Uzbekistan

Azima has lived with HIV since childhood; she was abandoned by her parents and raised by her grandmother.

Today she is recognized as an inspirational community leader in the HIV response, including for the vital role she has played in tackling stigma as the first young woman in Uzbekistan to disclose her HIV-positive status.

"I am strong. I have a bright future ahead. And I will achieve my goals,” says Azima.

She has faced both positive and negative reactions since her disclosure. Throughout, Azima has remained a committed activist. She is especially thankful to her community of peer support, a group of children and young people living with HIV supported by UNICEF.

“In the end, the energy of the people who supported me was so strong that it helped me rise above other people's criticism,” she said.

As a peer educator, Azima works tirelessly to raise awareness about HIV.

Today, Azima is studying psychology at Fergana State University. This choice of future career was encouraged by her grandmother and inspired by a psychologist who worked in her support group.

Because of her HIV treatment, Azima cannot transmit HIV to her husband. Several months ago, she gave birth to an HIV-free baby girl.

She is thankful for her family. “My husband has always supported me,” says Azima.

Azima’s story exemplifies the progress made in Uzbekistan’s HIV response. Antiretroviral therapy is provided free of charge to all in need in Uzbekistan. The country is also making efforts to ensure all women living with HIV receive timely treatment, so that all babies will be born HIV-free. Coverage of pregnant women who receive antiretroviral treatment to prevent vertical transmission of HIV has been around 98% since 2016, according to the Uzbekistan Republican Center to fight AIDS.

“The rate of vertical HIV transmission in 2023 was 0.2%. We aim to reduce this figure to 0%. The Republic of Uzbekistan is on the verge of receiving an international certificate for the elimination of mother-to-child HIV transmission,” said Bahrom Igamberdiyev, Director of the Republican AIDS Center in Uzbekistan.

The country has approved a "Roadmap for Implementing Measures to Achieve the Validation of the Elimination of Mother-to-Child Transmission of HIV for 2024-2026". This roadmap will be implemented with the participation of all partners, allowing Uzbekistan to reach its goal and obtain validation for the elimination of vertical transmission of HIV. An effective HIV response is a priority for both the government and civil society in Uzbekistan.

However, some critical challenges in the HIV response in Uzbekistan, particularly concerning HIV prevention, which are deeply rooted in societal norms and systemic inequalities.

These, according to the recently released Gender Assessment Report for Uzbekistan, include limits on women's decision-making power, leaving many women dependent on male relatives for important life choices, including healthcare decisions.

Despite the Government’s commitment and legislative efforts to address gender-based violence, underreporting remains a significant issue. The prevalence of early and arranged marriages also contributes to the limited autonomy of women, depriving many of them of educational and economic opportunities and impeding access to comprehensive sexual education. Cultural norms limit open discussions on reproductive health and prevention in many social contexts including family and educational settings.

As a result, the latest survey found that only 14% of women between 15 and 49 years old have comprehensive knowledge about HIV. This reduces to 10% for young women between 15 and 25 years old.  “Addressing these systemic issues requires comprehensive efforts to promote gender equality, ensure access to sexual and reproductive health and rights, and empower women economically. UNAIDS is working with partners to improve access to education and create an enabling environment for women to realize their full potential,” said Eamonn Murphy, UNAIDS Regional Director for Asia-Pacific and Eastern Europe and Central Asia.

Azima is stepping up her advocacy role, pointing out that openness and education are crucial in fighting stigma and advancing access to prevention, testing and treatment. She advises young women to disclose their HIV status to partners early in relationships and emphasizes the importance of adherence to treatment and of mutual support within families.

Azima will continue breaking stereotypes, promoting awareness, and embracing her journey with courage and determination. Azima exemplifies the learning that HIV responses succeed when we let communities lead.

Last year, Elina Kruglova made a bold decision. She disclosed her HIV status during the casting of a popular reality TV show in Uzbekistan.

“I disclosed my status right at the casting because the project lasted for several months, and I needed to take medicine daily,” she said. “I made the decision to be honest and mustered up the courage. I thought they wouldn't accept me, but I passed the casting," Ms Kruglova explained.

In her second-year student in the Faculty of Agricultural Economics at Tashkent State Agrarian University in Uzbekistan, she grew up in an orphanage. She was the first child living with HIV in her country to start antiretroviral (ARV) therapy seventeen years ago. Despite facing stigma, she has been taking life-saving medicine daily.

Uzbekistan struggles with HIV-related stigma and discrimination.

According to the recent Multiple Indicator Cluster Survey (MICS) in Uzbekistan, 76% of women aged 15-49 in the country would refuse to purchase vegetables from a vendor living with HIV and would not accept children living with HIV attend school with other children. Prejudice is fuelled by a lack of knowledge; only 14% of women in the same age group possess comprehensive information about HIV. Uzbekistan's HIV cases have steadily risen by 44 % in the last six years (31,088 in 2016 to an estimated 45,000 in 2022.)

Throughout the TV show, Ms Kruglova shared her experiences of being an orphan and living with HIV. Over time she became an inspiration for young people and those living with HIV.

"When the TV episode aired, I started contemplating how people would perceive me, what they would say, and how they would react,” she recalled. “Psychologists were working with us during the project, which made it easier for me to handle the pressure."  

To her surprise, people positively reacted when they recognized her on the streets, and she received numerous supportive messages from people living with HIV via Instagram.

"I am grateful for the trust they placed in me " she said.

For her, the Tashkent day-care center for children and families affected by HIV supported by UNICEF and UNAIDS played a crucial role in her life. It provided a safe haven, gave guidance throughout her childhood and teenage years. The center's support group, the professional consultations, and master classes helped her develop practical life skills. She is optimistic about the future and believes that people can change their attitudes towards HIV with the right information and education.  In her mind, hiding only makes things worse.

Aida Muravyova knows all about the power of disclosing her HIV status.

She is a 16-year-old school student in Kazakhstan and learned about her HIV status when she was 6 years old. Although advised against disclosing her status at school and extracurricular activities, Aida chose a different path.  She shared her HIV status with her classmates in school and took on the role of breaking down the myths and misconceptions surrounding HIV in front of her peers and adults.

“When I was told about my HIV diagnosis, I thought to myself, 'Okay, I have red hair, I have HIV, I take pills... what else?!'"

Ms Muravyova found solace through the Teenergizer Movement, a youth-led initiative supported by the Kazakhstan Government, UNICEF, UNAIDS and other donors. Teenergizer aims to empower young people living with HIV. It created a safe space for young women like her to connect, have fun, and share experiences without shame or stigma. The movement has reached many young people in the country, creating a ripple effect of reliable information and support.

When Teenergizer came along, Ms Muravyova invited classmates to join. "They got valid information, learned with me, and even conducted training sessions,” she said. “The most gratifying part was when one of my classmates' mothers, initially frightened by my HIV status, learned about HIV through her child's participation in Teenergizer.”

Her friend told her that her family had an open conversation, hashed out concerns, and now everything is okay.

Gender assessments conducted in several countries of Central Asia, including Kazakhstan, confirmed that gender inequality, stereotypes, customs and practices increase women’s vulnerability to HIV as well as limit their choices and expose them to socioeconomic and health difficulties.

Ms Muravyova refuses to let her HIV status define her or limit her dreams.. "I have seen many people living with HIV, but never in my field of Electrical and Aerospace Engineering... I want to change that perception and demonstrate that living with HIV can be different, cool, and interesting."

The UNAIDS Regional Policy and Equality Officer in Central Asia, Elena Kiryushina, sees role models like Elina and Aida as well as community networks as key.

“Promoting leadership among adolescent girls and young women, fostering positive masculinities in boys and men, providing care and support to adolescents living with HIV, especially those who lost parents and access to comprehensive sexuality education in and out of schools, and supporting gender-transformative approaches are essential steps to address HIV and gender-related stigma and to build foundation for the gender equality in Central Asia and beyond,” she said.

UNAIDS and partners believe empowering women and girls and challenging cultural norms is crucial to address HIV stigma and ensure equal access to support and health services.

Ms Muravyova has one mantra. “Speak, and don't be afraid!,” she said. “We are together, and together we'll make it through.”

The Russian Federation has donated a mobile clinic to Uzbekistan to provide primary health care for people in remote and hard-to-reach regions of the country, including testing for HIV, COVID-19 and other diseases.

The mobile clinic is equipped with the latest medical equipment and diagnostic systems, including for HIV and COVID-19, and is ready to provide people with access to integrated HIV testing and counselling and other forms of medical diagnostics and treatment.

“Thanks to this programme, the citizens of Uzbekistan living in different regions of the country will be able to receive timely information about the symptoms and ways of transmission of infectious diseases, which has become more important than ever,” said Botirjon Asadov, Uzbekistan Ambassador to the Russian Federation.

The clinic was donated as part of a technical assistance programme supported by the Russian Government that is being implemented by UNAIDS in partnership with the Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing (Rospotrebnadzor) and the nongovernmental organization AIDS Infoshare.

The programme aims to strengthen health systems, ensure better epidemiological surveillance of HIV and promote the scale-up of HIV prevention programmes among populations at higher risk in Armenia, Belarus, Kyrgyzstan, Tajikistan and Uzbekistan.

“Our work in today’s coronavirus pandemic is more relevant than ever. We continue our cooperation to fight COVID-19 and fully support the efforts of the Uzbek authorities to normalize the epidemic situation in the country as soon as possible, and assure that the Russian Federation is ready to provide the necessary assistance,” said Irina Bragina, Deputy Head of Rospotrebnadzor.

To date, 12 mobile clinics have been donated—four to Tajikistan, three to Armenia and five to Kyrgyzstan. Apart from the primary health-care services and a range of HIV screening services, the clinics provide tests for COVID-19, viral hepatitis and sexually transmitted infections and obstetrics, gynaecology, cardiology and urology care. All the mobile clinics offer services free of charge. So far, more than 1.6 million people have used the services provided by the clinics.

“Mobile clinics today not only continue providing primary health-care services, including HIV testing, but also have come to the forefront to combat a new threat—COVID-19,” said Aleksandr Goliusov, Director, a.i., of the UNAIDS Regional Support Team for Eastern Europe and Central Asia.

Lola Makhmudova (not her real name) grew up in a close-knit family, but her parents were afraid to tell her about her HIV-positive status for a long time, even though they both work in the health sector. She found out about it by chance, after hearing nurses talking in the hospital when she was 10 years old.

“Once, a few years later, when I already knew a lot about HIV infection and treatment, I was in the hospital with one boy, he also had HIV,” Ms Makhmudova said. “But his parents refused to give him antiretroviral therapy for religious reasons. I told them about myself, that therapy helps you to remain healthy, that I feel good and live a full life. I am happy that I managed to convince them. We are still friends with this boy.”

Ms Makhmudova is now 18 years old and has been a peer counsellor and volunteer at the Day Center for HIV Affected Families in Tashkent, Uzbekistan, for several years. She communicates with children and adolescents living with HIV, helps them to accept their diagnosis and explains the need for treatment.

Ms Makhmudova has not yet decided precisely what she will become when she is an adult, but she is sure that she wants to help people. She became one of three young people living with HIV to join the new United Nations Youth Advisory Board in Uzbekistan.

She takes her work on the Board for Youth Affairs seriously. “I was scared at first,” she said. “Everyone there is so grown up and smart. But I decided that I would study, I would learn languages ​​so that I could be heard, and I could influence decisions that concern young people.”

The Board for Youth Affairs includes 15 young people from different regions in Uzbekistan, representing various social groups and interests, including the most disadvantaged and marginalized.

“Uzbekistan has agreed to be a fast-track country for implementing the Global United Nations Youth 2030 Strategy. The United Nations Board for Youth Affairs is part of the initiative. Currently, the board works with partners to ensure that the views of young people are taken into account in the development and implementation of United Nations strategies and programmes as well as the State Youth Policy in the country,” said Charos Maksudova, UNAIDS Country Manager for Uzbekistan.

Guzal Akhmedova (not her real name) is a young woman who has been living with HIV for eight years. She is a second-year student at the University of World Economy and Diplomacy and speaks Uzbek, English and Russian and is learning Chinese.

“I have been working as a peer educator for five years, and it is giving me a lot of opportunities. I’m a delegate of the International AIDS Society. In 2018, I was selected to go to the Netherlands to participate in the conference. And this year, I got a scholarship to take part in the virtual AIDS 2020 conference. My life and my story of living with HIV are unique because I love myself, my illness, my body and everything that I have. This all started when I accepted myself as I am. I suggest my simple motto to everyone: positive mind, positive life!”

Shirin Botirova (not her real name) found out that she was living with HIV five years ago, when she was 15 years old. Like many of her peers, she had to go through all the stages of accepting her HIV status. And this, according to her, was not easy. “After a while, I decided to start a new life without self-stigma. And from that day, my activism began. I started going to a self-help group, studying all the information about HIV.”

She also began studying law to know her rights and how to protect people living with HIV.

Since 2015 Ms Botirova has been actively participating in various trainings for peer counsellors.

“Today, I am a national trainer, and I try to share the knowledge and skills that I have. We conduct training throughout the country, and even in other countries, talk about peer self-help groups and consultations, give general concepts about HIV.”

Ms Botirova is doing everything to ensure that the world accepts people living with HIV without stigma. “I want to contribute to creating a world without stigma and discrimination. I set myself the goal of changing the attitude of people towards us, people who are living with HIV, since this is one of the most urgent tasks in our region. I believe that everything depends on ourselves, and I believe that together we can create a world without borders.”

Shakhnoz Amirova (not her real name) lives in Tashkent, Uzbekistan. She has been taking antiretroviral therapy regularly since 2017, when she discovered that she was living with HIV. She continued the treatment while pregnant with her child, so she did not have to worry about her baby’s health, which was born HIV-free. But the COVID-19 pandemic has changed everything, and the lockdown restrictions severely limited access to medical services.

The immediate anxiety about the possible disruption to her HIV treatment and that of her husband, who is also living with HIV, was allayed by the health-care facility that she attends, the Republican AIDS Center, dispensing a two-month supply of antiretroviral therapy for everyone who needs it.

However, Ms Amirova was pregnant again and worried about the impact that COVID-19 may have on her and her unborn child, since information on how COVID-19 may affect people living with HIV was scarce. She was even unsure whether the coronavirus outbreak would stop her being able to have her baby at the maternity hospital.

“Women living with HIV feel especially vulnerable during pregnancy and childbirth, as fear of virus transmission, stigma and discrimination are added to the fears for the well-being of their baby. Of course, the situation with coronavirus is an additional stress factor. At such a difficult moment, women really need help and support, and we are trying to provide this help to them,” said Evgenia Korotkova, a representative of Ishonch va Khaet, an organization that helps people living with HIV.

The Positive Maternity programme run by Ishonch va Khaet helps women living with HIV who are pregnant or have recently given birth with social support, delivering antiretroviral therapy and baby food and providing medical care. During the COVID-19 outbreak, Ishonch va Khaet and similar organizations are working doubly hard so that people who need help get it as quickly as possible.

Yuldashev Kahramon Haldarovich, the Director of the Republican AIDS Center, noted the special role of nongovernmental organizations during a pandemic. “Community involvement in HIV prevention and support for people living with the virus are very important, especially at such tense moments, when the efforts of all health professionals and doctors are concentrated on fighting another pandemic. We cannot leave people who need HIV services behind; they also need help, and they need it today. The work of volunteers from social organizations is priceless.”

Since keeping patients and medical personnel in maternity hospitals safe from COVID-19 is such a priority, UNAIDS and the United Nations Population Fund have made a donation of a range of personal protective equipment, including masks and gloves, and disinfectant to 21 maternity hospitals in Uzbekistan.

“Protecting medical personnel in maternity hospitals from infection is as important as protecting pregnant women. The country is currently on the way to eliminating mother-to-child transmission of HIV. Preventive measures against COVID-19 are important for supporting the progress made,” said Charos Maksudova, the representative of UNAIDS in Uzbekistan.

Ms Amirova safely gave birth in the maternity hospital, happy that both her and her baby avoided becoming infected by the new coronavirus and that her baby was born HIV-free. “But fear for my children, especially for a newborn, does not leave me for a minute,” said Ms Amirova.

Now back at home, she is receiving help from peer counsellors from the Positive Maternity programme.

Samir, a shy 15-year-old, has come a long way. Living in Uzbekistan and diagnosed as HIV-positive around a year ago he thought at the time his life was over. He felt hopeless and depressed. Now, however, he is looking forward to a brighter future thanks to his involvement as a peer-to-peer trainer in an innovative project spearheaded by UNAIDS and UNICEF in Tashkent.

During the most recent project workshop Samir joined 22 other adolescents living with HIV in the Uzbek capital. They were there to learn more about how to provide peer-to-peer support for other adolescents living the same experience in their home regions. 

The trainees learned more about HIV prevention, care and support services as well as the increasing availability of HIV treatment options and the related improvement in quality of life. Learning how to challenge stigma and discrimination, which are still very prevalent in Uzbek society was also on the agenda. Many people living with HIV still fear being rejected and so keep their status secret.

For Samir the programme has made all the difference and he is now much more confident and optimistic. “I’m proud of having two hands, two legs and a head and I’m grateful to be alive. The most important things are family, health and a job that you like,” said Samir who wants to work in a bank in the future.

The peer-to-peer educator initiative started two years ago and UNAIDS and UNICEF have already trained 37 young people and intend to have ongoing training for new HIV-positive adolescents as well as reinforcing the capacity of those already trained. According to UNAIDS Country Director for Uzbekistan and Turkmenistan Lev Zohrabyan, the programme is playing a crucial role. “This initiative provides an opportunity for adolescents diagnosed with HIV to not only effectively cope with their own status but to also become leaders in guiding other peers in effective integration into society and living a fulfilled life”.

For Robert Fuderich, UNICEF Representative in Uzbekistan, the programme provides a safe haven where young people whose lives have been impacted by HIV “have access to psycho-social support, medical and legal counseling and most importantly, to an environment free of stigma and discrimination.”

Although HIV prevalence in Uzbekistan is relatively low, with an estimated 0.1% of the adult population living with the virus, the country is in a region which continues to have the largest increase in newly registered HIV cases in the world.

No travel restrictions in Andorra and Slovakia confirmed.

GENEVA, 21 October 2013—The Joint United Nations Programme on HIV/AIDS (UNAIDS) welcomes the recent lifting of all restrictions on entry, stay and residence for people living with HIV in Uzbekistan. The reforms were passed by Parliament in August of 2013 and signed by the President of Uzbekistan, Islam Karimov, on 23 September 2013.

“I welcome this important milestone in Uzbekistan and I hope this will encourage other countries to take similar action towards a world with zero HIV-related stigma and discrimination,” said the Executive Director of UNAIDS, Michel Sidibé.

UNAIDS advocates for the right to equal freedom of movement—regardless of HIV status. There is no evidence that restrictions on the entry, stay or residence of people living with HIV protect the public’s health.

As part of its on-going dialogue with countries on this issue, in July 2013, UNAIDS sent official communications to all countries, territories and areas that appeared to have HIV-related entry, stay and residence restrictions. Through this exercise, new information was received from Andorra and the Slovak Republic, indicating that there are no HIV-related restrictions in these countries. 

With the removal of Uzbekistan’s restrictions, and confirmation that there are no restrictions in Andorra and Slovakia—UNAIDS counts 41 countries, territories, and areas that impose some form of restriction on the entry, stay and residence based on HIV status. These include: Aruba, Australia, Bahrain, Belarus, Belize, Brunei Darussalam, Comoros, Cuba, Cyprus, Democratic People’s Republic of Korea, Dominican Republic, Egypt, Iraq, Israel, Jordan, Kuwait, Lebanon, Lithuania, Malaysia, Marshall Islands, Mauritius, New Zealand, Nicaragua, Oman, Papua New Guinea, Paraguay, Qatar, Russian Federation, Samoa, Saudi Arabia, Singapore, Solomon Islands, Sudan, Syrian Arab Republic, Chinese Taipei, Tajikistan, Tonga, Turkmenistan, Turks and Caicos Islands, United Arab Emirates and Yemen. 

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners to maximize results for the AIDS response. Learn more at unaids.org and connect with us on Facebook and Twitter.