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HIV infections build in Uzbekistan as prostitution flourishes
By Gulnoza Saidazimova
December 29, 2004
The 30-year-old prostitute refuses to give her name. She says she discovered
she was infected with HIV, the virus that causes AIDS, roughly two years ago.
She doesn’t know when she contracted the disease, or from whom. But she says
she has no one to blame but herself:
"There were some clients who didn’t want to use condoms. They were drunk. Men
usually buy [sexual services] when they’re drunk."
The woman says it is difficult to convince drunk clients to wear condoms. She
believes she contracted HIV by having unprotected sex with one of these men.
The 30-year-old divorcee turned to prostitution in order to make a living and
raise her 10-year-old son. But once she found out she was infected with HIV,
she stopped her work and lost her livelihood.
Her family now refuses to have contact with her. But the worst part, she says,
is knowing that she is dying: "The immune system doesn’t work, and a person
dies gradually from this illness."
The woman says she takes vitamins and some medicine to keep herself healthy.
But it is expensive and she can’t continue it for long.
Some 11,000 people in Uzbekistan are believed to be infected with HIV or AIDS.
According to official data, 20 percent of those are sex workers.
Prostitution has been on rise since Uzbekistan obtained independence just over
a decade ago. Many blame high unemployment, especially among women, for the
growth in prostitution. As the most populous country in Central Asia -- and a
transit point for truckdrivers from throughout the region, as well as Turkey
and Iran -- Uzbekistan has more prostitutes, and more risk of an AIDS epidemic,
than any of its neighbors.
In the capital of Tashkent alone, an estimated 6,000 women offer sexual
services.
One woman, Gulya, says she has been infected several times with curable
sexually transmitted diseases (STDs) like trichomoniasis. But she has not
contracted HIV, and describes what she and her co-workers do in order to avoid
being infected: "Usually we use condoms. Some clients say they don’t want to
use them. That is also possible. If we don’t use condoms, we ask a man to
[ejaculate] outside of us. Then disease can’t be transmitted. We are very
experienced. It’s enough for us to look at a man once and say whether he is
sick or not."
Safe-sex advocates face a challenge in Uzbekistan, where the average monthly
salary is $15. A pack of three condoms costs $1 -- a purchase few people can
afford to make.
The Washington-based organization Population Service International (PSI) works
with HIV/AIDS sufferers in all of the Central Asian states but Turkmenistan.
Artur Niyazov heads PSI’s work in Uzbekistan, and says the group is working to
promote safe sex and condom use among the country’s young people. It
distributes information and sells low-priced condoms in areas where
prostitution and drug use among young people is known to be high. Niyazov says
PSI volunteers also work with prostitutes directly at the sites where sex
services are provided:
"They go directly to the field -- meaning to streets, to highways, to
apartments, anywhere where [prostitutes] gather. We collaborate with ’Mama
Rozas’ (eds: women who find clients for prostitutes). The collaboration is also
between peers, because we have Mama Rozas among our outreach workers. Sixty
percent of our outreach workers are former commercial sex workers and Mama
Rozas."
PSI sells condoms at a price of 220 Uzbek soms for a three-pack of condoms --
nearly three times cheaper than the regular price.
Niyazov says the group also offers additional incentives to prostitutes to
convince them to buy condoms: "We started a campaign to motivate them to buy
condoms. If they buy 10 packs, they get a medical test for free. As you may
know, such tests are quite complicated for these types of women [in
Uzbekistan]. If a woman is diagnosed with an STD, she is registered and sent to
a venereal disease center for compulsory treatment. Therefore, they hide their
diseases. We give them the chance to have an anonymous test in a friendly
clinic. We choose the clinic and we pay the doctors."
Government officials in Uzbekistan say they are fighting the battle against
HIV/AIDS as well.
Bakhtiyor Madaminov is deputy head of the Health Ministry’s AIDS center. He
says in 1999 the country passed a law on preventing HIV infection that aims to
protect the rights of those diagnosed with HIV and AIDS and provide them with
free medical services.
To that end, the Health Ministry has opened AIDS centers in different regions
of the country, as well as what Madaminov calls anonymous "trust rooms."
"Their major task is to provide drug addicts with new syringes and [a] chemical
substance to disinfect used needles as well as with condoms," Madaminov said.
"It’s all financed by the government, from a state budget."
A number of nongovernmental organizations are also involved in the battle
against the disease. One, "Ishonch va hayot" -- or "Trust and Life" -- holds
special classes for people living with HIV/AIDS. Sergei Pyatayev, the deputy
head of the NGO, says many of the group’s psychologists, lawyers, and health
counselors are themselves HIV-positive. It is one way, he says, of fighting the
stigma attached to those living with the deadly disease.
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