In Tajikistan LGBTI Face Blackmailing and Threats

Author: Nargis Hamrabaeva, Tajikistan

In Tajikistan, gays and lesbians were included into a register maintained by law enforcement agencies. However, there are cases when this information is used for blackmailing and intimidation.

In October this year, the Prosecutor General’s Office of Tajikistan published the list of members of LGBTI (the abbreviation was first used in English and stands for lesbian, gay, bisexual, transgender and intersex) groups in the departmental magazine. In the register, there are 319 gays and 78 lesbians. “They have all been identified in the course of operations implemented by the national law enforcement department codenamed “Morality” and “Purge.” The fact that they belong to LGBTI groups has been proved and they have been entered into the police register,” informs the magazine.

HIV experts emphasize that this category of people is one of the populations vulnerable to HIV. “The data of sentinel surveillance in Tajikistan show that in 2015 the level of HIV prevalence among gay men was 2.7%, whereas in 2011 – 1.5%,” says Dilshod Sayburkhanov, the Deputy Director of the Republican AIDS Centre in Tajikistan.

“It will be difficult to regain their trust”

Our interviewees – representatives of non-governmental organizations (NGOs) and LGBTI groups – agreed to comment on the situation provided that they will stay anonymous.

Representative of an NGO protecting the rights of LGBTI (the abbreviation was first used in English and stands for lesbian, gay, bisexual and transgender) told us that, according to the official statistics, currently there are 13.5 thousand members of sexual minorities residing in Tajikistan.

In his opinion, registration with police may lead to people from LGBTI going underground, exposing their partners to even higher risks. “It will be difficult to regain their trust. This is not a way to resolve the problem of HIV. Vice versa, the problem will grow bigger,” he says.

Blackmailing, intimidation and harassment

Our interviewee is sure that the register of LGBT community members is illegal and harmful for the community members. “It is harmful because all law enforcers will have access to this register, which will lead to the lack of confidentiality, intimidation and blackmailing to earn some money,” he shares his thoughts.

Aziz became a victim of such blackmailing. “When an officer of the local police precinct learned that I belong to the community, he started demanding two thousand dollars from me. He threatened that otherwise my photo and information about me will be on TV and in the internet. I have a wife and a family. Therefore, I had to agree, but where is the guarantee that this situation will not be repeated?” he asks.

Rustam, another representative of the LGBTI community said that just recently he suffered an attack in the entrance hall of the apartment building where he lives. “Two guys attacked me, kicked me down on the floor and were beating me with their feet yelling: “No fags in Tajikistan!” Then they ran away. I do not know where they got information about me as I try to hide my way of life. I am afraid that it came from this register. In fact, I could go to the police, since we have got a security camera at the entrance, but decided against it. I know that law enforcers will not protect the rights of such people as myself and it will only worsen my situation,” he says.

In Tajikistan, LGBTI face not only blackmailing and intimidation but also cyberbullying – harassment in the internet. That is why many members of the LGBTI community try to leave the country and seek asylum. According to some reports, in the recent year two gay men and two transgenders from Tajikistan were given asylum in Western Europe because they were victims of harassment based on their sexual orientation.

Michel Kazatchkine Became the Special Advisor to UNAIDS

Michel Kazatchkine joined Undetectable means Untransmittable campaign

United Nations Special Envoy for HIV/AIDS in Eastern Europe and Central Asia (EECA) Michel Kazatchkine was recently announced to serve as special advisor to UNAIDS for HIV, tuberculosis and hepatitis C. Such announcement was made by the UNAIDS executive director Michel Sidibe. The term of Michel Kazatchkine as the Special Envoy for HIV/AIDS is coming to an end.

AFEW International is happy to greet Prof. Michel Kazatchkine with his new position. It is important to have Prof Kazatchkine continue his work as a special advisor to UNAIDS, we believe however that the urgency of three epidemics in the EECA region would have justified a position as UN special envoy for the region. The annual number of new HIV infections in EECA increased with 60% between 2010 and 2016. From all regions in the world, the EECA region is furthest away from reaching the UNAIDS 90-90-90 targets by 2020. Treatment coverage remains alarmingly low (28%), and less than a quarter of people living with HIV had suppressed viral loads (end-2016). Specific populations, such as men who have sex with men, drug users and sex workers face specific human rights violations, impeding their access to prevention and health services.

AFEW International is also hoping for the support of Prof. Michel Kazatchkine during the 22nd International AIDS Conference that will take place in Amsterdam in 2018. The largest health conference in the world will have a special focus on Eastern Europe and Central Asia. The need and the urgency to show the challenges of the EECA region during the Conference are extremely vital.

Michel Kazatchkine was appointed United Nations Secretary-General’s Special Envoy for AIDS in Eastern Europe and Central Asia in July 2012. Mr Kazatchkine has devoted thirty years of his professional life to the AIDS response. From 2007 to 2012 he served as the Executive Director of the Global Fund to fight AIDS, Tuberculosis and Malaria and from 1998 to 2005 he was Director of the French National Agency for AIDS Research. Between 2005 and 2007 he served as France’s Global Ambassador for HIV and Communicable Diseases.

HIV Voluntary Counselling and Rapid Testing Points in Three More Cities in Tajikistan

Voluntary counselling and rapid HIV testing points (VCT) on the premises of public organizations were opened in three more cities of Tajikistan – Dushanbe, Kulob and Khujand – on December 1, 2017. On this day, voluntary counselling and rapid HIV testing services were launched in public organizations Vita, SVON Plus and Amali nek.

“Opening a VCT point on the premises of our organisation will undoubtedly increase the detection of HIV among the key populations. Our clients and AIDS centres are very much interested in this because the timely treatment will help them to save their health and life,” the director of the public organization Amali nek Abduholik Abdurakhmonov is saying.

Creating HIV voluntary counselling and rapid testing points, namely training of medical personnel, making the reparations, purchasing necessary furniture and equipment, became possible because of the project ‘Bridging the Gaps: Health and Rights for Key Populations 2.0’ and due to the regular consultations with AFEW-Tajikistan’s specialists.

“In 2015, AFEW-Tajikistan appealed to the Ministry of Health and Social Protection of the Republic of Tajikistan with a proposal to open a VCT point on the premises of the second office of our organisation in Khatlon region. This initiative was approved by the order of the Ministry and since October 2015, all HIV service organizations of the country had the opportunity to introduce the VCT service. Exactly one year ago, on December 1, 2016, the first point that provides voluntary counselling and rapid HIV testing service started its work in the city of Kurgan-Tube. It operates on the premises of our office in Khatlon region. Now our experience helps other public organizations to create and equip similar offices,” the project manager of AFEW-Tajikistan Dilshod Pulatov is sharing.

In April and September 2017, in Qurghonteppa and Khujand, AFEW-Tajikistan organised a seminar and workshop to share the experience of the organisation on the introduction of VCT services on the premises of a public non-profit organization. The participants also studied the procedures for documenting and planning the costs for maintaining VCT points.

“The seminar-meeting on the introduction of VCT service helped me to understand the main stages of work, what documentation is needed, what requirements for equipping the premises are, how to train staff and what the process of budgeting activities is to introduce VCT service,” the director of the Public Association VITA Eraj Nazarov is saying. “AFEW-Tajikistan helped us to renew the premises according to the necessary requirements, and also trained two of our medical workers for providing pre-test counselling and HIV testing services.”

During the opening ceremony of voluntary counselling and rapid HIV testing points, everyone had an opportunity to be counselled and tested for HIV.

European and Central Asian Countries Can End TB Ahead of The Rest of the World

Stop TB Partnership engage with partners in regional meetings in Kazakhstan, Estonia and Belarus

15 December 2017 – Geneva, Switzerland – Stop TB Partnership Secretariat engaged with essential partners to support their efforts and country TB programmes to advance in the fight to end TB in the European Region to prepare the ground for the UN High Level Meeting for TB in 2018.

In just one week, three regional meetings held in Astana, Kazakhstan, in Tallinn, Estonia and Minsk, Belarus put TB in the spotlight in a region that can lead the way towards a world free of TB.  The discussions were centered around migration and migrants and their access to services, how to sustain and expand programmes after donor support ends and how communities, civil society, and networks of people affected by TB can work together.

“It is very impressive. We managed to focus our efforts on Europe this week and we organized and participated in meetings discussing essential aspects if we want to end TB: vulnerable groups, political leadership, domestic financing, and donor support — including the European Commission’s vision, issues around migration, advocacy and civil society engagement and the UN HLM for TB in 2018. The European region benefits from strong TB programmes and health systems, and amazing partners, especially the European Commission, WHO European Region team, ECDC, networks of civil society and communities, TB people as a network of people affected by TB, IFRC, Project HOPE, IOM, as well as UNAIDS and the Global Fund.  As a European, I hope this region will actually end TB before 2030. There is absolutely no reason not to do it,” said Dr Lucica Ditiu, Executive Director of the Stop TB Partnership.

 

Migration and TB were front and center in Astana, Kazakhstan, when TB experts, policymakers and advocates convened for the third high-level regional meeting on “Migration and Tuberculosis: Cross-border TB Control and Care in the Central Asian Region.”

The meeting, held 6–7 December, was organized by the Ministry of Health of the Republic of Kazakhstan, Project HOPE, the Global Fund and the United States Agency for International Development (USAID) with participants from government agencies, national TB programmes and migration authorities from Central Asia; representatives of civil society and communities, experts from the WHO, Stop TB Partnership, IOM, and IFRC.  The event was organized in line with the

 

Comprehensive Plan to Fight TB in the Republic of Kazakhstan for 2014-2020, which calls for activities to address TB among migrants and expand their access to services, as well as the programme “Addressing Cross-border Control of TB, MDR/XDR-TB and TB/HIV among Labor Migrants in the Republic of Kazakhstan” implemented by Project HOPE and funded by the Global Fund. The meeting advanced the regional dialogue on migration matters between Kazakhstan and neighboring countries in Central Asia. The dialogue takes place on a mutually beneficial basis, towards signing of bilateral agreements for effective regional cooperation on cross-border control, prevention, and care of TB in the region.

TALLINN, ESTONIA

For two days, 100 participants from TB and HIV programmes in EU member states and neighboring countries met in Tallinn, Estonia at an event organized by the Ministry of Social Affairs and National Institute for Health Development from Estonia, WHO European Region, UNAIDS, and the Global Fund. The participants, panelists, and speakers discussed challenges and opportunities in ensuring sustainability of programmes when transitioning from donor support to sustainable health systems.

Stop TB Partnership was part of the opening panel and centered its discussion around the need for vision and political leadership in TB and the ambition towards concrete asks for the UN HLM on TB in September 2018. Participants had an opportunity to hear how the Estonian government and TB and HIV programme, in strong collaboration with civil society and community, managed to decrease the number of new HIV cases from 1, 474 in 2001 to 229 in 2016.  Additionally, TB incidence decreased from 47/100,000 to 12.7/100 000.  The meeting discussed concrete steps towards strengthening the national TB and HIV programmes as well as the need for more significant advances in the integration of TB and HIV services.

MINSK, BELARUS

TB advocates in the Eastern Europe and Central Asia region came together in Minsk, Belarus, this week for a three-day workshop on strengthening community TB advocacy and engagement.

The workshop, held 11–13 December, was organized by International Federation of the Red Cross (IFRC) and Stop TB Partnership, in collaboration with national Red Cross and Red Crescent societies, and support of community advocates from the regional networks, TBPeople and TB Europe Coalition (TBEC). Activities broached on subjects as diverse as community challenges in the regional TB response, regional epidemiology, TB treatment literacy and communities, rights and gender tools to build an evidence base for an effective TB response. There was also a community consultation focusing on the rights and responsibilities of people affected by TB. This event was the second of five regional workshops that will focus on building stronger, more-coordinated affected communities, advancing strategic partnerships – particularly between Stop TB Partnership, IFRC, national Red Cross societies and community TB advocates – and composing of an advocacy plan and engagement strategy to ensure community priorities are represented and stakeholders are engaged during the UN HLM on TB in 2018. We look forward to continue to support the advocates of the region as we continue toward the HLM and work together to end TB.

Source: European AIDS Treatment Group 

AFEW Builds Models for the Future with Improved TB/HIV Care

AFEW, Hivos and PharmAccess and KNCV representatives after the presentation on the Dutch congress ‘Soa.Hiv.Seks’

Author: Olesya Kravchuk, AFEW International

The ‘Improved TB/HIV Prevention & Care – Building Models for the Future’ project was presented during the Dutch National Congress ‘Soa.Hiv.Seks’ on 1 December 2017 in Amsterdam, the Netherlands. Three working models from Kazakhstan, the Philippines, and Nigeria implemented by AFEW, Hivos and PharmAccess with KNCV Tuberculosis Foundation as the lead agency were shown to the Congress audience.

HIV and TB are two of the biggest public health threats in the world. Mounting challenges associated with these mutually reinforcing diseases are both medical and socio-political. In the efforts to address many of the common challenges, AFEW, HIVOS, PharmAccess and KNCV, with support from the Dutch Ministry of Foreign Affairs, collaborate in different parts of the world via the ‘Improved TB/HIV prevention and care-building models for the future’ alliance to jointly design and pilot innovative models of cooperation between the public, private and community sectors involved in the fight against HIV and TB, to find new ways of ensuring and expanding affordable, patient-centred and high quality access to care for key affected populations.

“After the project has started in Almaty, Kazakhstan, we can observe positive changes. A patient has information about good quality care, knows where to go for treatment and support, and has a choice in seeking care in the public sector, private sector and civil society,” the executive director of AFEW International Anke van Dam is saying. “Self-support groups and client management for TB patients are being organized and the HIV and TB working group is supported by the head of the Almaty City Health Department.”

Private clinics in Kazakhstan are now engaged in the public healthcare sector. They are integrated into the national monitoring and evaluation system for public/non-public TB/HIV care provision in Almaty city.

AIDS Day in Ukraine: Online Test, Quest for Adolescents

Author: Yana Kazmirenko, Ukraine

On December 1, an online HIV test was presented in Kyiv

On December 1, a wide range of activities marked the World AIDS in Ukraine. On this day, the first in Ukraine online test for HIV was presented in Kyiv. It is available at HIVtest.com.ua or via a mobile application ‘HIV test.’

“The test makes an audit of your health, rapidly assessing the risk of infection, and offers information about the nearest testing sites,” said Dmitry Sherembey, the Chairman of the Coordination Council of the All-Ukrainian Network of PLWH.

Four weeks before the campaign, organizers placed billboards with the intriguing social advertising – a dangerous blade hidden in a juicy burger ­– in the streets of Kyiv. Dmitry Sherembey reveals the intrigue: for many people HIV is invisible, with 130 thousand out of 250 thousand people living with HIV in Ukraine not aware of their diagnosis.

The test contains about two dozen of questions – their number depends on the respondent’s lifestyle. For example, the question “Do you use condoms when having sex or not?” is relevant in Ukraine, where 51% of people living with HIV get infected through the sexual route of transmission. After a person answers all the questions, the test will show the probability of HIV infection and will show the information about the nearest clinic or confidential counseling room to get tested. The online test has been developed for two months and, according to Dmitry Sherembey, it shows the result that person is getting after the testing in 40% of cases.

Testing should become a routine procedure

Dmitry Sherembey shows the online test on his phone

According to Pavel Skala, Director of the Policy and Partnership at the Alliance for Public Health, the annual campaigns dedicated to the World AIDS Day should be changing and moving forward. On one hand, public awareness on HIV is growing, but on the other hand – people are losing interest in the repeating topics.

Testing should become a routine procedure for every Ukrainian, emphasizes Roman Ilyk, the Deputy Minister of Health. He says that over 50% of cases are diagnosed at the third and fourth clinical stages of HIV infection, when the person’s health is poor. 80% of people who die are 25-49 years old. The Ministry of Health called on Ukrainians to get tested for HIV and underlined that early detection of the disease allows to timely access treatment.

Interactive activities for teenagers

Every year, civil society organizations conduct campaigns for teenagers dedicated to the World AIDS Day. Alexander Mogilka, the coordinator of the social support project for adolescents at the Kharkiv Day Care Center for Children and Youth “Compass” thinks that the success of Ukraine in curbing the HIV epidemic largely depends on the progress in working with this target group. This year, “Compass” organized a quest called “The Safety Route” in Chervonohrad, Kharkiv region.

Teenagers from Chervonohrad walked the Safety Route

“The format of this game was developed by the German agency GIZ. The teams are to go through several checkpoints: contraception, routes of HIV transmission, environment assessment. When you answer a question, you may go to the next point,” tells Alexander.

He claims that 70% of “troubled” teenagers have experience of using drugs. Usually, these are children from dysfunctional families.

“Before, teenagers could access drugs through dens, but now they can just use internet and stashes hidden in agreed venues. There is a sad contrast: the drug business is developing and taking new forms and the prevention is lagging behind,” sums up Alexander.

He underlines that to develop new formats of working with young people – combining quests, flash mobs, and social campaigns – is a new challenge for civil society organizations.

The Train is off but HIV Stays

Author: Anastasia Petrova, Russia

Testing in Kurgan

From 8 July to 20 October 2017, a train carriage went throughout the territory of Russia offering HIV testing services to everyone interested. The campaign was aimed at raising the awareness and increasing the coverage with testing services among the general public.

The strategic train

The train offering HIV testing is a project of the Russian Ministry of Health in cooperation with the Russian Railways. The campaign was initiated within the State Strategy to Combat the Spread of HIV in Russia through 2020. Long-distance passenger trains were equipped with an additional carriage offering free and confidential testing. Project workers conducted pre- and post-test counseling and informed people about HIV and the ways of its transmission. The route lied from Vladivostok to St. Petersburg and included the regions most affected with HIV. Apart from offering HIV testing on the way, mobile laboratories were also functioning on the railway stations. The campaign was aimed at the first component of the global 90/90/90 strategy, which stipulates that 90% of people living with HIV should be aware of their status.

The silent epidemic

The carriage where the testing was conducted

The testing campaign covered 24 regions, with the following cities leading in terms of people tested: Chelyabinsk (2,039 people), Nizhnevartovsk (1,645 people), Irkutsk (1,446 people), Kurgan (1,290 people), and Samara (1,227 people). Moscow was the city with the lowest coverage – only 290 people got tested there. According to the Ministry of Health, within the campaign 25 thousand people were able to get tested and receive professional counseling in the carriage and in railway stations.

“The fact that those 24 regions were covered is important. Here in Russia, 10 out of 85 regions have 50% of new HIV cases, and as for the 24 regions covered, they have over 70% of such cases. That is why I think that this campaign has a concrete result as it is focused on the most affected regions,” the chief independent expert in HIV diagnostics and treatment at the Russian Ministry of Health, Yevgeny Voronin is saying.

Awareness-raising materials in the format of railway tickets

It is interesting that no official statistics was announced on the total number of HIV cases detected. However, according to the Minister of Health, Veronika Skvortsova, as of the date when the train was passing Moscow the number of HIV positive cases detected was 248. Thus, the total number of such cases is more than 250 or 1% of the people tested. Considering the fact that testing was conducted in the general population, this number shows the severe epidemiological situation in the country and proves the tendency of HIV epidemic going beyond the key populations.

The train is off

Such campaign is an unprecedented intervention aimed at raising the awareness of people in the area of HIV/AIDS. Apart from testing passengers, the campaign was an important newsmaker. Reports in federal and regional mass media allowed millions of people in Russia to learn about the importance of this problem and about the necessity of regular testing. A positive outcome is that after the train left mobile sites to continue testing remained at some railway stations.

Closing ceremony in St. Petersburg

Alongside with that, if the data about one percent of the HIV cases detected in the general population is confirmed, it will mean that the situation has got out of control. In this case, the measures taken by the Ministry of Health are to be scaled up a hundred times and are to be aimed not only at awareness raising and detection of new cases but also at treatment. Testing as it is is not a measure of response to the epidemic. Every patient should receive therapy in order to achieve minimal viral load not to transmit the virus to other people. However, in Russia less than a half of people living with HIV get the necessary medications.

 

“I have HIV and it is not a verdict”

Amina from Tajikistan lives with HIV for nine years

Author: Nargis Hamrabaeva, Tajikistan

In her memories, her life is divided into ‘before’ and ‘after’ she learned she had HIV. As strange as it may seem, with the therapy ‘after’ is not a verdict, not a tragedy, not the end…

We are meeting 29-year-old Amina (the name has been changed) in one of the coffee houses in Dushanbe, Tajikistan. She came to our meeting after work, short of breath, as she was afraid to be late. Good looking, with a glow of health on her cheeks, a strand of hair appearing from under her neatly tied headscarf, and snow-white teeth. One could say that she was to the full of her health.

Sipping her coffee, she tells her story. Amina has been living with HIV for nine years and she is not at all ashamed of her status. She is convinced that a person with such diagnosis may live the same life as with any other chronic disease. The main thing is to take antiretroviral (ART) therapy on time and attend medical check-ups.

Fire, hospital, blood transfusions…

In 2007, Amina married her distant family member. In fact, as it often happens in Tajik families, her parents arranged their marriage.

“It happened that my two sisters married the relatives of my father and to keep some kind of “balance,” my marriage was arranged with my mother’s family relative. I struggled. We lived in the house of my husband’s parents. My sisters-in-law, who moved back to their parents’ house after the divorce, also lived with us. I could only dream of a quiet life,” tells Amina.

Sometimes, the young woman became an object of her sisters-in-law’s vengeance after their quarrels with her husband. Once, after another big quarrel, Amina made a bonfire in the yard and was cooking some food in a big pot. She already had a one-year-old and was pregnant with her second baby. The girl was throwing more brushwood into the fire to make it stronger when suddenly someone approached her from behind and pushed her right into the flame…

Amina woke up in a hospital ward several days after. She was in awful pain – she had 40% of her skin burnt. Ahead, she had two months of hospital stay, treatment, loss of her baby, interrogations of police officers and many blood transfusions. It turned out that it was one of her sisters-in-law who pushed her into the fire.

After several months, the wounds of her body and soul were healed and Amina got pregnant again. As all pregnant women, she did all the required tests, including an HIV test. It came back positive. She was worried, desperate, scared. She did not know what to do. Professional psychologists of the AIDS center talked to her and explained that it was not the end, that she would need to take her therapy and would be able to live a normal life with certain conditions.

“You have HIV and you will die in half a year”

However, the conversation with her husband was hard.

“He also got tested and his result was negative. He blamed it all on me; said that if I have HIV, I would die in half a year. He said that he wanted neither me nor our child. Soon I gave birth to our second son, but it did not save our marriage. We broke up. Both my boys are HIV-negative,” adds Amina.

She thinks that she got infected during one of the blood transfusions in the hospital.

“After the diagnosis, you can and should go on living your life,” the woman is saying now. Earlier, she was alone and hopeless. Her children were her only comfort. For them, she was fighting for her life. “I have been taking ART for five years. It includes several drugs, each of which influences a certain stage in the HIV replication cycle. In other words, when a person takes the therapy, the virus no longer replicates in the cells of his immune system.”

Building a house and finding a true love

A local organisation working with HIV-positive women helped Amina to become stronger and believe in herself. Now the young woman works as an outreach worker there, helping other women who are diagnosed with HIV to overcome their fears and depression. Her two wonderful boys are growing up. One of them goes to the third grade, and the second one has started his first year in school.

“To my ex-husband’s surprise, I am still alive, though nine years have already passed,” she says with a smile on her face. “Money that I make here is enough for us, but I am afraid to think about what can happen if the project is closed. Now there is a crisis everywhere. I could go to Russia to earn some money, but there I would have to make a mandatory HIV test to get a job and then I might face deportation.”

“What is your dream?”, I am asking her.

“Now I am on a waiting list to get a land plot and I would like to build a house for my children,” says Amina. Currently, she lives with her mother and her brother’s family. “They are all well aware of HIV, they know the routes of transmission, so they are not afraid to give me a hug or to eat from one bowl with me, and my brother’s wife sometimes leaves her children for me to look after.”

Besides, Amina is dreaming about meeting her true love and creating a family. This strong and self-confident young woman may be a role model for many people living with HIV.

With Tuberculosis, it is Important to Take Medicine and Believe in Yourself

Sultanmurat from Kazakhstan wanted to get cured of tuberculosis no matter what but the treatment was difficult

Sanat Alemi is one of the civil society organizations (CSOs) supported by the Improved TB/HIV prevention & care – Building models for the future project which gives support to TB patients and their relatives. Founded in 2016 in Almaty, Kazakhstan by a group of ex multidrug-resistant or extensively drug-resistant TB patients, they quickly showed successes through their established self-support groups as well as one-to-one TB patient support. Sanat Alemi is also implementing several community-based activities such as social mobilization, advocacy, and communication to improve TB literacy among people affected by TB, TB/HIV, AIDS and other socially significant diseases (drug abuse, alcoholism, etc), aiming at reducing stigma, discrimination.

Success is possible with trust and professionals

“The social support for TB patients plays a key role in increasing adherence to the treatment. The success in treatment is possible with the combination of trust, human relationships and the support of professionals, such as a psychologist and social worker,” the current director of Sanat Alemi Roza Idrisova is saying.

A TB patient and client of Sanat Alemi Sultanmurat did not know anything about tuberculosis, except that it was a dangerous disease.

“I was horrified when I heard I had TB. I could not even imagine how I got it. I started coughing blood which was so scary, but I did not suspect that it could be TB,” he says. “I thought that the pain was caused by my liver or another internal organ. I told about this to my mother, as she is my closest relative. The other relatives reacted with understanding and this helped me a lot.”

What does not kill us makes us stronger

Sultanmurat wanted to get cured no matter what but the treatment was difficult. In the beginning, he could not tolerate the drugs, and he developed allergies.

“I struggled and tried not to miss a single day of medications and injections. I heard about Sanat Alemi from other patients and started to attend their self-support groups. Receiving support from other patients and social workers during treatment is of great help and being able to join trainings and meetings with different specialists is very useful and gives a lot of interesting information. I had the opportunity to ask questions that I had for a long time. I believe that in the future Sanat Alemi will keep the same spirit and will support many other TB patients,” Sultanmurat says. “TB completely changed my life. I started to appreciate life and learned to tolerate the sickness. I started to appreciate and love my relatives even more as they proved once again that they are there for me and that they would never give up on me during difficult times.”

Sultanmurat would like to say to other TB patients that this disease is curable like many other diseases. The most important thing is to follow the treatment, take pills without interruption, eat well and do sports. It is also important to be friendly, always and everywhere provide support and assistance to other people with TB. The most important thing is to believe in the best, in your recovery and do not forget that what does not kill us makes us stronger.

Undetectable means Untransmittable: Anti-Stigma Campaign in EECA countries

Informational materials of the campaign

AFEW International supports the large-scale campaign “Неопределяемый значит не передающий” (Undetectable means Untransmittable) aimed at overcoming stigma against people living with HIV. Experts and activists from Eastern European and Central Asian countries also take part in the flash mob.

Research studies confirm the effectiveness of the “treatment as prevention” approach to prevent the sexual pathway of the spread of HIV. In 2014, the PARTNER study conducted in 14 European countries, showed no cases of HIV transmission in 44,000 cases of unprotected sex in discordant couples (1,145 couples totally took part in the study). The study report, published in 2016, showed a complete absence of HIV transmission in more than 58,000 cases of condomless sex.  In July 2017, the Opposites Attract study gave additional evidence in favor of the fact that HIV is not transmitted if the viral load is undetectable. This study was conducted in Australia among 358 serodiscordant gay couples in Australia, Thailand, and Brazil, and showed zero cases of HIV transmission among HIV positive people with undetectable viral load and their sexual partners. Just recently, in September 2017, the US Centers for Disease Control and Prevention (CDC) confirmed the thesis that undetectable viral load prevents sexual transmission of HIV. In November, the Lancet HIV wrote that “CDC officially backing the science behind the campaign is another key step towards U=U being the most important message of 2017 in the fight against HIV.”

Michel Kazatchkine, United Nations Secretary-General’s Special Envoy for AIDS in Eastern Europe and Central Asia

“Н = Н” is the Russian-language part of the global U = U (Undetectable means Untransmittable) campaign, which was launched by American activist Bruce Richman in early 2016. Its core is the Consensus Statement of experts and professional organizations that undetectable viral load prevents sexual transmission of HIV. By November 2016, more than 475 organizations from 65 countries of the world joined the campaign. Currently, more AIDS centers, NGOs, and activist organizations from the EECA countries keep joining the campaign. Signatures have been received from Armenia, Belarus, Georgia, Ukraine, Moldova, Kazakhstan, Kyrgyzstan, Russia, and Estonia. In our region, the campaign is supported by Life4me+.

Today, the science provides more and more evidence that undetectable viral load prevents sexual transmission of HIV, but in Eastern Europe and Central Asia a few people except experts are aware of it. The first Russian-language campaign “Н=Н” (Неопределяемый значит не передающий, Undetectable means Untransmittable), aims to convey this information to as many people as possible. For this purpose, the Consensus Statement and information about the campaign have been translated into Russian.

From October 16 to December 1, 2017, the participants of the campaign tell that today there is an opportunity to curb the spread of HIV through broad access to treatment, early detection and high adherence, and that the stigma of people living with HIV is based on groundless fears and outdated views on the epidemic. The key message of the campaign is that HIV is no longer the “plague of the XXI century.”  It is a chronic infection, with which one can have a good quality of life. With HIV, people can create families and have children, run marathons and make great careers, grow old and retire, just like people without HIV.

It is important to remember that “U=U” does not mean the possibility of not using other means of prevention. Unprotected sex can still lead to sexually transmitted diseases and unwanted pregnancies. In addition, due to limited access to treatment or other reasons, people may have obstacles to achieving an undetectable viral load.

Everyone from any Eastern Europe and Central Asia country can join the campaign. Organizations can sign the Consensus Statement, and individuals are invited to participate in an online flash mob by making a photo with the campaign logo and uploading it on social networks with a hashtag “НравноН.”