Overcoming the Stigma of HIV/AIDS: Two Brave Women Inspire Hope in Central Asia

Takhmina Khaidarova, 29, was devastated when she learned she had contracted HIV from her husband in 2008  --  a status that carries huge stigma in Tajikistan.

Although she hoped to continue her studies after graduating from high school, Takhmina instead married her cousin  --  a seasonal labor migrant who split his time between Russia and Tajikistan  -- and gave birth to what seemed like a healthy daughter. Takhmina believes her husband was infected with HIV during his time as a labor migrant and infected her during one of his trips to Tajikistan after the baby was born.

Sadly, Takhmina’s child was diagnosed with leukemia at age 2 and died soon after. Takhmina started feeling sick around the same time and, when a medical examination determined she was HIV-positive, Takhmina confronted her husband, who not only denied he gave it to her but was furious she found out. Shortly after this conversation, he returned to Tajikistan for the final time in the last stages of AIDS and died two weeks later.

This chain of tragic events caused deep family divides  --  Takhmina’s family still has no contact with her husband’s family. And her father has not spoken to Takhmina since she adopted her husband’s other daughter, who was abandoned at 6 months of age by the woman her husband was living with in Russia.

Finding New Hope

“I wanted to die after my diagnosis,” is how Takhmina felt as she initially confronted a lot of misunderstanding about HIV.

Instead she found new life through antiretroviral therapy treatment and is now serving as hope and inspiration for others. As the head of the USAID-supported Tajik Network of Women (TNW) Living with HIV/AIDS, Takhmina is open about her status, which is unusual for HIV-positive women in Tajikistan, many of whom face violence, threats and blackmail from relatives, friends and even health professionals.

In Tajikistan, over 2,000 women have been diagnosed with HIV (out of an estimated 5,400 people living with HIV/AIDS in the country). TNW, the first and only national network of women living with HIV in Tajikistan, provides social and psychological support and peer counseling. The organization provides hope for many of these women, saving them from isolation, stigma and possibly suicide.

This year, Takhmina proudly notes that, in addition to her work with TNW and caring for her now 6-year-old adopted daughter, she will finally complete the studies she had put aside and will graduate from the Faculty of Psychology of the Tajik State Pedagogical University with a degree in teaching.
She also hears from others that her father is very proud of her achievements.

Stories of discrimination and stigma like Takhmina’s, unfortunately, are also common in neighboring Kazakhstan, where, as in Tajikistan, the HIV epidemic is particularly concentrated among people who inject drugs, sex workers, and men who have sex with men. As in other parts of the region, those ages 25–40 are the most severely affected.

The Silk Road, which once brought prosperity to Central Asia, is now a transit route for drugs from Afghanistan  --  which produces about 70 percent of the world’s heroin  --  to Russia. Amid high rates of unemployment, migration and poverty, the drug trade is proliferating due, in part, to the low volume of drug seizure, lack of border controls, and corruption of government officials.

Treatment Support for Injecting Drug Users

A medically assisted treatment (MAT) program that combines behavioral therapy and medications to treat substance use disorders in Kazakhstan is having positive effects in curbing the spread of HIV. Through the President’s Emergency Plan for AIDS Relief, USAID supports the United Nations Office on Drugs and Crime to advocate for increased access to and quality of MAT services.

The program includes daily methadone treatment, which, because it reduces the incidence of drug injection use, also reduces the risk of HIV for people like Elena Romanenko.

A native of Ust-Kamenogorsk, Kazakhstan, Elena started using drugs in 1994. Soon her drug use spiraled to heroin and Elena lost her job, dropped out of school, separated from her husband, was in and out of prison, and sent her young daughter to live with her mother. On one occasion, she was caught by the police with a syringe in an Almaty apartment.

Elena, who will soon be a grandmother, discovered the MAT program in 2012, and now says, “These days I see the different colors; I have my life back.”
Elena receives her methadone treatments at the Narcological Dispensary, a state hospital and the first of its kind in Kazakhstan. She is also a volunteer at the hospital  -- earning a small stipend equivalent to $100 a month  --  and a peer mentor for MAT patients. The program provides counselors and specialists who oversee the general state of their patients’ health and ensure they adhere to HIV/AIDS treatment and MAT. It is also a last resort for many of the patients  --  72 percent who have been injecting drugs for over 10 years.

espite the challenges of daily attendance at the program, which Elena says requires participants to remain close to the site, after a year, none of the patients have had any issues with the law. All report a higher quality of life, and many have found jobs, married, and had children.
USAID believes the HIV/AIDS epidemic will not be controlled until stigma and discrimination are eliminated. Therefore, the Agency’s new anti-discrimination policy is ensuring key populations  --  like those represented by Takhmina and Elena  --  have equal access to critical HIV/AIDS treatment and prevention services.

About the Author: Jessica Benton Cooney is the Communications Specialist for USAID’s Center of Excellence on Democracy, Human Rights and Governance.

Editor's Note: This entry originally appeated in USAID's 2030: Ending Extreme Poverty in This Generation publication on Medium.com.

For more information:

Left: Elena Romanenko, a participant and peer counselor in a medically assisted treatment program in Kazakhstan. Right: Takhmina Khaidarova, head of the civil society organization Tajik Network of Women Living with HIV/AIDS. [Jessica Benton Cooney, USAID]
December 2, 2016

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