Communities take the lead on HIV prevention in Uzbekistan

Central Asian migrants stranded at a Russian airport during the COVID crisis

Each year thousands of Uzbek workers migrate to Russia, the Republic of Korea and Türkiye in search of work in construction, hospitality, and agriculture. They send money back and visit home occasionally. 
They are almost exclusively men and while abroad they are at a higher risk of engaging in behaviors that may expose them to HIV, mainly through unprotected sexual contacts.  While their partners at home might suspect or be aware of this, traditional mores mean they are often not able to broach the subject. 
“There is a widespread lack of knowledge on sexually transmitted infections (STIs), including HIV, and, often the husband or his mother prevent Uzbek women from getting tested for HIV or other STIs,” according to Dr Chiaki Ito, IOM’s health specialist covering Central Asia.
To help counter this phenomenon, IOM Uzbekistan recently brought together staff from NGOs in regions most prone to migration to train them on how to raise awareness of HIV and STIs among migrant workers.  
“The unanimous feeling among the group was that the peculiarities and challenges of the migration process, including being separated from the family and working under perilous conditions, are enhancing migrant workers’ vulnerabilities and drive them into risk taking”, noted Dr Ito. 
The training also focused on reaching spouses of migrant workers through working closely with migrant communities and their communities and families. 

"We found that being aware of the relation between gender roles and decision-making in this context is essential when designing

migrant-friendly HIV prevention programmes, testing, and treatment services,” said Ursula Wagner, Migration Health coordinator at IOMs Vienna regional office.
To better understand knowledge gaps and access issues, IOM is launching a survey of five selected regions with high density of migrant populations. The findings will help to tailor outreach campaigns to reduce vulnerabilities to HIV across genders, according to Wagner.
There аre 48,000 people living with HIV in Uzbekistan, 13 per cent of whom are migrants. This has prompted the government of Uzbekistan to prioritize migrant workers in its HIV prevention programmes. Voluntary testing is available in 14 regional AIDS centres, and antiretroviral treatment is free. Stigma around HIV is still a major obstacle in accessing such services.

The project is implemented with support of the IOM Development Fund. 
Anvar is a 40-year-old former migrant who is living with HIV:
“The first time I went to Moscow to work was when I was 24 years old, like everyone else I wanted to earn money for an apartment and a car, for a better life… My acquaintance constantly called me and told me to come, he promised to find a job for me. It was the end of 2009; I decided to sell my phone and buy a ticket to Moscow.  
“I flew to Moscow just before the New Year and started working hard. I could afford to come home to Tashkent only every two years. After 2015 a change in legislation in Russia made it necessary to undergo medical tests to get a patent*.  
“Two weeks later I got a call and was asked to come to the Federal Migration Service. The doctor there told me that I had tested positive for HIV. I didn't believe it. Still, they took a confirmation from me that I knew my status and I had to leave Russia within the next ten days. However, I stayed without documents and worked there for four years.
“There was time when physical work became hard for me, and I came back to Uzbekistan where today I am taking anti-retroviral therapy and I’m feeling well. I became a volunteer for a HIV prevention project and am glad that migrants like me are getting support.” 
It is worth noting that to date, there are over 15 countries, territories and areas that impose Mandatory HIV testing and bans on entry, stay and residence based on HIV status. The United Nations, via UNAIDS advocates for the elimination of these laws. 

*A patent is a work permit certifying that a person works legally in the country. 

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