People around the world with HIV/AIDS are often treated as social outcasts, deprived of human dignity as they battle not only the disease, but also religious, social, and cultural stigma. In Central Asia, however, the challenges are often even tougher for those with HIV/AIDS. In some countries, prejudice is actually contributing to the spread of the disease. And reports of abuse are widespread. For example, prisoners in Uzbekistan have reportedly been threatened with injections of the HIV virus for misbehavior. In the third of a four-part series on AIDS in Central Asia, RFE/RL looks at the attitudes of government and religious officials, as well as society in general, to the disease.
Prague, 30 November 2004 (RFE/RL) -- Like many Tajik men, Sharif Nuraliev's friend went to work in Russia. But he brought back an unwelcome souvenir -- HIV, which he then passed on to his wife.
Now, Nuraliev says his friend's wife has hardly left home in six months, apparently out of shame over her HIV-positive status.
"Doctors have checked my friend's wife so many times," Nuraliev said. "Doctors wanted to know how she was affected, they wanted to know the history of her illness, and found out that her husband had been working in Russia, and he 'brought' this illness."
Shame, stigma, discrimination. All over the world, these are problems shared by people with HIV, the virus that causes AIDS. The countries of Central Asia are no exception.
In some, human rights activists say people with HIV/AIDS -- or those at high risk of contracting the virus, such as injecting drug users or prostitutes -- can face harassment by police.
Human Rights Watch last year issued a report detailing such abuses in Kazakhstan, including police beatings of sex workers and false charges against drug users.
That creates a strong disincentive to come forward for information or treatment. And experts say the legal systems in the region often force high-risk groups underground: "Injecting drug users are doing their best to escape any contacts with governmental services and other official organizations," said Aleksandr Kossukhin, the national program officer in Almaty for UNAIDS, the United Nations agency that combats the disease. "They do not get appropriate information, education, and that's why their vulnerability increases. The similar situation is with commercial sex workers. In many countries in Central Asia commercial sex work is not considered to be an offense, like in Kazakhstan or Kyrgyzstan. However, commercial sex workers could be arrested for other reasons, and there is a strong hostility against them."
Kossukhin said the stigma and risks associated with HIV/AIDS in Central Asia actually contribute to the spread of the disease:
"There are cases when people living with HIV are persecuted by employers," Kossukhin said. "There are cases when people living with HIV are refused their enrolment into education. And now, unfortunately, it is not advantageous to a person to know his HIV status. In such a situation, indeed, good conditions are artificially created for the spread of HIV/AIDS."
In Uzbekistan, there have been reports of a different kind of abuse related to HIV/AIDS.
Uzbek journalist Ruslan Sharipov spent time in jail on what rights defenders say were trumped up charges. Sharipov, who now lives in the U.S., says he was one of an unknown number of prisoners who have been threatened with injections of the HIV virus.
"I saw syringes with different labels," Sharipov said. "They say, this is an injection with AIDS, this is TB -- they say it openly. But you don't know what it is. So I think it's psychological pressure first of all, though it could really be the infection they say it is."
RFE/RL is unable to independently verify Sharipov's claims.
Discrimination or rights abuses are not only serious for the individuals involved. They also contribute to the underreporting of the disease, which ultimately harms everyone.
Jonathan Cohen is with Human Rights Watch's HIV/AIDS program in New York. "When people are nervous about engaging with the health-care system, when they fear that outing themselves as an injecting drug user or as a sex worker will result in arrest and possible incarceration, when they face routine stigma and discrimination on the basis of the fact that they might be addicted to narcotic substances or work in the sex trade, then they are much less likely to come forward and get an HIV test," Cohen said. "And that contributes to lower statistics than might otherwise exist, which in turn contributes to less political will to address the epidemic, because one develops a false sense of how serious the crisis really is."
Azam Mirzoev is the head of the Tajik Anti-AIDS agency. He says according to official figures, only 317 people are registered in Tajikistan as having HIV. But he says the real numbers are far higher than this -- possibly as high as 5,000.
(RFE/RL's Central Asian services as well as NCA correspondent Antoine Blua contributed to this report.)
Now, Nuraliev says his friend's wife has hardly left home in six months, apparently out of shame over her HIV-positive status.
"Doctors have checked my friend's wife so many times," Nuraliev said. "Doctors wanted to know how she was affected, they wanted to know the history of her illness, and found out that her husband had been working in Russia, and he 'brought' this illness."
In many countries in Central Asia commercial sex work is not considered to be an offense, like in Kazakhstan or Kyrgyzstan.
Shame, stigma, discrimination. All over the world, these are problems shared by people with HIV, the virus that causes AIDS. The countries of Central Asia are no exception.
In some, human rights activists say people with HIV/AIDS -- or those at high risk of contracting the virus, such as injecting drug users or prostitutes -- can face harassment by police.
Human Rights Watch last year issued a report detailing such abuses in Kazakhstan, including police beatings of sex workers and false charges against drug users.
That creates a strong disincentive to come forward for information or treatment. And experts say the legal systems in the region often force high-risk groups underground: "Injecting drug users are doing their best to escape any contacts with governmental services and other official organizations," said Aleksandr Kossukhin, the national program officer in Almaty for UNAIDS, the United Nations agency that combats the disease. "They do not get appropriate information, education, and that's why their vulnerability increases. The similar situation is with commercial sex workers. In many countries in Central Asia commercial sex work is not considered to be an offense, like in Kazakhstan or Kyrgyzstan. However, commercial sex workers could be arrested for other reasons, and there is a strong hostility against them."
Kossukhin said the stigma and risks associated with HIV/AIDS in Central Asia actually contribute to the spread of the disease:
"There are cases when people living with HIV are persecuted by employers," Kossukhin said. "There are cases when people living with HIV are refused their enrolment into education. And now, unfortunately, it is not advantageous to a person to know his HIV status. In such a situation, indeed, good conditions are artificially created for the spread of HIV/AIDS."
In Uzbekistan, there have been reports of a different kind of abuse related to HIV/AIDS.
Uzbek journalist Ruslan Sharipov spent time in jail on what rights defenders say were trumped up charges. Sharipov, who now lives in the U.S., says he was one of an unknown number of prisoners who have been threatened with injections of the HIV virus.
"I saw syringes with different labels," Sharipov said. "They say, this is an injection with AIDS, this is TB -- they say it openly. But you don't know what it is. So I think it's psychological pressure first of all, though it could really be the infection they say it is."
RFE/RL is unable to independently verify Sharipov's claims.
Discrimination or rights abuses are not only serious for the individuals involved. They also contribute to the underreporting of the disease, which ultimately harms everyone.
Jonathan Cohen is with Human Rights Watch's HIV/AIDS program in New York. "When people are nervous about engaging with the health-care system, when they fear that outing themselves as an injecting drug user or as a sex worker will result in arrest and possible incarceration, when they face routine stigma and discrimination on the basis of the fact that they might be addicted to narcotic substances or work in the sex trade, then they are much less likely to come forward and get an HIV test," Cohen said. "And that contributes to lower statistics than might otherwise exist, which in turn contributes to less political will to address the epidemic, because one develops a false sense of how serious the crisis really is."
Azam Mirzoev is the head of the Tajik Anti-AIDS agency. He says according to official figures, only 317 people are registered in Tajikistan as having HIV. But he says the real numbers are far higher than this -- possibly as high as 5,000.
(RFE/RL's Central Asian services as well as NCA correspondent Antoine Blua contributed to this report.)