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Defeating the stigma around HIV and AIDS in Kyrgyzstan
 

27 November 2007

Building a DFID-funded drop-in centre for injecting drug users in BishkekAccording 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 diseases treatment.

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.

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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 quality healthcare.

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Key facts

  • external linkUNAIDS 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 "go 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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