EECAAC 2018: in Search of Optimism

Peter Reiss, Local Co-Chair of the 22nd International AIDS Conference (AIDS 2018), Professor of Medicine at the Academic Medical Centre (AMC) in Amsterdam, the Netherlands

Author: Marina Maximova, Kazakhstan

While the VI Eastern Europe and Central Asia AIDS Conference (EECAAC 2018) was going on in Moscow, Svetlana (the name was changed), a 28-year-old woman living in Karaganda, Kazakhstan became a mother for the first time. It seems that these events are not related at all. However, these two facts were brought together not accidentally. At the international forum, scientists, medical professionals, policy-makers, public officials, international experts and civil society activists argued and discussed how to curb the HIV epidemic and achieve the ambitious 90-90-90 UNAIDS targets. Meanwhile, they were not particularly optimistic. At the same time, a woman living with HIV for eight years gave birth to healthy twins. Maybe it is a sign that we should not give up hope?

Optimists and pessimists together

The question of HIV vaccine has become proverbial. For many years, the best scientific minds of the world have been struggling to invent it. There is no consensus among scientists about the feasibility of a panacea for HIV – the discovery of a vaccine.

Vadim Pokrovskiy, Head of the Russian Federal AIDS Centre honestly says that he is pessimistic about it.

“Personally, I think that it is not possible. There are infectious diseases, to which people naturally become immune after they recover from them. HIV is more like malaria, which does not belong to this category. However, I would be very happy to see such vaccine discovered,” says Dr. Pokrovskiy.

Salim Abdool Karim, Director of the Centre for the AIDS Programme of Research in South Africa (CAPRISA), vice versa, says that he has never been as optimistic about the HIV vaccine as today.

“A study on the production of HIV antibodies is already in progress. In South Africa, there is a woman, whose antibodies kill about 87% of all known modifications of the virus. We take her antibodies and test their efficiency in HIV prevention,” tells the scientist.

This positive attitude is also shared by Peter Reiss, Local Co-Chair of the 22nd International AIDS Conference (AIDS 2018), Professor of Medicine at the Academic Medical Centre (AMC) in Amsterdam, the Netherlands. He points out that HIV vaccine trials successfully started in Thailand several years ago. Currently, research is going on and the preliminary data are promising. However, this work takes a long time.

Prolonged ART gives a hope for tomorrow

At EECAAC 2018, the leading world scientists shared information about the development of two ARV drugs with prolonged effect

At EECAAC 2018, the leading world scientists shared information about the development of two ARV drugs with prolonged effect. It means that people living with HIV will be able to substitute daily pills with periodic injections. It is much more convenient. Currently, two major research studies of prolonged-action drugs are going on in South Africa.

Stefano Vella, Head of the Department of Therapeutic Research and Medicines Evaluation at the Italian National Institute of Health says that the studies of prolonged-action drugs are currently underway.

“It is not just about injections, but also about implants. For instance, like female contraceptives. It is important that there should be an option to remove them in case of side effects. Every patient should have a choice which medicines to use and the patient’s preferences should be taken into account,” he says.

There is no doubt that the right to choose has an impact on adherence to treatment. For those who have problems with adherence, the ability to take drugs not in the form of pills and without the need of daily administration may be the key to undetectable viral load and better quality of life.

Just a story

Svetlana from Karaganda learned about her positive HIV status when she was 20. The woman did not have a vaccine. For a long time, she could not accept her diagnosis. She even had suicidal thoughts. Svetlana had no idea how to go on living her life. However, she met a man, fell in love with him and they got married. ARV medicine helped her to give birth to healthy children. The happy mother with her babies has already been released from the maternity clinic. The twins have a good appetite; they are quickly gaining weight. This is the main cause of optimism for the woman.

According to the statistics since the 1990s, only in Karaganda region mothers living with HIV gave birth to more than 400 babies. Last year, 36 babies were born. They all remain under follow-up care until they turn 18 months old.

Metropolis 2020: on the Way to 90-90-90

Author: Anastasia Petrova

Dynamics of the HIV epidemics in big cities is a pressing issue all over the world. According to the United Nations, by 2050 most people will live in big cities. This is most relevant for the developing countries with low incomes and growing HIV epidemics. Considering that the key populations are concentrated in metropolises, experts point out that there is obviously a need to implement HIV prevention and treatment programs at the municipal level. The decision to end the AIDS epidemic in big cities by 2020 is embedded in the Paris Declaration signed on 1 December 2014 with support of the UNAIDS.

This topic is the basis of the Fast-Track TB/HIV Responses for Key Populations in EECA Cities Project implemented by AFEW International in collaboration with Alliance for Public Health and presented within the VI Eastern Europe and Central Asia AIDS Conference (EECAAC 2018) held in Moscow, Russia. Together with the municipalities of five big EECA cities, civil society representatives developed measures in response to the spread of HIV/TB in key populations.

On 20 April, Anke van Dam, Executive Director, AFEW International moderated a session called “Fast-Track HIV/TB Responses in Healthy Cities” at EECAAC 2018. The session was co-chaired by Svetlana Plămădeală, Country Manager, Coordinator, UNAIDS, Moldova; Alla Yatsko, President, Public Association ‘Youth for the Right to Live’, Moldova; and Erika Tserkasina, Program Officer, Eurasian Coalition on Male Health, Coordinator, MSM Programmes in Almaty, Beltsi, Odesa and Sofia, Estonia.

“We cooperate with five metropolises in the region: Odesa (Ukraine), Tbilisi (Georgia), Beltsi (Moldova), Almaty (Kazakhstan) and Sofia (Bulgaria). The key criteria in selecting the cities were HIV prevalence and readiness of the local authorities for cooperation. Through organizing a network of community representatives, we established cooperation with the municipalities,” said Anke van Dam, Executive Director, AFEW International.

The goal of the Fast-Track TB/HIV Responses for Key Populations in EECA Cities Project is to contribute to achieving 90-90-90 targets, including reduced mortality and increased funding for HIV/TB treatment. One of the main tools is strengthening partnership between the authorities and civil society. To achieve this objective, the project includes research studies, workshops, and meetings with decision-makers. It is planned that the preliminary results of the project will be presented at the International City Health Conference ‘Developing healthy responses in a time of change’ to be held in Odesa on 13-14 September 2018.

How to Become AIDS 2018 Participant

To register for the 22nd International AIDS Conference with the standard fee is possible before May 18. After this date, the registration will be possible only with the higher fee. Deadline to submit a visa application and to request a Letter of Invitation is June 1.

We are presenting this and other information on how to register for the Conference in our new video. Especially for you, we explained online registration in details and answered your questions.

Will see you in Amsterdam in July!

GeNPUD is Allowed Official Registration

A landmark judgment allowing an official registration of Georgian Network of People Who Use Drugs for Human Drug Policy (GeNPUD) was delivered on March 26, 2018, by Tbilisi City Court Judge Tamar Chuniashvili.

The lawsuit was prepared on behalf of GeNPUD after the network was refused official state registration as stated in LEPL National Agency of Public Registry’s decision. The rejection of registration was based on the “name issue.” Public Registry references the law which says that the name of GeNPUD (any kind of drug users’ organizing assembly) seemed to be an attempt “to put the illegal activities in the legal framework” and is misleading the entire society. GeNPUD is disagreeing saying that this is the violation of the community’s fundamental rights guaranteed by the Constitution and the European Convention.

Within the lawsuit and during the Court hearing among legal arguments versus the Public Registry, Strasbourg Court’s judgments solid arguments as well as factual circumstances that demonstrated the importance of the network activities in the process of human rights protection, harm reduction services’ effective delivery to the targeted groups, liberalization of the drug policy, formation of effective health system and in overall all for public benefit were presented.

GeNPUD believes that Tbilisi City Court’s judgment would be an important step in the protection of the communities’ rights and interests not only at the local level but at the international scene and it will become the new window of opportunities to fight for health and the fundamental rights of the community members. It is believed that this judgment will further strengthen the democratic values on the way of establishing the effective drug policy.

Source: Drug Policy Georgia

Ex-Prisoner in Tajikistan Advocates Healthy Lifestyle

Umed is a participant of the START Plus programme implemented with AFEW-Tajikistan

Author: Nargis Harambaeva, Tajikistan

Umed Boev, age 41, an ex-prisoner from Tajik town of Bokhtar advocates healthy lifestyle among risk groups – people who use drugs, sex workers and ex-prisoners.

In 2001, when Umed was 24, he went to Russia to earn money. He liked partying and spent quite some money on that. In 2004, during one get-together he had a quarrel and a fight, causing another person grievous bodily harm. He was sentenced for 10 years and served his time at Novosibirsk maximum security prison.

While in confinement, Umed tried heroin for the first time. One syringe was often shared by many people. One day his fellow countrymen, who served sentence in the same prison, found out and talked to him.

“They convinced me to stop taking drugs, telling me that prayers would help. I mustered all my will power, it was extremely hard during withdrawal, but I stuck it out. I prayed hard and it really helped me. I stopped using drugs,” tells Umed.

10 years later, when Umed returned home, he was diagnosed with HIV.

“Upon return, I first worked at a construction site, then the crisis hit and the construction was put on hold. I needed money. An acquaintance of mine told me I could donate blood and get some money that way. Therefore, I went to the clinic and they did an HIV test and the result was positive. I was registered with the clinic but I did not take my diagnosis seriously, did not take antiretroviral therapy,” recalls Umed.

Timely request for help

Because of his weak immune system, soon Umed developed tuberculosis.

“In December 2015, I suddenly felt very ill, had a torturing cough for three months. In April 2016, I was taken to a hospital and diagnosed with tuberculosis. I was in a very poor state of health. I could not even walk, had no appetite. During that time, I rapidly lost 20 kilos. Only later doctors told me I turned for help just in time. Another couple of weeks and I would have died. I was treated, and recently when I had fluorography examination tuberculosis was gone. I am so happy about that,” he says.

Today Umed is a participant of the START Plus programme implemented with AFEW-Tajikistan. The purpose of the programme is to reduce the prevalence level of public health concerns like HIV, TB and viral hepatitis at penitentiary facilities and improve the quality of life of persons released from prison.

“I discovered help for people like me when I was diagnosed with tuberculosis. I came to AFEW-Tajikistan local office in Bokhtar. I received food packages as well as assistance in the form of information. Currently, they are helping with the purchase of necessary medicines,” tells Umed.

Becoming part of the Board

Umed is a member of the Board of representatives of key population groups that was organised within AFEW-Tajikistan office in Bokhtar to help persons in risk groups who are neglecting their health.

“There are four of us in the Board. I am responsible for creating awareness among key groups about infectious diseases. These groups include ex-prisoners, people who use drugs and sex workers. We help AFEW-Tajikistan, inform them about the needs of the groups, adjust assistance that is being provided so that it gains better quality and effectiveness,” says Umed.

By the way, one of the topics of the 22nd International AIDS Conference in Amsterdam is prison health. Other public health issues like HIV, hepatitis and TB in Eastern Europe and Central Asia will be also in focus during AIDS 2018.

PLWH Network Launches New Concept Clinics in Ukraine

Author: Yana Kazmirenko, Ukraine

All-Ukrainian Network of People Living with HIV (PLWH) plans to open five 100 Percent Life all-patients-friendly clinics this year. The ultimate plan is to cover the entire Eastern Europe and Central Asia (EECA) region.

The Project to create the 100 Percent Life network of clinics is a challenge for the Charitable Organisation All-Ukrainian Network of People Living with HIV/AIDS. It is considered to be the largest patient organization throughout the former Soviet Union. During the past several years, modern medical centres accessible for all patients have been opened in each region of Ukraine. Medical centres will provide treatment and social support to those frequently dealing with discrimination at regular hospitals: people living with HIV, representatives of key risk groups. HIV-positive patients will receive services free of charge, clients, in general, will receive them at below-market prices.

In autumn of 2016, a pilot clinic was opened in Poltava, and this year medical centres in Kyiv, Zaporizhia, Lviv, Chernihiv and Zhytomyr will receive their first patients. The capacity of the clinic in the capital will be 900 patients per month.

The Network is preparing to present the Clinic Network Project at the 22nd International AIDS Conference AIDS 2018 in Amsterdam. They are convinced that such format will be highly sought in all countries of the EECA region.

“The first centre of this kind abroad will be opened in Moldvova – they have liberal legislation. Georgia and Kazakhstan are also expressing interest,” says Dmitriy Sherembey, the Chairman of the Coordination Board of Charitable Organisation All-Ukrainian Network of PLWH.

The philosophy and services of these clinics will be a drastic difference from the reality of Ukrainian AIDS centres. Below is the outline of the main differences.

Donors become investors

The Clinics Project changes the roles of donors and non-profit organisations. Under the PLWH Network, model donor organisations become investors, and non-governmental organisations (NGOs) become entrepreneurs.

“At the present time, donors award grants, and in the end, they receive a report on “why it did not work and how flawed the world is.” We are knocking this system down: each hryvnya spent on the clinic by donors continues to work after grant completion. All profit from clinics will be invested into the development of new services. The donor acts as an investor and receives profit not in monetary equivalent but in humanitarian terms,” says Mr. Sherembey.

According to calculations of the Network Head, 50 thousand dollars invested in a clinic will turn into a million within 20 years. At the same time, money spent by a patient at the clinic will turn into a service to a person who wants to live, as opposed to being just owner’s profit.

Medical staff of Poltava clinic praised for thoughtful treatment. Photo by PLWH Network

The clinic in Poltava has become profitable just six months after opening. This gives a chance to NGOs to say good-bye to the role of petitioners and enter the market of medical services, which is rated at 100 billion US dollars a year in Ukraine.

“The network of clinics will allow maintaining programmes and staff in case the Global Fund leaves Ukraine. We have been observing the negative experience of closing up programmes and discharging specialists in the Eastern European countries that have joined the European Union,” adds Yaroslav Blyakharskiy, Manager of Social Entrepreneurship Section of PLWH Network.

Medical centre is put together like Lego

Each clinic will have a different set of services, depending on the diseases in the region, what is offered by competitors and the paying capacity of the population. Three specialists will form the basis: a family doctor, an infectious disease specialist and a drug treatment specialist.

Poltava was not a random choice for the pilot project – it is a typical medium-size Ukrainian city. If the project proved to be sought after in this city, it is bound for success in other regions.

“The pilot clinic provides help in the following fields: neurology, allergology, nosology, narcology, pain and withdrawal syndrome relief. Narcology has proven to be in the highest demand,” says Mr. Blyakharskiy.

In Kyiv centre this list will be supplemented with gynecology, urology and dermatology.

Progressive standards of care

Progressive European treatment protocols will be used at 100 Percent Life medical centres. The Clinics Project is integrated into the medical reform, which is currently dismantling the Soviet-times model. Under the reform, each citizen of Ukraine will have to select a family doctor; and the Government will transfer money to the doctor for treatment of this patient. The family doctor will be able to prescribe antiretroviral therapy, which is currently received by 90 thousand patients in Ukraine.

A mobile application as your health manager

100 Percent Life medical centre will make all communications between patients and medical staff automated as much as possible. Clients will be able to install an application on their mobile phones enabling on-line arrangement of appointments, medical tests, receipt of prescriptions and seeing the entire treatment regimen. Patient’s medical record will also be available electronically. The application will allow covering 60% of all communications between the patient and the clinic.

Medical centre accommodates the patient

Poltava clinic is open until 10 p.m. seven days a week. For the PLWH Network it is vital that all categories of patients get equal access to proper quality services and treatment and do not face rejection and discrimination.

According to the research conducted by the PLWH Network, around 19% of surveyed HIV-positive patients in Ukraine have faced refusal of medical examinations that did not involve contact with blood (the research is titled Evaluation of multiple stigma faced by high risk group representatives with regards to HIV infection – editor’s note). Around 80% of patients were refused by the consulting physician.

HIV in Georgia: is there any stigma

Author: Irma Kakhurashvili, Georgia

Our meeting with David Ananiashvili was appointed in a green courtyard of the Infectious Diseases, AIDS and Clinical Immunology Research Centre. The Centre is located in an old building in one of the central districts of Tbilisi, Georgia. The authorities have been promising a new working space for the centre since long ago, but so far there has been no progress in this process. However, David feels at home – he knows every corner here. He was one of the first people in Georgia who publicly spoke about their HIV status. David is the head of the Georgian Plus Group NGO. Since 2000, the NGO has been implementing various projects to protect the rights of people living with HIV and standing up to stigma and discrimination.

In the meeting room, David says that the civil society sector in the area of HIV/AIDS is quite small. Besides, there are not many resources available to fight stigma. In Georgia, all people have access to free HIV treatment (antiretroviral therapy is available and accessible for patients since 2004 through the grant of the Global Fund to Fight AIDS, Tuberculosis and Malaria), while stigma is one of the main factors hindering access to testing of HIV. David says that most stigma-related issues may be observed in health facilities, in the relations between doctors and patients. The HIV-related stigma in the healthcare system – both in state-run and in private clinics – is so strong that sometimes doctors and other medical personnel do not provide the required high-quality services. There have been cases when doctors refused to perform life-saving surgeries if their patients had HIV.

Stigma is reinforced by myths

The situation is worse in regions of the country, especially in smaller towns and villages where patients are afraid of social isolation and are reluctant to disclose their status even to their family members. Here, the HIV diagnosis still leads to the feelings of panic and helplessness as it used to be in the 80s.

“HIV is a stigmatized disease causing a number of emotional and social problems. Stigma is reinforced by a variety of myths, for instance, that HIV is a result of the person being irresponsible, practising immoral behaviours or using drugs,” explains David.

The community of people living with HIV in Georgia is not as open as it should be but David believes that everything has its time and that this issue may be resolved. Current scale of the response to hepatitis C may serve as a good example. Until 2015, people in Georgia had never talked out loud about this disease, but after the government started the national program of hepatitis C elimination the ice was broken: many people were able to recognize they had hepatitis and start effective treatment.

In the nearest future, hepatitis C elimination programme will also include screening for HIV, which means that the patients who are tested for hepatitis C will also be screened for HIV. The initiator of this idea – AIDS Centre – is sure that integrated services will significantly improve the HIV detection rates. David says that countering stigma requires a comprehensive approach instead of one-sided efforts.

Strategic plans

The estimated number of people living with HIV in Georgia is 12,000 people. Apart from countering stigma and discrimination, the main goal in the AIDS response is detection of the new HIV cases.

David says that there is a need to bring up the issue of preventive treatment of discordant couples in Georgia. Pre-exposure prophylaxis of HIV (PrEP) is a new method of HIV prevention. PrEP provides additional protection in cases when people do not use condoms for whatever reason.

David Ananiashvili and his colleagues plan to make their contribution to the development of a new National Strategic Plan to Fight HIV/AIDS. Its main objectives will be delivery of services to vulnerable groups and further scale up of prevention programmes.

“We would like to implement a new project by creating a consortium to make sure that in future our services – counselling centre, mobile clinics, outreach services, group activities, etc – and interventions are explicitly described in the HIV/AIDS strategic plan and to add new services to the existing ones. We will conduct focus groups, identify common challenges and needs to analyse and understand which services are needed for vulnerable populations and which of them are more effective,” says David.

Artificial Respiration: will Russia End Tuberculosis by 2030

In 2016, 1.3 million people worldwide died of tuberculosis. Over the same year, 10.4 million people fell ill with tuberculosis

Author: Anastasia Petrova, Russia

March 24 is World Tuberculosis Day. Tuberculosis (TB) is the ninth leading cause of death worldwide. Russia is one of the top three countries with the highest burden of drug-resistant TB. At the first World Health Organisation Global Ministerial Conference on Ending TB held at the end of the last year in Moscow, the Russian Minister of Health Veronika Skvortsova proclaimed that Russia, supporting the global community goal, aims to end TB by 2030. Experts comment on how feasible this goal is.

Treatment is not cost efficient

Tuberculosis is called a biosocial disease as people from the most socially disadvantaged populations face the highest risk of being infected. People from low- and middle-income countries – India, Indonesia, China, Nigeria, Pakistan, Philippines and South Africa – are affected the most. Such countries cannot procure the required drugs at high prices and, as the treatment access experts point out, it is not cost effective for the pharmaceutical companies to invest in the production of drugs, which will not bring them enough income. It complicates the development and launch of new drugs, while the lack of innovative drugs leads to the development of drug-resistant forms of tuberculosis, aggravating the situation.

In 2016, 1.3 million people worldwide died of tuberculosis. Over the same year, 10.4 million people fell ill with tuberculosis.

Sustainable threat

TB morbidity rate in Russia is 58.44 cases per 100,000 people. On one hand, there has been a steady declining trend in TB mortality in the country since 2005 (except for the vulnerable populations). According to the WHO, in 2016 the mortality rate was 8.2 cases per 100,000 people a year (as compared to 16 cases in 2011). On the other hand, WHO experts observe two crucial problems in the Russian Federation: growth in TB morbidity among people living with HIV and widespread of the drug-resistant forms of TB – extensively drug-resistant tuberculosis (XDR-TB), multidrug-resistant tuberculosis (MDR-TB), and rifampicin-resistant tuberculosis (RR-TB).

According to the WHO, Russia is one of the top three countries with the highest burden of extensively and totally drug-resistant tuberculosis, with higher rates in India and China only. In 2016, the share of XDR-TB in the new TB cases in Russia was 27%, and in recurrent TB cases – 65%. It means that now there is no effective treatment for many people. Only 31% of people recover from XDR-TB. The cause of drug-resistant TB is first of all associated with treatment interruptions. The main reason of patients “dropping out” is the lack of social support.

“Patients should not only be treated but should also be provided with comprehensive social support. The treatment is long and hard, it takes over a year. It leads to many people losing their jobs. If people have no means of subsistence, they have to stop their treatment and go to work. The situation is even more complicated for people who have small children,” says Svetlana Prosvirina, member of TBpeople, the Eastern European and Central Asian network of people with experience of TB. “Such drop-outs are extremely dangerous as the bacteria which survive after the treatment interruption adjusts to the medications, which contributes to TB evolution to MDR-TB and XDR-TB.”

Coverage of people living with HIV with treatment is low

Experts agree that to curb the epidemic of tuberculosis by 2030, the government should make efforts to fight drug-resistant forms of TB and create conditions for the patients not to interrupt treatment

Tuberculosis is the main AIDS-defining disease and the leading cause of death among people living with human immunodeficiency virus. The risk of co-infection is related to the low immune function of people living with HIV, who need to receive antiretroviral therapy (ART) constantly to stabilize their immune responses. However, in Russia treatment coverage of people living with HIV remains extremely low. According to the Federal AIDS Research Centre of the Rospotrebnadzor Central Research Institute of Epidemiology, in 2017 the coverage rate was only 35.5%.

People who use drugs are also in a difficult situation. TB activists point out that TB treatment clinics often do not have a drug counsellor and sometimes do not even have a license to provide help to people who suffer from the abstinence syndrome (group of symptoms with varying combinations and severity, which develop when a person terminates using psychoactive substances or reduces the dose taken after their recurrent use, usually during a long-term and/or in high doses – editor’s note). Those symptoms make the patients refuse from further treatment, which not only leads to drug resistance but also creates pre-conditions for further transmission of the disease.

Ending TB by 2030

Experts agree that to curb the epidemic of tuberculosis by 2030, the government should make efforts to fight drug-resistant forms of TB and create conditions for the patients not to interrupt treatment.

“Comprehensive support of vulnerable populations, including the patients, is required to prevent the spread of tubercle bacillus,” says Kseniya Shenina, activist, member of the TBpeople Coordination Council.

Based on the conclusions of the Russian Public Mechanism for Monitoring of Drug Policy Reform, an important pre-condition to overcome the problem is the revision of the Russian drug policy in compliance with the “Support Don’t Punish” approach. Experts believe that the country urgently needs to approve recommendations of the numerous UN bodies on drugs and HIV, including recommendations of the Committee on Economic and Social Rights. Only compliance with these conditions will make the goal of ending tuberculosis by 2030 more feasible.

Persecution and Activism of Sex Workers in Kyrgyzstan

Author: Olga Ochneva, Kyrgyzstan

For almost a year and a half, law enforcement agencies have been persecuting sex workers in Kyrgyzstan. During this period, the number of sex workers receiving HIV prevention services in some regions of the country reduced twice. Civil society organisations registered more than 450 cases of sex workers’ rights violations by the police every year.

Extortion, detentions, and threats

In 2017, 81% of all reports of abuse and human rights violations submitted to the Shah-Aiym Sex Workers Network were complaints against police officers on extortion. Shah-Aiym documents such cases with the support of Soros Foundation-Kyrgyzstan and street lawyers of public associations all over Kyrgyzstan within the framework of the Global Fund via Soros Foundation-Kyrgyzstan. Both sources recorded 475 cases of sex workers’ rights violations by law enforcement agencies in 2016 and 459 cases in 2017. Most often, those are cases of extortion, arbitrary detention, threats, blackmailing, pressure and degrading treatment.

“The wave of mass raids started in mid-2016 when City Directorate of Internal Affairs in Bishkek announced that it was going to “clean the city by getting rid of prostitution.” They even asked local people to conduct night raids, make photos of sex workers and pass such photos on to the policemen,” tells Shahnas Islamova, head of NGO Tais Plus. “At first, press service of the Chief Directorate of Internal Affairs was reporting detentions, not even hesitating or not understanding that they were, in fact, announcing unlawful acts of the law enforcement agencies.”

In Kyrgyzstan, sex work is decriminalized, which means that it is neither an administrative nor a criminal offense. To punish sex workers, law enforcers use other provisions of the Administrative Offences Code. Most often, sex workers are detained for alleged disorderly conduct or petty crimes.

“Sex workers try to avoid court proceedings: they buy off. There are some cases when law enforcers know what a girl does to earn her living and start blackmailing her. They threaten to take photos of the girls, tell their relatives about their occupation or take them to a police station, so the girls agree to pay: the standard charge is up to 1,000 soms ($15),” tells Alina (the name is changed), a street lawyer of a civil society organization. “If girls try to defend their rights, law enforcers find other ways to detain them: they draft reports of disorderly conduct or failure to obtain registration. Those who have bad luck or are not able to buy off may be arrested for three to five days.”

According to Alina, many sex workers have gone underground: they often change their rented apartments and phone numbers. Such situation in some regions of the country hinders the access of NGOs to sex workers to conduct HIV prevention interventions: distribute condoms, offer testing, conduct awareness-raising activities, and consultations.

“Since the start of the “purge”, our organization has been monitoring the dynamics in the coverage of sex workers with prevention programmes in Bishkek,” says the head of Tais Plus NGO. “In a year and a half, the coverage has reduced twice, and in the second quarter of 2017 the actual indicator went down to 39% of the planned coverage.”

Activism in the challenging environment

Mass raids of 2016-2017 echoed almost in every region of the country. Groups of people who explained their actions with the “religious motives and interests of the society” helped law enforcers in their “fight” against sex workers. As the end of 2017 approached, things calmed down: sex workers got used to the new conditions, while the pressure from the side of police weakened a bit and the mass raids ended. However, “police marks” stipulating sex workers paying money to the law enforcers for the so-called “protection” and “permit to work” are still there.

“Currently, in most cases pimps are the ones to keep contact with police, while there are almost no girls who work on their own,” says Nadezhda Sharonova, director of the Podruga Charitable Foundation about the situation in Osh. “Recently, our street lawyer has been more and more often reporting complaints of sex workers against their pimps who beat and blackmail the girls.”

Despite the fact that civil society organizations in Kyrgyzstan offer legal support, sex workers rarely report their offenders. Representative of the Tais Plus NGO thinks that this fact is easy to explain: to go through all the legal prosecution process, one needs boldness and strength as well as certain savings – not to cover the legal expenses, but to be able not to work for a while and keep out of the law enforcers’ sight.

At the same time, the sex workers movement is growing and becoming stronger. The Shah-Aiym Network unites sex workers in Kyrgyzstan, Tajikistan, Russia. The network documents human rights violations and provides support to the victims of human rights violations, actively protects the interests of sex workers’ community and publicly campaigns against violence towards sex workers. The network ensures conditions for strengthening activists’ capacity to claim and defend their rights.

“We have seen cases when sex workers defend themselves,” says Shahnas Islamova. “For instance, at the court hearings on administrative offenses some sex workers now openly say that they are engaged into sex work and do not violate any laws, while the police has violated the law when detaining them. As a result, such sex workers have left the courtroom free from any accusations.”

AIDS 2018 March in Amsterdam

AFEW International received the invitation to join AIDS 2018 march in Amsterdam, and we are sharing this message with you. Please fill in the form below in case you are planning to join the march:

Hello everybody,

In a couple of months the International AIDS Conference 2018 will be held in Amsterdam. We are excited and are looking forward to work together with activists all over the world and make this event one to be remembered.

As you might know from previous conferences, traditionally there will be a march or demonstration of HIV and AIDS activists. This year the march will take place just before the official opening of the conference at the RAI Amsterdam Convention Centre in the afternoon of Monday, 23rd of July 2018. With this email we would like to introduce us to you and ask you to join us in the march/demonstration to raise our voices for and with people living with HIV.

We are aware that we might be a little ahead of time. But it gives us together with you more time to activate more people and to organise a good march in cooperation with the local authorities. Please forward this email to more organisations, people, living with HIV or relatives and friends you know and who might like to become part or support the march. 

For some organisational matters we kindly ask you to let us know if you and your organization are interested in updates or possibly want to get  involved. You can do so by filling out an online form: https://goo.gl/forms/ahKbXV9xO2gRSmnd2

You will soon hear from us again (if you want).

Kind regards,
Alexander P. &
Hans V.  &
Alexander S.

Source: www.aidsactioneurope.org