HIV/AIDS among labour migrants causes concern

Mirzo Saidov (not his real name), a 32-year-old labour migrant from Tajikistan, worked on a construction site in Moscow like many of his fellow countrymen and used to earn good money by Tajik standards. After a traffic accident in December, he was taken to a hospital with his limbs broken. There, along with other blood tests, he had an HIV test. The test results were positive whereupon he was promptly deported from Russia back to his homeland. That was a blow for his family back in the southern Tajik province of Kulyab, about 250 km south of the capital Dushanbe, as he was the only bread-winner for his extended family. But in addition to now being jobless with no means to get by, he was obliged to keep his HIV status secret, a burden immensely painful given the stigma attached to the disease in this largely conservative society. While his wife and children were in Kulyab, he lived in Moscow with a Russian woman, but claimed he had no idea whether he caught the disease from her - given the number of other sexual partners he had. Matluba Rakhmonova, head of the epidemiological department of the Tajik National AIDS Prevention Centre, told IRIN that Mirzo's case was not unusual, adding that the issue was now a source of concern. "In 2004 alone, two more Tajik labour migrants were deported from Russia for the same reason," she said. More than 600,000 Tajik labour migrants, most of them illegal, work and live in Russia, a staggering amount given that Tajikistan's population is just 6.5 million. Many young people, driven by chronic unemployment in the country, go to Russia and other Commonwealth of Independent States (CIS) countries in search of jobs, leaving their families behind. Away from their families for prolonged periods of time, both married and single male migrants are known to engage with commercial sex workers, a high-risk group in terms of HIV/AIDS. Upon returning, labour migrants do not test for HIV and as a result can infect their wives with sexually transmitted infections (STIs), including HIV. One of the deported migrants has already infected his wife, according to health officials. Azamjon Mirzoev, the director of the National AIDS Prevention Centre, told IRIN in Dushanbe that 26 people who had returned from Russia and other CIS countries over the past few years were found to be HIV positive, of whom five were residents of Dushanbe, two from the southern Khatlon province, eight from the northern Sogd province and 11 residents of the eastern Gorno-Badakhshan autonomous region. Although officially the number of registered HIV cases is some 330, the joint UN programme on HIV/AIDS (UNAIDS) estimates the real number to be close to 5,000 people, 15 times higher than the official figure. The main mode of transmission, more than 60 percent, is through injecting drug usage, while sexual transmission was around 7 percent, with the remaining modes of transmission in some 25 percent unidentified. According to the provincial AIDS Prevention Centre in Sogd province, in 2004 the number of patients who contracted HIV through sexual intercourse increased twofold. Khabibullo Orifov, the director of the centre in Sogd, said labour migration was a primary factor fuelling the increase. In 2004 alone, eight of 16 HIV-infected people in the province were labour migrants. Health officials also attribute the growth of other STIs in Tajikistan to labour migration. Many wives of migrants come to antenatal clinics with gynecological complaints, Rakhmonova said, adding that the vast majority never even suspected that the reason for their health problems were various STIs, including gonorrhoea, syphilis, trichomoniasis and other diseases supposedly contracted from their husbands. In an effort to assist the government in tackling the HIV/AIDS issue in Tajikistan, the poorest of the former Soviet republics, the UN Global Fund to fight AIDS, Tuberculosis and Malaria would provide more than US $2.5 million over the next two years, Murotbek Beknazarov, the Global Fund's grant implementation subdivision manager in Tajikistan, told IRIN. Within the framework of the project, a special component aims to focus on prevention activities among labour migrants, their families, street children and prisoners. The Labour and Social Protection Ministry, Defence Ministry and the Health Ministry determined 15 pilot districts in the country, where the largest number of labour migrants come from. In 2005, trust centres supported by the project will open in those districts for the vulnerable groups. "Free-of-charge counselling and medical treatment of STIs will be provided to labour migrants and their families as well as awareness raising, HIV testing and post-testing counselling. It is also planned to organise helplines at these centres," Mirzoev explained.