Uzbekistan Faces AIDS Epidemic

Tashkent resident Yekaterina is only 20-years-old, but her life has lost all its purpose. A drug user, she regularly shared needles with her fellow addicts in a rundown apartment in the capital. A year and half ago, she was told that she had contracted the HIV virus.

"We didn't take any precautions during sex or in our drug use. The syringe was passed around and eight to ten people were using it in every session," she told IWPR.

Since Yekaterina was diagnosed as HIV-positive, around 20 of her friends have lost their lives. "It is possible that many of them had AIDS, or maybe they died because of an overdose. Nobody knows the exact cause," she said.

Her story is a sad one, but it is becoming increasingly common in Uzbekistan - a country where cases of HIV and AIDS infection have doubled in only one year.

According to official data from the Ministry of Health of Uzbekistan, 1,399 people - 1,230 men and 169 women - were confirmed as having contracted the virus by July 1 of this year. At the end of 2001, only 779 patients were registered across the country.

Doctors believe that 60 per cent of sufferers were infected through drug use, with the remainder contracting the virus via unprotected sex or blood transfusions.

These figures are frightening, but many analysts fear that the real number is far higher than the official statistics suggest - with the country's capital and its Fergana Valley region singled out as "areas of heightened risk".

Uzbekistan as a whole has all the conditions for an HIV epidemic, according to local doctors and specialists from international non-governmental organisations, NGOs, working on the ground.

Drugs traffickers use the country as a transit route from Afghanistan to Russia and Europe, increasing the availability of illegal substances.

The desperate economic climate has brought about high levels of unemployment, poverty, and a growing feeling of hopelessness. This has resulted in an increase in drug use and prostitution, especially among the young, and there is little or no information available on sexual health and disease prevention.

Sarbinaz came to the western city of Nukus, capital of the autonomous republic of Karakalpakstan three years ago as a bright-eyed and hopeful young woman eager to study at university. However, her application was rejected and she was unable to find any other employment. She has been working as a prostitute ever since.

"I came here from a remote village, and I have only recently learned what AIDS is and how it is transmitted," she said. "I don't know if I have this disease, but I'm too scared to go for an HIV test. Not one of my clients has ever practiced safe sex."

She is not alone. Doctors at the Nukus branch of the Centre for Reproductive Health have concluded that the majority of prostitutes are serving their clients without taking any precautions whatsoever. Many of them know nothing about the symptoms and prevention of venereal disease.

Nukus' prostitutes argue that a potential client will pay much less if he is forced to use a condom. And as the charge for one session can be as little as three US dollars, they are not happy to drop the price any lower.

These issues demand attention, and leading Uzbek medical official Doctor Bakhtior Niazmatov told IWPR that the authorities are now undertaking a programme of HIV-prevention work.

"Free syringes and condoms are being provided to those at risk and we are conducting seminars for drug addicts and infected people. This has led to a drop in the number of new cases in Tashkent," he said.

But no matter how successfully AIDS prevention work is conducted in Uzbekistan, the republic still cannot do without the support and assistance of international NGOs.

For example, the NGO Population International Service, PIS, intends to carry out a project to assist people in high-risk groups. It intends to work with the Uzbek state media to broadcast information about AIDS prevention through video clips and advertising.

So far, the republic's media has not been forthcoming on this delicate issue, and has often taken a harsh stance on HIV/AIDS - sometimes even blaming prostitutes, homosexuals and drug addicts for "bringing it upon themselves".

The general public, who take a dim view of high-risk groups and believe that they do not deserve to be helped, can share this attitude.

Fearing this, the people who are most vulnerable are the least likely to attend a clinic or take an HIV-test. And the likes of Yekaterina, who has already been diagnosed and knows she is facing an early death, live in isolation and misery.

"I do not know how much longer I have got, but I want to live these days or maybe years having forgotten the dreadful things that have happened to me," she told IWPR. "I'm not afraid to die - it is worse to be living like this, like a convict waiting for the axe to fall."

Karina Insarova is a pseudonym of an IWPR correspondent in Uzbekistan.