Integrated front line approach to tackling HIV/AIDS

On a street corner in the Uzbek capital, Tashkent, an inauspicious doorway marks a new approach to dealing with the growing threat of HIV/AIDS in the country. In an effort to combat stigma and encourage testing, the government has introduced integrated facilities under one roof: a clinic for anonymous testing, a needle exchange for intravenous drug users and an advice centre for sex workers. In addition, in some parts of the country, an NGO where people living with the virus are available for counselling and support can also be found close to the other facilities. "We are serious about reducing infection rates and providing all these services related to HIV together is a good start, we are making it easy for people to get tested and to get support," Guzal Giyasova, Director of Uzbekistan’s National AIDS Centre, said. The total number of registered HIV/AIDS cases in Uzbekistan is the highest recorded in Central Asia, according to the UN’s Millennium Development Goals (MDGs) report for Uzbekistan published in April. Nearly 2,200 cases were registered in 2005, bringing the official total to 7,800. Unofficial estimates put the number of infections much higher. The needle exchange – where drug users can get supplies without being criminalised - is an important component of the integrated approach to tackling the epidemic on the streets. A rise in the number of injecting drug users is driving the increase in infections - particularly in prisons where more than 34 percent of new infections were registered in 2004. "We are right on one of the main trafficking routes from Afghanistan to Russia and on to Europe, therefore, cheap drugs are available in Uzbekistan, despite the battle of law enforcement agencies to stop trafficking," Dr Aziz Khudoberdiev, a programme officer with Uzbekistan’s Joint UN Programme on HIV/AIDS, said. Young people have become highly vulnerable to HIV infection in the wake of rapid social and economic change in the republic and are being targeted by education and advocacy campaigns. This is where NGOs like Trust and Life come in. Based in the same building as the testing and advice facilities, it’s made up of people committed to reducing the spread of the virus, some of whom are HIV positive. "Our location here is critical, often someone will emerge from anonymous testing next door with a positive result, here we can offer them immediate support and show they are not alone but among friends," said Sergey Petaev, who runs the NGO’s sub-office in this part of the capital. Other members of Trust and Life are busy with outreach work, spreading the word about the integrated facilities at colleges, cafes, nightclubs and Internet providers where young people congregate. "Lack of information and knowledge are the big killers, if you know how to protect yourself that is powerful," Violetta, one of the outreach volunteers said as she grabbed another batch of leaflets and condoms for distribution at a football match later that evening.