The 3rd regional autumn school in Bishkek

On October 29, AFEW partners came together in Bishkek, the capital of Kyrgyzstan, for 3 days to take part in the annual Autumn School, which is organized within the project “Bridging the Gaps: health and rights of key populations“.

The great energy of the participants and amazing nature gave a chance to everyone to enjoy the event and to discuss important issues on prevention and treatment of #HIV, harm reduction, migration, and financing in the region of Eastern Europe and Central Asia. Participants in the Autumn School included representatives of AFEW partners from Kazakhstan, Kyrgyzstan, Ukraine, Russia, and the Netherlands, sub-recipients of the project “Bridging the Gaps”, as well as other partners and experts including those from Great Britain and the USA.

Active space

The Autumn School quickly became an active space for discussion: about strategy, barriers, innovations, and partnership opportunities between the participating organizations. During the first day, participants shared updates on the “Bridging the Gaps” project and activities in their countries – Georgia, Kyrgyzstan, Ukraine, and Tajikistan. The afternoon session was devoted to a World Café, in which partners exchanged ideas and developed specific actions to overcome challenges that they often encounter in their work.

The second day was devoted to the topic “Stimulant use and chemsex”. Benjamin Collins, director of International HIV Partnership (IHP), which partners with medical and community activists across Europe and the Middle East for successful responses to HIV and viral hepatitis, joined the Autumn School in Bishkek to share his experience on chemsex . The topic of (problematic) chemsex was further elaborated in the presentations of Monty Moncrieff, Chief Executive of London Friend, a London charity working to promote the health and well-being of lesbian, gay, bisexual and trans (LGBT) people, and Daria Alexeeva, program director of AFEW International. Monty spoke about the London experience in harm reduction, while Daria presented materials of Nikolay Lyuchenkov, an infectious disease doctor and expert on sexual health issues from Russia, which were focused on trends and responses to chemsex in Russia and EECA region.

 

The third and final day of the conference was devoted to workshops on migration, rehabilitation and financial sustainability. Evgeniya Alekseeva, director of Public Health and Social Development Foundation “FOCUS-MEDIA”, presented analysis of NGOs funding situation in EECA region; Elena Zhirnova, manager of the project “Our Choice: Empowering Vulnerable Women in Kyrgyzstan” (AFEW-Kyrgyzstan) told about challenges and opportunities of social entrepreneurship in the country; and Fatima Yakupbayeva, co-founder of law firm “PRECEDENT” and publisher of the book “From Grant to Business Project”, shared auditing resources for launching a business model and recommendations on how to implement business ideas.

 

The session on migration started with a presentation by Rukhshona Kurbonova, coordinator of the Migrant Health Programs at International Organization for Migration in Tajikistan. She talked about labor migration in Central Asia, while Zulaika Esentaeva (IOM Kyrgyzstan) shared their experience on service-delivery by IOM Kyrgyzstan for vulnerable migrants.

The session on rehabilitation was devoted to building information campaigns. During the session, Marina Govorukhina, specialist on strategic communications and branding, author of the books “Communications in Public Organizations”, “Strategic Communications in Public Organizations”, demonstrated specific techniques of developing informational marketing campaigns for rehabilitation centers to the participants from Georgia, Kyrgyzstan and Ukraine.

Moreover, the School included a 2-day training for AFEW communication managers, during which participants focused on learning about storytelling and SMM in the context of NGOs.

 

 

Natalya Shumskaya, director of AFEW-Kyrgyzstan

I especially noted the session on new psychoactive substances. This topic is relevant for our country, as sexual ways of HIV transmission keep growing in Kyrgyzstan, and new psychoactive substance use impacts sexual behavior. For us it is a wonderful opportunity to take on the experience of those countries that have already faced similar problems, and elaborate effective strategies for preventative measures in our country.

The third day was remarkable due to the acute topic of sustainability of civil society organizations. We all see the tendency of decreasing donor support in our countries. That means that civil society should aim to ensure financial sustainability independently, and one of the opportunities is the development of social entrepreneurship. During this meeting we shared the experience of creating our own social enterprise – a beauty salon. I would like to especially point out the session by Fatima Yakupbayeva from the “Precedent” company. She gave us specific business-ideas, which could be developed by an NGO in order to earn money independently and further direct it to realization of our statutory goals.

The importance of this event is in sharing and exchange of experience. When the financial support for our organizations is not that high, it is important to avoid duplication of activities, and, on the other hand, to consolidate our efforts in order to realize our main strategic goals. For instance, the past regional meetings allowed us to bring good practices of working with youth at risk from Ukraine to our country. We are very grateful that we didn’t have to be the pioneers in this, but rather adapt and use their experience. Also, I think that the experience of Kyrgyzstan will be useful to some of our colleagues, and they will be able to apply it in their countries.

Monty Moncrieff MBE, Chief Executive of London Friend

It’s important for people working in the region on the same issues to have the opportunity to come together and share their knowledge and experience. It helps build the data on important topics, and enables participants to share what they’re seeing locally, as well as share tips on how to address new and emerging trends. It also helps build relationships, which spark ideas for new partnerships. Even though the internet gives us great opportunities to connect and work together online it’s difficult to get that richness of connection without bringing people together in person, and doing so for a number of days provides lots of opportunities for conversations outside the formal sessions.

We can always learn from one another, and hopefully by inviting people who have been working on issues for some time in other countries we can bring the benefit of that experience. We can share leaning about what’s worked and what hasn’t for us, and hopefully that can benefit people who are only starting to see these issues emerge locally.

Evgeniya Alekseeva, PHD in medical sciences, Director of Public Health and Social Development Foundation “FOCUS-MEDIA”

Meetings such as the Autumn School are important, because they bring together people from different countries and cities, create space for discussing acute issues and situations in our field, allow to form alliances, agree about partnerships, as well as have informal conversations and take a break from the daily routine.

At the Autumn School in Bishkek, I especially noted a very interesting session on chemsex, sessions on business projects for NGOs, and on migration. I will certainly use this knowledge further while writing proposals, developing new projects and creating new ideas.

Zarina Siyakova, program coordinator of the Tajik Network of Women Living with HIV

This meeting provided me with a great opportunity to learn more about what is happening in other countries in regards to promoting prevention and treatment of HIV. I especially noted the session on chemsex, as I hadn’t had a chance to encounter this issue before. I was particularly interested in the presentation by Monty Moncrieff, as well as the presentation of Nikolay Luchenkov from Russia on chemsex in EECA.

Also, I received answers to many questions on migration that I’m interested in, and most importantly, exchanged contacts with almost all the participants. It is well known that nowadays there is a very large stream of migrants from Tajikistan to Russia, and many of them lack information about services for migrants and d existing organizations in Russia. Now our organization will be able to refer our clients to these organizations, and we won’t lose them out of sight.

If you are interested in specific presentations of the Autumn School, please send your request to autumnschool@AFEW.nl.

Support. Do not punish!

In June 2019, dozens of cities in the EECA region hosted the campaign «Support. Do not punish». Activists took to the streets to publicly protest against repressive drug policies.

This action, which is held annually all over the world, is a great chance to once again draw attention to this unresolved problem. How it was in the EECA region in 2019 you can read here.

Plans for 2020

Are you part of a collective, network or organisation advocating for drug policies that prioritise health and human rights? Are you planning to join the 2020 Support. Don’t Punish Global Day of Action and have an outstanding plan to build momentum? If your answer is “yes” then this call for applications might be for you!

Through this call, the Support. Don’t Punish campaign aims to identify and support local partners (up to 7) with funding of between USD 2,000 – 4,000 for strategic, creative and collaborative projects building up to the 2020 Global Day of Action that advance drug policy reform, bolster harm reduction and build bridges with/within/between communities disproportionately affected by the “war on drugs” (e.g. people who use drugs, farmers of crops deemed illicit, youth, ethnic minorities, LGBTQ+, among many others).

You can apply for the grant here.

What is “Support. Do not punish”?

Support. Don’t Punish is a global grassroots-centred initiative in support of harm reduction and drug policies that prioritise public health and human rights. The campaign seeks to put harm reduction on the political agenda by strengthening the mobilisation capacity of affected communities and their allies, opening dialogue with policy makers, and raising awareness among the media and the public.

The campaign’s yearly high point is the Global Day of Action, which takes place on, or around, 26th June (the International Day Against Drug Abuse and Illicit Trafficking). Historically, this date has been used by governments to showcase their drug control “achievements” in coercive terms. The campaign’s Global Day of Action seeks to reclaim and shift that day’s narrative. And so, every year, an increasing number of  activists in dozens of cities all over the world join this unique and multifaceted show of force for reform and harm reduction.

The Support. Don’t Punish campaign aligns with the following key messages

  • The drug control system is broken and in need of reform
  • People who use drugs should no longer be criminalised
  • People involved in the drug trade at low levels, especially those involved for reasons of subsistence or coercion, should not face harsh or disproportionate punishments
  • The death penalty should never be imposed for drug offences
  • Drug policy should focus on health, well-being and harm reduction
  • Drug policy budgets need rebalancing to ensure health and harm reduction-based responses are adequately financed.

 

Monitoring of HIV-related stigma and discrimination

The ways in which HIV-related stigma and discrimination are manifested and experienced are complex and varied. Many different measures from different perspectives are currently used to monitor HIV-related stigma and discrimination.

To better understand the status of HIV-related stigma and discrimination and progress towards their elimination, support advocacy for addressing HIV-related stigma and discrimination and highlight data gaps, UNAIDS is coordinating the development of summary measures of HIV-related stigma and discrimination. Please see the concept note for more background information.
Starting on 19 August 2019 for a period of three weeks, various elements of the draft measures will be discussed. A few key questions will guide the moderated discussion each week. Inputs and recommendations from each week will be shared at the start of the following week and used to inform the next element of the measures to be discussed.
To participate in the consultation please read more information here.

Through the 2016 Political Declaration on HIV and AIDS, the global community committed to eliminating HIV-related stigma and discrimination by 2020 “for the equal enjoyment of all human rights and equal participation in civil, political, social, economic and cultural life, without prejudice, stigma or discrimination of any kind” of people living with, at risk of and affected by HIV.
The proposal is to develop one summary measure of HIV-related stigma and discrimination and four accompanying summary measures of stigma and discrimination experienced by sex workers, gay men and other men who have sex with men, people who inject drugs and transgender people related to factors other than HIV. This will make it possible to capture the diverse forms of stigma and discrimination that may be experienced by key populations most affected by HIV that may not be directly due to HIV but that have important impact on the HIV response.

This virtual consultation aims to encourage broad participation, particularly of people living with and affected by HIV, gay men and other men who have sex with men, transgender people, young people, sex workers, people who use drugs and women, from all regions. Contributions through this consultation will be used to inform the development of the measure(s) and ensure they are people-centered, reflecting the lived experiences and realities of people, and meaningful to inform programmatic action.
A summary of inputs and recommendations from the consultation will be shared in September 2019. 

New collaboration of AFEW International

We are happy to announce that AFEW International represented by executive director Anke Van Dam became a consultant of an international project “Optimizing HIV prevention portfolios targeting people who inject drugs using dynamic economic modeling” awarded with NIH grant.

As one of the significant contributors AFEW International will act as a liaison to the key networks, organizations, and partners in the countries in the region of Eastern Europe and Central Asia. We will help the project team access data and the best level expertise for undertaking modeling in EECA. As well as we will provide consultations and feedback on the modeling process in the EECA region.

The overarching aim of the project “Optimizing HIV prevention portfolios targeting people who inject drugs using dynamic economic modeling” is to optimize HIV prevention strategies for people who inject drugs (PWID) in 108 countries worldwide using dynamic economic modeling based on multiple large data sources.

The project will:

1) Develop an epidemic model to estimate the impact of HIV prevention portfolios among PWID for every country with available HIV prevalence data among PWID (108 countries), based on data from multiple large systematic reviews.

2) Externally validate the model in 9 key countries with the highest numbers of HIV-positive PWID (including Russia and Ukraine)

3) Develop a user-friendly and web-based multi-platform portal for dissemination of the epidemic economic model and associated data.

The research team of the project consists of:

Natasha Martin, DPhil, Associate Professor, a leading economic infectious disease modeler (University of California);

Steffanie Strathdee, PhD, Professor and a leading epidemiologist focusing on HIV among PWID with 500 publications;

Javier Cepeda, PhD, Assistant Professor, an economic modeler with expertise in cost data collection among PWID;

Peter Vickerman, DPhil, Professor, a leading modeler of HIV transmission among high-risk groups including PWID, MSM and FSWs (the University of Bristol);

Louisa Degenhardt, PhD, Professor, an epidemiologist with over a decade of experience in conducting global systematic reviews on IDU and health harms among PWID (the University of New South Wales);

Sarah Larney, PhD (the UNSW team).

 

UNAIDS outlines progress on HIV, but decries funding cuts

The Joint United Nations Programme on HIV/AIDS (UNAIDS) released its latest report on the status of the HIV epidemic and the global response ahead of the 10th International AIDS Society Conference on HIV Science (IAS 2019), taking place this week in Mexico City.

The report highlights the impact community programmes have had in successfully expanding access to HIV treatment, supporting adherence and preventing new infections. However, it also shows that this progress is slowing and has been uneven, and that global funding for the HIV/AIDS response has fallen for the first time.

“We urgently need increased political leadership to end AIDS,” said UNAIDS interim executive director Gunilla Carlsson. “This starts with investing adequately and smartly and by looking at what’s making some countries so successful. Ending AIDS is possible if we focus on people, not diseases, create road maps for the people and locations being left behind, and take a human rights-based approach to reach people most affected by HIV.”

Some countries are meeting or exceeding the UNAIDS 90-90-90 targets – 90% of people living with HIV knowing their status, 90% of those diagnosed being on antiretroviral therapy and 90% of those on treatment having viral suppression by 2020 – while others are falling behind.

Global progress stood at 79% knowing their status, 78% on treatment and 86% with viral suppression in 2018. However, when looking at the proportion of all people living with HIV worldwide – not just the proportion of the previous subset – the figures are less impressive, with just 62% being on treatment and 53% having viral suppression.

But these figures mask some notable disparities. Nearly 90% of people in Western and Central Europe and North America know their HIV status and are on treatment, but only about 80% of those have an undetectable viral load. In Asia and Latin America, the proportions tested and on treatment are lower, but almost everyone on treatment has achieved viral suppression. Eastern Europe and Central Asia, the Middle East and North Africa, and Western and Central Africa are falling behind on all three measures.

Globally, new infections and AIDS-related deaths continue to decline, but less steeply than before. At the same time, the number of people on HIV treatment continues to rise and appears on track to meet the 2020 target. According to UNAIDS global estimates, in 2018:

  • 37.9 people worldwide were living with HIV;
  • 23.3 million (62%) had access to antiretroviral therapy;
  • 1.7 million newly acquired HIV;
  • 770,000 died from AIDS-related illnesses.

This represents a 16% drop in new infections since 2010, with most of the progress seen in Eastern and Southern Africa. But incidence has increased in some regions including Eastern Europe and Central Asia (up 29%), the Middle East and North Africa (up 10%) and Latin America (up 7%).

The report shows that members of key populations and their sexual partners now account for more than half (54%) of the 1.7 million people who newly acquired HIV in 2018. These groups include men who have sex with men, transgender people, sex workers, people who inject drugs and prisoners. In Eastern Europe and Central Asia and in the Middle East and North Africa, these populations are thought to account for 95% of new infections. Here too, the distribution of who bears the brunt of the epidemic varies widely by region.

Despite the availability of antiretrovirals that can prevent mother-to-child HIV transmission, just 82% of pregnant women have access to them, resulting in 160,000 new infections among children – well short of the target of less than 40,000.

Regarding HIV prevention, the report says that only around 300,000 people worldwide – including 130,000 in the US – are using pre-exposure prophylaxis (PrEP), although this is at best a rough estimate. Similarly, although people who inject drugs account for a high proportion of new HIV infections in some regions, many lack access to adequate harm reduction services.

Although it is harder to gauge progress in this area, the report notes that stigma, discrimination, criminalisation, harassment and violence remain problems for many people living with HIV.

 

The development of Community Advisory Councils in Tajikistan

Newly detected HIV cases in Tajikistan increased by 25% in 2010. Key populations most affected by HIV are people who use drugs (13.5%), gay men or other men who have sex with men (2.7%) and sex workers (3.5%). There is a growing concern that the prevalent pathway of HIV transmission has been radically changed from injecting drugs to sexual transmission. Moreover, HIV is also found more among migrants. This group often does not have knowledge of HIV prevention tools or has no access to health care services. Partners of migrants are now getting HIV as well. The fact that more women live with HIV also risks an increase in mother-to-child transmission.

In 2018, AFEW-Tajikistan expanded its NGO testing services for females who use drugs, sexual partners of people who use drugs (PUD), female prisoners and women living with HIV. With the aim of increased inclusion of people who use the services, Key Population Advisory Councils (KPACs) were established in four cities in Tajikistan: Bokhtar, Dushanbe, Khujand and Kulob. The KPACs represented people living with HIV, sex workers and people who use drugs. Per city, the KPAC consists of four members who serve a term of two years. These members bring recommendations forward and involve the service beneficiaries more closely.

The Tajikistan network of Women Living with HIV (TNW+) started mentoring the KPACs and introduced evaluation tools for people who use the services. While the members of the councils are changing a lot and regular training among members of the current KPACs is still desired, the councils now have a patient-complaint procedure. The concept of “being asked for feedback on your service” is new to Tajikistan and is showing results. In 2018, 85% of all total complaints received were positively resolved. The councils received training and have become convinced of the belief that they could change not only their lives but also society. Apart from monitoring tasks, the members of the councils also offer support on paralegal counselling and peer-to-peer education.

“A woman who used drugs gave birth to a baby. The Drug Treatment Service of Bokhtar has people show up and get their methadone before noon. Sometimes this woman was late because of all the duties with  a baby. Therefore, she sought help in a civil society organisation, which contacted the administration of the methadone site. Now the centre is open until 2 pm, and the woman I mentioned before can get her methadone easier.” 

Takhmina Khaidarova, TNW+

The expansion of service delivery for Civil Society Organisations in Tajikistan has led to a bigger coverage of services for key populations. People who use the services are now taking part in the development of services, planning and implementation of activities and the evaluation of provided services. It has also led to an improvement in providing services with longer opening hours, shorter waiting times in health facilities and friendlier attitudes of medical staff. Besides, TNW+ is linked to the daily reality of the people who use the services. The government considers civil society accountable for monitoring the services, providing feedback and seeing changes.

By integrating TNW+ and service beneficiaries into a system of service delivery, both the community network and the service beneficiaries are strengthened. This leads to more gender-sensitive services for female PUD, (ex)-prisoners and sexual partners of PUD.

Children with Tuberculosis and HIV Do Not Have Access to Education in Tajikistan

Children with HIV and TB do not have access to education in Tajik schools

Author: Nargis Hamrabaeva, Tajikistan

10-year-old Zarina (the name is changed) is from Dushanbe. The girl has a double diagnosis: HIV and tuberculosis. Zarina has never studied anywhere.

Her mother learned she was HIV-positive during the pregnancy. She received her HIV-positive status from her husband. The girl’s father died of AIDS several years ago, and her mother got married again. The stepfather did not accept Zarina, and that is why she lives with her grandmother.

When Zarina turned seven, the grandmother sent her to the first grade in one of the schools in Dushanbe, but the director said the school could not accept the girl, explaining that “she was sick and could infect other children with tuberculosis.”. Therefore, Zarina has not been studying anywhere for three years. The guardianship and trusteeship bodies never asked why the girl did not go to school.

The dialogue that never happened

Human rights activists found out about Zarina’s case and tried to help the family. The representatives of the Tajik network of women living with HIV and the public fund Your Choice approached the officials of the Ministry of Education to find out whether there was a mechanism for providing access to education for such children, but they faced a wall of misunderstanding.

“We were asked to leave the office. The Ministry representatives said that we lied, that there were no such cases, that all children were receiving education, and that we, representatives of non-governmental organizations, only traveled abroad and tarnished the country’s image before the international community. The dialogue never happened,” says Larisa Aleksandrova, representative of the public fund Your Choice.

According to her, children with a double diagnosis of HIV and tuberculosis do not have access to compulsory secondary education in Tajikistan.

“The revealed fact confirms that education officials improperly monitor and keep track of children who do not attend school due to tuberculosis, and they also do not provide these children with the opportunity to receive education at home, the so-called family form of education or homeschool. Although, according to the Health Code, the authorized body in the field of education is obliged to develop programs for getting education at home or in the hospital,” says Larisa Aleksandrova.

With discrimination and without statistics

Larisa Aleksandrova, representative of the public fund Your Choice

The human rights activists are sure that Zarina’s case makes the situation with discrimination of children living with HIV in an educational institution clear.

“The Law on education states that educators should keep track of children of preschool and school age, and monitor their education prior until they complete the compulsory education. In Tajikistan, a nine-year education is compulsory. However, the Law does not define the mechanism for identifying children not covered by compulsory education,” says Larisa Aleksandrova.

The number of children with tuberculosis and HIV who do not have access to education in the country is not known. The Ministry of Education of Tajikistan said that they do not keep such statistics.

We Fight, We Hide or We Unite

We Fight, We Hide or We Unite: coping strategies amongst resilient harm reduction organisations and community networks in the context of shrinking space for civil society in Eastern Europe and Central Asia

The title of this report, ‘We Fight, We Hide or We Unite’, reflects the survival strategies we identified amongst resilient harm reduction non-governmental organisations and community networks of people who use drugs (PWUD) in Eastern Europe and Central Asia (EECA). This assessment forms a part of the regional approach of the AFEW Network within the ‘Bridging the Gaps: health and rights of key populations’ programme, financed by the Ministry of Foreign Affairs of The Netherlands. This report presents the primary findings from the assessment, ‘Shrinking Space for Civil Society Organisations in Eastern Europe and Central Asia’, conducted between June and September 2017 at the international level by AFEW International and at the regional level.

We provide a detailed description of the overall study purpose, methodology, background and context regarding the shrinking civil society space and the coping strategies of HIV and PWUD CSOs working under these circumstances. The results of this assessment will be used to develop ideas and strategies on how to cope with the local contexts of the shrinking civil society space. In this way, it will contribute to the survival of CSOs and improving the current situation. This assessment represents the first step in the development of this focus within the AFEW Network’s regional approach within the ‘Bridging the Gaps’ programme. It will be followed by an analysis of existing gaps in the support necessary for specific interventions and initiatives to support specific coping strategies; the development of pilot projects on advocacy, service delivery or capacity building; and the continuous monitoring of results.

The full version of the report is available here.

Expert: Polygamy Increases the Risk of the HIV Spread in Tajikistan

Author: Nargis Khamrabaeva, Tajikistan

Polygamy is one of the main factors contributing to the rapid spread of HIV in Tajikistan. This is stated in the research of the Tajik network of women living with HIV. In 2018, this network in cooperation with the public fund Your Choice conducted a review of the legal environment in relation to HIV.

Protection of rights regardless of the status

In Tajikistan, polygamy is officially prohibited and is punishable by a fine of two years of correctional labour. However, as the religious influence on the society increases, many men have several wives. The second and subsequent marriages are not registered but are consecrated by a mullah and normally wives do not live in one house.

“The committee on the elimination of discrimination against women called on Tajikistan to ensure the protection of women’s rights in existing polygamous and religious marriages regardless of their registration status,” says Larisa Aleksandrova who represents the public fund Your Choice and acts as a gender and legal consultant of the research.

According to the expert, polygamy has negative consequences in relation to HIV. First of all, in sexual relations women in Tajikistan usually do not have the right to make a decision to use condoms. Women are not able to counteract the unsafe pattern of men’s intimate behavior. According to the statistics on HIV, programmes promoting safe sexual behavior and family planning are not successful. They also do not have impact on men and youth.

Undisclosed  information is a threat to unofficial wives

Larisa Aleksandrova says that another problem is that men living with HIV prohibit their wives to go to the hospital for treatment.

Larisa Aleksandrova, representative of the public fund Your Choice, gender and legal consultant of the research

“One of the reasons why men have such behavior is the fear of public disclosure of their HIV status. Another reason is additional expenses on the treatment of the spouse, who usually is being financially taken care of by the husband. In many cases, such behavior led to the death of women,” tells the expert.

Besides that, polygamous men living with HIV infect all their spouses. During consultations in the AIDS Centre, they often choose not to tell that they have several wives because polygamy is a criminal offence. Therefore, undisclosed information becomes a threat to the lives of unofficial wives. They simply will not know about their status and will not be able to receive the treatment.

“Polygamy is a major risk for the spread of HIV. In 2017, in the town of Nurek a lawyer defended the interests of a woman who contracted HIV from her husband. She demanded compensation for moral and material damage due to the transmission of HIV. The investigation showed that the woman’s husband had a second wife who had died of tuberculosis. After that, according to the Muslim traditions, the man got remarried for the third time. He was seen together with his new spouse in the AIDS Center in Nurek where both of them were receiving antiretroviral therapy. It is possible that the third wife already was HIV-positive as well”, tells Larisa Aleksandrova.

This is not an individual incident. When interviewing women living with HIV, some respondents said that their husbands had second wives, and in most cases, they found out about it when they got to know about their positive HIV status.

 

Findings from a needs assessment survey of labour migrants among people who use drugs in the pilot regions of Kyrgyzstan and Tajikistan

Findings from a needs assessment survey of labour migrants among people who use drugs in the pilot regions of Kyrgyzstan and Tajikistan

30 November 2017

Financial support for this survey was provided through the budget of the project ‘Bridging the Gaps: Health and rights for key populations 2.0’, funded by the Ministry of Foreign Affairs of the Netherlands. Additional financing agreements with AFEW International as of 1 July 2017 and with the UNAIDS country office in Tajikistan as of 31 July 2017 helped finance the survey.

Our analysis points to a set of problems related to information, as well as social, legal and education issues. People who use drugs face these same problems whilst planning, remaining in and returning from periods of labour migration. A lack of finances and social vulnerability represented key problems faced by migrants when planning their labour migration. A lack of finances hampers access among people who use drugs to complete medical examinations through primary healthcare facilities, HIV testing and TB diagnosis in order to obtain the necessary certificates, including those from HIV centres, drug rehabilitation centres and TB control institutions.

The full version of the report is available here.