If they found out about that, they would turn away from me,” Zukhro said. “Few people know that HIV is not contracted while sharing the same house,” she added. Clients using her sexual services do not know about her illness either. According to Tajik law, if an HIV-infected person infects somebody, he or she will bear criminal responsibility. Asked whether she was afraid of infecting her clients, Zukhro answered in the negative. “I use condoms,” she said, pulling out a pack of Russian-made contraceptives from her pocket. In Tajikistan it is illegal to make public details of those who carry the deadly infection. Article eight of the Tajik law “On prevention of HIV/AIDS” adopted in 1993 says, “transfer of such information is authorised only by legal representatives of this person, medical institutions, law enforcement bodies and the court.” Jumaboi Sanginov, a lawmaker at the Tajik parliament, told IRIN in Dushanbe that the legislation was there to protect the rights of those with the disease. If such information was public, HIV-infected people could face discrimination, violence and segregation in a society that remains largely ignorant of the infection. But legislators were now working on amendments to the law to bring it up to date. “Over 10 years have passed since the law was adopted,” Sanginov said. “Since then, much has changed. Under present conditions, more openness is really necessary, and we will consider whether to keep this article of the law or not.” Campaigners want any change in the law to be liked to education and awareness campaigns that would serve to reduce levels of ignorance and foster sympathy and understanding for carriers of the disease. This is important in Tajikistan where HIV/AIDS is on the rise, fuelled by an increase in the number of sex workers and intravenous drug users, Azam Mirzoev, head of the Tajik AIDS centre, told IRIN in Dushanbe. The centre estimates that there are about 8,000 women in the country involved in the sex industry. Most are driven to the trade by poverty. A sharp increase in the amount of heroin trafficked through Tajikistan from neighbouring Afghanistan is feeding cheap drugs into impoverished communities and creating a generation of new addicts. Since 1991 some 230 cases of HIV/AIDS have been registered in the country, with some 68 percent of HIV-infected people being injecting drug users and around 10 percent contracted the infection through sex, the centre said. Unofficial estimates are up to ten times higher. Masudbek Narzibekov, a programme expert at the United Nations Development Programme (UNDP), told IRIN in Dushanbe that needle exchange units for drug addicts and 'counselling and condoms' centres for sex workers were now up and running in 10 cities across Tajikistan, with UNDP's financial support. But Nabidjon Okhonov, manager of a needle exchange unit in the town of Isfara, 220km northeast of the capital, noted not everybody within the local community approved of such initiatives. Over half of the local population who had heard about the units' activities, thought these centres contribute to the prevention of HIV/AIDS. But others believed they just promote drug addiction by offering free needle distribution. Many people have the same opinion about advice and support centres for sex workers. Khadicha Khakimova, a gynaecologist at Isfara's central district hospital and coordinator at the local sex workers' drop-in centre, told IRIN that many people accused them of encouraging prostitution. “You distribute free condoms among them [sex workers], and treat them free of charge, so you encourage prostitution among them,” one local shopkeeper told IRIN. “However, this is not the case,” said Khakimova. “We only want to promote the prevention of HIV and AIDS.” In an effort to fight HIV/AIDS in the impoverished Central Asian state, the Global Fund to Fight AIDS, TB and Malaria agreed this month to support a joint Tajik government and UNDP initiative on treatment and prevention of HIV/AIDS, Narzibekov said. The world anti-AIDS body is expected to provide more than $8 million to help people like Zukhro live a healthier life while preventing further infections.