Author: Nargis Khamrabaeva, Tajikistan
According to the UNAIDS estimates, there is around 1.5 million people living with HIV in Eastern Europe and Central Asia. The Ministry of Health and Social Protection of the Republic of Tajikistan registered 348 new cases of HIV infection in Tajikistan in the first half of 2017. There is a compulsory rule for newly married couples in Tajikistan now: the couple has to submit not only the application for marriage to the registry office, but also the results of a comprehensive medical examination, including the test on HIV. Authorities believe that these measures will facilitate the creation of strong families and the birth of healthy children*.
We are talking about this with the medical doctor and expert in HIV field, the member of European AIDS Treatment Group (EATG), the member of online conference committee EECA 2017 (Moscow, Russia) Zoir Razzakov.
– Zoir, please tell us about the obligatory medical and HIV couple examinations for the registry offices in Tajikistan.
– The number of HIV infected women in the country has been growing lately. Many of these women acquired HIV positive status from their migrant husbands. There were many cases when women found out about their status after the marriage and before giving birth to children. For example, women have to take the HIV test prior to receiving the prenatal record. I will tell you about one example: there was a child in one family who often got sick, had temperature and doctors were unable to come up with a diagnosis. Somebody advised to take the HIV test, and it turned out the child had been infected. It also turned out that the mother of the boy was infected from her migrant spouse. Unfortunately, doctors could not save the child.
– Do you have any statistical data of the number of identified HIV-infected people through the introduction of this particular testing?
– According to the available data, the local AIDS centre detected two cases of HIV infection of those who did before-marriage testing this year. I do not know if the marriage was prohibited due to these reasons. Another question: if future spouses know about each other’s statuses and are not against creating a family, what happens then?
– Many experts note that such compulsory HIV testing contradicts with international standards on voluntary testing of the population and the basic law on HIV. What do you think?
– From some point, I consider the compulsory before-marriage testing discriminating. Suppose we find out one spouse is HIV-positive, what happens next? HIV-infected people are equal to all other citizens of Tajikistan and have equal rights.
There are some advantages of this testing, of course. Many people in the Republic of Tajikistan do not know about their status, and are not informed about the HIV infection and its ways of transmission and prevention. Migrant workers are in the risk group. They live in poor conditions in foreign countries and have to satisfy their physical and sexual needs with someone else while living away from their families.
After they return home, they usually do not get tested and infect their partners. This leads to conflicts in families and further divorces. Everybody should know their status. This should become a common unspoken rule for the society. It should also be a voluntary action in which people should take interest. Media should also come to the rescue. We need more informational materials, social ads on TV and radio. I would say that people have to be informed, and in this way, they will be forearmed. Forearmed means protected, and protected means safe.
– Do you think the following testing can prevent HIV spread in the country?
– This is a difficult question. Usually, when people find out about their positive status, they start denying it. During the period of denial they do not understand the importance of protection. Others take avenger’s position: they think that once they are infected, they should infect others in vain. There are also HIV-dissidents, who begin to assert that there is no such virus in nature. In any case, all of them are informed on the criminal liability for deliberate infection of others. I would suggest that a person takes HIV test twice a year, without taking into consideration whether he had unprotected sex or did some irrational thing.
*AFEW International does not support mandatory testing while getting married.
