Turkmen Authorities Play Down HIV/AIDS

Tuesday, 11 January, 2011

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IWPR Central Asia

Health experts in Turkmenistan warn that blanket denials that the country has an HIV/AIDS problem will do nothing to curb the spread of the virus.

Unlike other Central Asian states, Turkmenistan is not listed in the 2010 Report on the Global AIDS Epidemic compiled by the United Nations agency, as the national authorities did not submit information.

The general approach is to deny there is a problem. The government marked World AIDS Day on December 1, for example, with a statement that “Turkmenistan is among those world countries where this terrible disease has not spread”.

According to official statistics, Turkmenistan has only had two recorded cases of HIV infection in the last two decades.

A commentator in the capital Ashgabat said healthcare workers were too fearful to talk about HIV/AIDS in public.

“But unofficially, doctors acknowledge that the problem exists and they doubt the figures that are cited are accurate,” he said.

A doctor in Turkmenistan agreed that it was hard to credit official data suggesting there were virtually no cases of HIV. “Look how many sex workers and drug addicts we have. In a situation like that, how is it possible to say with conviction that we don’t have AIDS here?” he asked.

“Doctors try to maintain silence on AIDS cases. It’s a taboo disease,” an analyst based in the northern Dashoguz region said. “Medical staff record cases as colds, hepatitis, typhus or cholera.”

In a report last April, the international medical assistance group Médecins Sans Frontières, which operated in Turkmenistan until it was forced out at the end of 2009, said healthcare workers risked dismissal or even imprisonment if they failed to manipulate records to keep them in line with official health targets.

“It is undeniable that tuberculosis and sexually transmitted infections including HIV/AIDS are more prevalent than reported figures would suggest and the Turkmen government is refusing to acknowledge this reality,” a press release accompanying the report said.

There is little independently-sourced information about HIV/AIDS incidence. The Vienna-based Turkmenistan Initiative for Human Rights, TIHR, said 68 HIV-positive individuals had been identified in the Caspian port city of Turkmenbashi.

The report noted that the city had significant numbers of sex workers, seen as a high-risk group especially in cases where illegal drug use involved sharing needles.

Turkmenistan has a long border with Afghanistan, and is one of the transit routes for heroin shipped to Russia and the rest of Europe. Again, the government has dealt with rising heroin use mainly by not talking about it.

The Turkmen government ascribes its success in keeping HIV/AIDS at bay to extensive preventive programmes and awareness-raising work among healthcare workers and other institutions.

Last September a National AIDS Prevention Centre opened, which the authorities say offers anonymous testing and the capacity to treat 20 in-patients.

UNAIDS is currently funding 36 testing laboratories and training HIV/AIDS specialists, but the Turkmen doctor interviewed for this report said the project will end in March 2011, apparently due to disagreements with the government.

“After that, we will face a real problem,” the doctor warned.

Analysts say preventive measures cannot be effective if the government will not admit that HIV is present in the country. They argue that awareness campaigns have focused on healthcare workers rather than the general population, and have not properly addressed issues like the role of condoms in preventing infection and the risk of transmission through breastfeeding.

“There is no education campaign among HIV-positive people, so there have been cases of ‘vertical infection’ where the virus spreads from a breastfeeding mother to her child,” an analyst based in the country said.

Interviewees also noted that that the stigma attached to HIV/AIDS meant many people were keen to conceal their status and would happily bribe doctors to give them the all-clear.

A local journalist who covers health issues said that even when a positive diagnosis took place at a clinic, the individual involved did not receive appropriate treatment because of the atmosphere of denial and because specialist doctors and medicines had not been put in place.

This article was produced jointly under two IWPR projects: Building Central Asian Human Rights Protection & Education Through the Media, funded by the European Commission; and the Human Rights Reporting, Confidence Building and Conflict Information Programme, funded by the Foreign Ministry of Norway.
The contents of this article are the sole responsibility of IWPR and can in no way be taken to reflect the views of either the European Union or the Foreign Ministry of Norway.