Among which age groups is the infection most frequently detected? What factors contribute to this?

Young people between the ages of 25 and 49 are most commonly affected by HIV infection. Several factors contribute to this trend. Young individuals often misuse contraception, engage in risky sexual behavior, and use drugs. Additionally, they may lack sufficient awareness about HIV transmission methods and preventive measures.

Fortunately, significant progress has been made in the field of medicine.

How is the issue of HIV prevention and treatment addressed in the country?

The problem, as I mentioned earlier, is very serious. Therefore, Tajikistan places significant emphasis on HIV prevention and treatment. For instance, in 2016, Tajikistan ratified the “Political Declaration on HIV and AIDS: Fast-Tracking the Response to End the AIDS Epidemic by 2030”.

In 2017, the Health Code was adopted, which in Chapter 24 focuses on HIV treatment and prevention and prohibits discrimination against people living with HIV (abbreviated as PLHIV) in all aspects of life.

In 2020, the government approved the National Program to Counteract the HIV Epidemic and Acquired Immunodeficiency Syndrome (AIDS) for 2021-2025, along with a general budget and an action plan. These documents outline ways to address the HIV problem, including the rights of PLHIV to receive free qualified and specialized medical assistance in healthcare institutions. The principles of voluntary HIV treatment, as well as confidential and voluntary HIV testing, are also recognized.

These measures aim to reduce the spread of HIV infection, provide early diagnosis, effective treatment, eradicate stigma and discrimination, and improve the quality of life for people living with HIV.

How is the provision of antiretroviral therapy (ART) for patients? Are there enough medications?

The situation regarding the provision of antiretroviral therapy (ART) to patients is satisfactory, thanks to the efforts of the government and the Global Fund. It’s worth noting that since the emergence of this virus, medicine worldwide has made significant progress in its treatment. For instance, currently, individuals living with HIV need to take just one tablet per day to mitigate the negative consequences of the infection.

Patients in need of treatment can turn to AIDS centers in their place of residence and receive medications free of charge. If someone suspects they have HIV infection, it is recommended to seek professional counseling and undergo HIV testing at local medical institutions or organizations dedicated to combating HIV/AIDS.

Why did you personally decide to lead an organization addressing the issues faced by women living with HIV?

In 2017, the Health Code was adopted, which in Chapter 24 focuses on HIV treatment and prevention and prohibits discrimination against people living with HIV (abbreviated as PLHIV) in all aspects of life.

In 2020, the government approved the National Program to Counteract the HIV Epidemic and Acquired Immunodeficiency Syndrome (AIDS) for 2021-2025, along with a general budget and an action plan. These documents outline ways to address the HIV problem, including the rights of PLHIV to receive free qualified and specialized medical assistance in healthcare institutions. The principles of voluntary HIV treatment, as well as confidential and voluntary HIV testing, are also recognized.

These measures aim to reduce the spread of HIV infection, provide early diagnosis, effective treatment, eradicate stigma and discrimination, and improve the quality of life for people living with HIV.

How is the provision of antiretroviral therapy (ART) for patients? Are there enough medications?

The situation regarding the provision of antiretroviral therapy (ART) to patients is satisfactory, thanks to the efforts of the government and the Global Fund. It’s worth noting that since the emergence of this virus, medicine worldwide has made significant progress in its treatment. For instance, currently, individuals living with HIV need to take just one tablet per day to mitigate the negative consequences of the infection.

Patients in need of treatment can turn to AIDS centers in their place of residence and receive medications free of charge. If someone suspects they have HIV infection, it is recommended to seek professional counseling and undergo HIV testing at local medical institutions or organizations dedicated to combating HIV/AIDS.

Why did you personally decide to lead an organization addressing the issues faced by women living with HIV?

The issue is that in 2010, the HIV problem affected my family. At that time, I didn’t see any organization in the country dedicated to protecting the rights of women living with HIV. In society, there was a widespread belief that only women engaging in risky behavior or using injectable drugs could contract HIV.

In practice, when I started working in this field, I encountered women who had become victims of HIV infection. These included wives of labor migrants, spouses of people who used injectable drugs, and women infected within medical institutions.

Despite progressive provisions in Tajik legislation, the reality showed that people living with HIV still face discrimination in all aspects of life. The reasons for this discrimination vary: misconceptions and lack of knowledge about the disease, low qualifications of relevant agency staff, limited legal awareness among the population, gender stereotypes, legislative contradictions, and more.

To change societal perceptions, I actively began working in this direction. My motto became: “We should not divide people based on status or social position! Stigma and discrimination against people living with HIV must cease! People living with HIV are equal citizens, just like everyone else.”

“Legislation should protect the rights of people living with HIV.”

According to previous surveys, many citizens are reluctant to visit HIV testing centers due to fear of criminal liability and societal stigma. What are your thoughts on this?

I wholeheartedly agree that fear of being held criminally responsible under Article 125 and the associated stigma are significant barriers preventing people from seeking help and getting tested for HIV. Indeed, specific measures are necessary to overcome these obstacles.

The state must ensure that information about HIV infection and test results remains confidential. To achieve this, it is essential to strengthen legislation and ethical norms that protect patients’ personal data.

Additionally, information campaigns about HIV/AIDS are necessary to eliminate insufficient knowledge and prejudices. The more people know about HIV, the less fear and stigma there will be.

Legislation should safeguard the rights of people living with HIV, preventing discrimination and persecution in society. It is also crucial to provide patients with access to legal support and psychological assistance to help them cope with stigma and the negative consequences associated with HIV/AIDS.

What can and should be done to stop the spread of HIV in Tajikistan? What solutions do you envision, and how feasible are they?

Stopping the spread of HIV in Tajikistan is a complex task that requires a comprehensive approach and significant efforts from the government, civil society, and the international community. Here are several ways to address this issue:

Ensure Access to Treatment: Guaranteeing access to HIV treatment, including antiretroviral drugs, testing, and counseling, is crucial. Properly trained medical staff should serve patients with HIV/AIDS without discrimination.

Information Campaigns: Conduct information campaigns to raise awareness about HIV, prevention methods, and transmission. Educating the public can reduce fear and stigma.

Stigma Reduction: Develop strategies and programs to reduce stigma and discrimination related to HIV/AIDS. Educational initiatives can protect the rights of people living with HIV/AIDS.

Legal Reforms: Eliminate discriminatory legal norms to create a supportive, non-discriminatory environment for people living with HIV, especially women.

I would like to highlight that advocacy for legislative change continues in our country, and significant steps have already been taken. Two major forums were held, involving representatives from the government sector, international courts, and civil society. I also participated in these events, delivering a presentation on the challenges and barriers faced by women living with HIV.

A working group, comprising civil society and Supreme Court representatives, developed a project plan for the Criminal Code. They introduced an amendment to Article 125, clarifying the circumstances under which a person poses a threat to another individual. This resolution aims to ensure a more objective examination of criminal liability related to HIV exposure and transmission. It incorporates international standards and recommendations, including the Undetectable = Untransmittable concept endorsed by UNAIDS and WHO. According to this concept, people living with HIV who are on antiretroviral treatment and have an undetectable viral load cannot transmit HIV.

Currently, Article 125 of the Criminal Code criminalizes HIV transmission and exposure, with penalties ranging from two years’ imprisonment (Part 1) to five to ten years’ imprisonment (Part 3) when committed against multiple people or a minor. Unfortunately, decisions were sometimes based solely on a person’s HIV-positive status, rather than ensuring access to HIV services, treatment, and support. Notably, over 70% of those convicted under Article 125 are women living with HIV. These women may face domestic violence, stigma, and discrimination, which deter them from seeking justice due to the fear of accidental disclosure of their HIV status and further criminal prosecution.

While this new resolution represents progress by allowing a fairer interpretation of existing laws, it does not completely remove Article 125 from the Criminal Code. Therefore, continued advocacy is essential to change the Criminal Code and decriminalize HIV transmission and exposure. The collaborative efforts of the Supreme Court, civil society organizations, UNAIDS, UNDP, and the Global Fund have contributed to this more just legal framework, addressing the complexities of HIV-related legal matters.

The punitive approach, where law enforcement takes precedence over medical professionals, has unfortunately contributed to the growth of the HIV epidemic in Tajikistan

Stopping the spread of HIV in Tajikistan is a challenging task that requires a holistic and inclusive approach. It demands significant efforts and resources. However, with proper planning and an adequate approach, I believe that halting the spread of HIV in Tajikistan is possible. It is crucial for all stakeholders to work together to achieve this common goal and ensure the health and well-being of the population.

“People living with HIV still face discrimination.”

What assistance does your organization provide to the country’s authorities in addressing the HIV problem?

The Government of Tajikistan actively collaborates with international and public organizations to prevent the spread of HIV infection and ensure access to testing, treatment, and support for people living with HIV.

Our organization assists the country’s authorities in addressing these issues, as well as reducing stigma and discrimination against people living with HIV. We engage in HIV prevention, conduct informational campaigns, and advocate for the interests of women and girls living with HIV to ensure their participation in decision-making.

Additionally, we organize community training, provide education to parents of children living with HIV, and contribute to the development of national strategies to combat HIV/AIDS and other infectious diseases. Our organization operates at both local and national levels, collaborating with government agencies and other public organizations to achieve the overarching goal of preventing HIV infection spread and ensuring effective treatment and support for people living with HIV.