AIDS spreads with migrant work in Central Asia (News Feature)

By Benedikt von Imhoff Jul 20, 2010, 3:06 GMT

Dushanbe/Moscow - Many poor Central Asian men are migrant workers in Russia. When they return home after being away for months, they bring not only money with them.

A growing number of these mostly young men are infected with HIV, the virus that causes the deadly disease AIDS.

Injection drug use with contaminated needles and prostitution are fuelling the epidemic. Expensive AIDS treatment, preventative care and AIDS education are sorely lacking in the predominantly authoritarian-ruled Muslim region. Sexually transmitted diseases are a taboo topic.

According to UNAIDS, the Joint United Nations Programme on HIV/AIDS, Uzbekistan, Kyrgyzstan and Turkmenistan, like Russia, impose restrictions on entry or visas for people with HIV.

The situation in Central Asia is one of the key topic discussed at the 18th International AIDS Conference, which is taking place in Vienna this week.

Like many migrant workers from Tajikistan, Malik - not his real name - became infected with HIV in Russia.

'I'm very worried about what will happen to my family and children when I die,' the 32-year-old told the German Press Agency dpa in the Tajik capital, Dushanbe.

He has not informed his relatives of his infection. 'I'm afraid they'll disown me,' he said softly.

The same fear gnaws at Timur, an educator in Kyrgyzstan who also asked that his real name not be published.

'If my illness became known, parents would demand my dismissal,' he said.

Central Asian women are increasingly at risk. Few send their husbands to be tested for HIV when they return from their sojourns in Russia. And few refuse to have unprotected sex with them.

A further problem is the lack of sex education in the region, particularly in rural areas. Since sexuality is considered an indecent topic, parents do not speak with their children about safe sex.

Public service ads on state-run television promoting condom use are rare - and prudishly indirect. Homosexuality is taboo.

Timur said that Kyrgyz HIV patients usually receive cheap medicines only. Many Central Asian nations cannot afford an efficient health-care system.

'The (health-care) employees are often insufficiently paid or not paid at all,' said Wolfgang Luster, a physician at the German embassy in Moscow. This makes doctors and nurses susceptible to the widespread corruption in the region and results in a large gap in care between rich and poor.

UNAIDS estimates the number of people living with HIV/AIDS in Central Asia at several tens of thousands, far higher than official figures published by national authorities whose information policies, experts say, remain restrictive.

Turkmenistan, Central Asia's most isolated country, releases no figures at all.

Although the number of HIV/AIDS cases in Central Asia remains quite low compared with African countries, UNAIDS wants to curb the epidemic there as early as possible.

It has lauded efforts made by Kazakhstan, the region's politically most important country. 'Due to governmental commitment and donor support, Kazakhstan managed to keep HIV at a low level,' UNAIDS reported in July 2008.

But it is unlikely that Central Asia will be able to solve its HIV/AIDS problem without outside help.