In 2024, pressure on the LGBTQIA+ community in Kazakhstan is increasing, leading to new waves of discrimination and restriction of rights. Recent events involving the proposal of discriminatory amendments to legislation and the dissemination of misinformation increase the threat to human rights defenders and activists. At the center of these developments are non-binary individuals and LGBTQIA+ activists facing open hostility and hate speech from some politicians and public figures. Let us consider two significant cases highlighting the complexity and importance of the ongoing struggle for equality and human rights in Kazakhstan.
Proposing discriminatory amendments to legislation
On April 10, 2024, NGO workers and human rights defenders in Kazakhstan learned of a proposal by two deputies to the Majilis from the Amanat party to introduce another discriminatory amendment to the law. In addition to amending Article 174 of Kazakhstan’s Criminal Code on incitement to hatred, the deputies proposed to add a provision to Article 14 of the Law on Peaceful Assemblies prohibiting protests if their subject matter concerns “propaganda of non-traditional sexual relations.”
Based on Article 1 of the Marriage and Family Code, the deputies said that marriage is a union between a man and a woman, which makes any form of LGBTQIA+ activism, in their view, unacceptable. Peaceful protests for the rights of the LGBTQIA+ community, in their view, should be banned, creating a legal basis for further infringement of the rights of this community.
This initiative provoked an immediate reaction from human rights defenders and LGBTQIA+ activists, who began to develop strategies to combat the discriminatory amendments. In a context of heightened political and social tensions, such measures pose significant risks to the peaceful expression of rights and freedom of assembly.
Disinformation and the spreading of hatred on social media
On 15 August 2024, two popular Kazakhstani cisgender male bloggers published a video on their Instagram page in which they spread false information about an event organized by the Queer.kz initiative and the NGO Education Community. The event was dedicated to a lecture on the topic of queer activism and intersectionality. Still, the bloggers in their video called it “agitation” and “propaganda”, trying to discredit its goals and participants.
In addition, bloggers publicly condemned two Kazakh male choreographers who were attacked for their high heels performances. Their actions were characterized as “effeminate,” which only added to the public pressure and misinformation surrounding the event and the queer movement itself in the country. At the time of the appeal, the video had garnered over 89,000 views, exacerbating the potential risks of bullying and threats to the safety of the Education Community and Queer. kz participants, as well as the choreographers themselves.
These actions were a clear example of the use of hate speech and the spread of misinformation, which reinforced stigmatization and led to possible security threats for human rights defenders and activists.
The situation in Kazakhstan for the LGBTQIA+ community is escalating, and the cases described vividly emphasize the extent of public and political pressure. However, active resistance and documentation of such cases are important steps towards equality and the protection of human rights. The LGBTQIA+ community in Kazakhstan faces many challenges in fighting for their rights, but their determination continues to inspire the fight against discrimination.
According to REAct data over 27,000 cases of human rights violations, discrimination, and stigma against key vulnerable communities have been registered in 14 countries in Eastern Europe and Central Asia since 2019 until 30th of June 2024.. Every second person who uses psychoactive substances has been denied medical services, with one in ten of them being denied in emergency situations. Over 50% of sex workers report physical violence, with every second one reporting sexual violence, and every third suffering from offenses committed by law enforcement agencies. Every member of the LGBTIQ community has faced hate speech at least once, and over 50% have experienced physical violence, with every third being a victim of their own relatives. People living with HIV have encountered discrimination due to their HIV status in medical institutions at least once. Every fifth person has faced the disclosure of their HIV status by medical workers.
Armenia
In 2024, an increase in the number of cases of human rights violations by the police was recorded in Armenia. Since the start of the anti-drug campaign announced in 2023, people from vulnerable groups have periodically reported intimidation and threats, as well as abuse of power, excessive use of force, and unauthorized searches. This is particularly common among sex workers and members of the LGBTIQ+ community.
For example, earlier this year, a sex worker and a representative of the LGBTIQ+ community were detained late at night in a park in his city. He was approached by two men who identified themselves as police officers. They searched, demanding to see his pockets, bag, and the last used app on his phone. The law enforcement representatives explained that there were many people using drugs in the park and the detainee, in their opinion, could be one of them. Further, the police read the man’s correspondence in Telegram, subjected him to humiliation, and mockingly ordered him to leave the park and walk outside the city where “people like him” gather.
A client of another national REActor described the case of a friendof his who admitted to drug use to a nurse while undergoing tests before an operation. She immediately informed the relevant authorities and two police officers arrested the man, who had not even had time to leave the building of the medical center. After that, communication with him ceased.
Such cases undermine trust in medical personnel and infringe on the rights of patients. Violation of confidentiality and ethical norms, as well as undue police interference, require immediate attention and resolution at the state level in Armenia. Instead of persecution, people from key populations should be provided with relevant assistance, support, and protection of their rights.
Azerbaijan
In Azerbaijan, special attention should be paid to the assistance provided by REActors in obtaining opioid substitution therapy (OST) and documentation in the absence of residence or registration for members of the community of people who use drugs. Clients are informed about their rights and treatment options depending on their current situation, including possible barriers and ways to overcome them, accompanied to medical facilities, and helped to make appointments. And in the case of legal aid, assistance with specialist advice on the paperwork required to access medical care.
REActors also continue to document cases of denial of access to medical services and HIV-related discrimination. One situation occurred when a client went to a dentist. After taking measurements and making an advance payment, the dentist said the onlay would be ready in a few days. When the client returned to finish what he had started, the dentist refused to do his work. The reason turned out to be the man’s positive HIV status, which he had mentioned at the first appointment. Attempts to return the money were ignored and the client was kicked out of the office. In desperation, the man appealed to the national REActors of Azerbaijan to seek justice and draw attention to the problem of discrimination in medicine.
REActors’ assistance continues in protecting the rights to privacy and freedom from discrimination. A 20-year-old student faced prejudice and discrimination because of his sexual orientation, realized at the age of 15. Fearing for the reaction of his elderly parents, he tried to hide his secret. However, when a classmate learned the truth and threatened to reveal it, the boy turned to a REActor for help. The lawyer to whom the student was referred arranged a meeting with the blackmailer. During the conversation, the lawyer explained the consequences of such behavior and mental abuse, which made the classmate apologize and promise to respect the client’s privacy.
Georgia
Since the beginning of the year, the situation in Georgia remains extremely worrying. The law on “foreign agents,” finally adopted in Georgia on May 28, poses a serious threat to access to treatment and medical and social services. It imposes strict restrictions on the activities of media and public organizations that receive funding from abroad, requiring them to register as “foreign agents”. The law directly affects many NPOs that play a critical role in providing services to key groups in the country and often depend on foreign funding to implement their programs and projects. The introduction of additional bureaucratic hurdles and potential sanctions, such as fines of several thousand dollars, will deter these organizations, reducing their ability to assist:
– Evasion of registration as an organization carrying out the interests of a foreign power or failure to submit the financial declaration stipulated in Article 6 of this Law within the term established by the same article – shall entail a fine of 25,000 GEL ($8,850).
– Failure to fulfill the requirement of Article 4, paragraph 2 of this Law, failure to fulfill the obligation to eliminate the deficiency stipulated in Article 4, paragraph 4 or Article 6, paragraph 1 of this Law or the declaration specified in Article 4, paragraph 1 of this Law. Article 8, paragraph 5 of this Law Failure to fulfill the obligation to complete and submit – shall be punishable by a fine of GEL 10,000 (USD 3,540).
– Continuation of the action provided for in paragraph 2 of this Article within 1 month from the date of imposition of the last administrative fine for the same action – shall entail a fine of GEL 20,000 (USD 7080).
– Failure to provide the person authorized by the Ministry of Justice of Georgia with the information requested by him/her by this Law – shall entail a fine of GEL 5,000 (USD 1,770).
In addition, the regulations requiring registration with the National Agency of Public Registry of the Ministry of Justice create an atmosphere of mistrust and fear, which may lead to a decrease in the number of organizations willing to work in Georgia. This, in turn, will limit access to services, especially in remote and low-income areas where the work of such organizations is vital.
The changes also affected the ability to provide pharmaceuticals in special cases. Previously, patients could receive a five-day supply of medication for long-term home treatment or a seven-day supply for those with severe disabilities or active TB. These exceptional regulations have been abolished. Now, even in the case of travel or ill health, patients may be given only a one-day dose.
Drug policy organizations, health experts, and public associations expressed alarm at these changes, believing that they would not adequately protect the rights of patients participating in the program. In this regard, a public appeal of Georgian NGOs to the Ministry of Health was prepared.
State-level proposals and changes such as these not only restrict civil liberties but also significantly impede critical services that could have irreparable consequences for the health and quality of life of both key groups and the general population in Georgia as a whole.
Kazakhstan
In Kazakhstan, there are problems related to the violation of the rights of key groups, in particular people living with HIV and viral hepatitis C. Reactors have documented cases of denial of treatment due to lack of mandatory social health insurance (MSHI), despite hepatitis being recognized as a socially significant disease, and medical professionals often disclose patients’ HIV status, violating their confidentiality.
The situation with the LGBTIQ+ community is also alarming, with increased police raids on closed LGBTIQ parties, harassment, and threats against activists. One student, an LGBTIQ+ activist, faced cyberbullying and threats of violence from another student who posted abusive messages under an anonymous Telegram nickname. To protect his rights, he sought help from REACTors, who filed a complaint with the university.
The situation in Kazakhstan requires significant efforts to improve the legal environment and reduce risks for members of key groups.
Kyrgyzstan
On March 14, 2024, the Kyrgyz Republic adopted a new law “On Non-Profit Organizations”, which was signed by the President of the country on April 2, 2024. This law introduced a new concept – “Non-profit organization performing the functions of a foreign representative”. This is an NPO established in the Kyrgyz Republic, which receives funds and other property from foreign states, their state bodies, international and foreign organizations, foreign citizens, stateless persons, or persons authorized by them who receive funds and other property from these sources (except for open joint-stock companies with state participation and their subsidiaries), and which participates, including in the interests of foreign sources, in political activities carried out on the territory of the Kyrgyz Republic. The law defines the political activities of non-profit organizations to include:
Participation in the organization and holding of public events (meetings, rallies, demonstrations, marches, picketing) and public debates, discussions, and speeches.
Activities aimed at obtaining a certain result in elections, referendums, observation of their conduct, formation of election commissions, as well as activities of political parties.
Public appeals to state bodies and local self-government, affecting their activities, including the adoption, amendment, or repeal of laws and regulations.
Dissemination of opinions about the decisions of state bodies and their policies, including the use of modern information technologies.
Formation of socio-political views and beliefs through public opinion polls and sociological research.
Involvement of citizens, including minors, in these activities.
The adoption of the new law had a significant impact on the functioning of REAct in the country. Since the beginning of the year, the work of the system has been suspended for the following reasons:
The United Nations Development Program (UNDP), the Global Fund, and the Soros-Kyrgyzstan Foundation withdrew from the contract that provided for the maintenance of street lawyers engaged in reporting in the REAct system.
The street lawyers were transferred to non-profit organizations working in the field of HIV prevention, and TB and working with key groups.
The composition of street lawyers was renewed in 2024, but new lawyers have not been trained, and mentors and advocates have not been hired by the Global Fund or UNDP.
Once the new law enters into force, Kazakhstan’s Ministry of Justice will develop bylaws that will possibly provide a detailed concept of the law, which will allow the active use of REActs to resume.
Also, the bill coincided with massive police raids targeting sex workers. The changes are linked to the creation of a “vice police” unit in the police department, officially called the department for combating human trafficking and crimes against public morals. Despite the authorities’ claims that the fight is against criminal networks and not sex workers/workers, human rights defenders and health workers note that police actions make it more difficult to track sexually transmitted diseases and ensure the safety of this group. Women complain of forced testing, harassment, and corruption by law enforcement officials, indicating their stigmatization and continued violation of their rights.
Also, since 2024, the team of specialized paralegals in Moldova has increased significantly, with the number of staff growing from 10 to 32. This expansion includes not only specialists providing HIV services but also those working in the field of tuberculosis. All paralegals use the REAct database to document and respond to cases of human rights violations. This improves the monitoring and resolution of legal issues at the community level. Due to the expansion of the paralegal network and new trends in the development of the Legal Cascade* In Moldova, all paralegals have become REActors.
*The Legal Cascade is an algorithm by which paralegals work with clients:
– Initial screening: human rights violations are assessed using the Harm Reduction Implementers’ Reporting System (1S).
– Mediation and sensitization: if a client needs mediation or sensitization about their rights, their case is resolved and documented at the national level in the SIA CNAJGS database.
– Documentation and response: if a rights violation and discrimination has been identified, the case is documented in the REAct database and a direct response to the violation is conducted.
Tajikistan
The situation faced by human rights defenders and some vulnerable communities in Tajikistan is of some concern. Recent developments point to a growing trend of restrictions on civil liberties and discrimination against the LGBTIQ community. The last two years have seen an increase in threats against human rights defenders in Tajikistan. Falsified cases under Articles 238, 239, and 241 of the Criminal Code are used as tools for harassment, resulting in activists being unjustly imprisoned. The use of personal photographs obtained through illegal searches to fabricate cases constitutes a serious violation of the right to privacy and fair process. For example, the most recent openly operating health care provider for the MSM (men who have sex with men) community, the NGO Equal Opportunities, was subjected to inspections, threats, and attacks on its office. Despite filing police reports, attempts at legal defense, and support from international donors, the organization’s activities were halted by a court ruling because: “the organization promotes sex services for men, which contradicts the moral norms of the country.”
Fear of discrimination and harassment leads MSM and trans community members to hesitate to seek necessary services, including HIV testing and prevention. In addition, the reluctance of lawyers to represent LGBTIQ individuals in criminal cases further exacerbates their vulnerability and denies them access to justice.
As a result, measures were proposed to improve the situation, including advocacy to improve access of women from vulnerable groups to shelters after cases of domestic violence and to organize low-threshold service centers in NGOs to reduce stigma and discrimination. It was also recommended to conduct information campaigns, trainings, and working meetings for employees of public services and NGOs involved in the prevention and identification of cases of violence. A Memo for employees of social service centers assisting victims of domestic violence and people in difficult life situations was developed. This document was approved at the level of the Ministry of Health and Social Protection of Tajikistan and by the Department of Sanitary and Epidemiological Surveillance for application for social service centers.
National REActors continue to work actively to help vulnerable groups of the population. In one case, a 46-year-old man living with HIV, a member of the community of people who use drugs, approached the REActors. His family had isolated him for fear of infection. The man asked to speak to his family to dispel myths about HIV and explain the importance of treatment. The REActor provided information about therapy and asked the family to support the man. As a result, their attitudes changed and the client started taking ART (as he also had preconceptions about treatment before).
A large number of reported cases concerned violations of the rights of people from vulnerable groups by medical workers of state institutions. In most cases, the violation of rights was accompanied by stigma and discrimination because of belonging to a risk group.
In one situation, a client went to a vascular surgeon who referred her for an ultrasound of her lower extremities. At the hospital, the nurse refused to do the ultrasound, citing the HIV diagnosis on the referral. The doctor rudely confirmed this, stating that healthcare providers should know who they are working with. The client contacted the REActor, where she was explained her rights, offered assistance in writing a complaint, and organized an escort to the Regional Hospital, where she received the necessary treatment.
Both in 2023 and 2024 there are cases of obstetric violence against women living with HIV. For example, a client went to a gynecologist because of lower abdominal pain and learned about her positive HIV status in an incorrect form. The doctor strongly recommended terminating the pregnancy, claiming that the child would be born sick. The stress caused her to bleed, and the hospital where she was taken hinted at a bribe. After finding REActors, she received support from a social worker, and HIV counseling, was registered, and received ART therapy. She was also offered the help of a psychologist and a lawyer and continues to receive psychological counseling and therapy.
Due to discriminatory attitudes, people from vulnerable groups lose the opportunity to timely detect serious life-threatening diseases. In particular, one client complained about an oncologist who refused to provide medical services because of her HIV-positive status, advising her to go to an AIDS center. The REActor discussed the situation with the deputy chief physician, who agreed with the violation and had a discussion with the oncologist. The client was booked for a follow-up appointment, where she received the necessary examination and treatment.
The issue of reducing the level of stigma and discrimination among the police towards people from vulnerable groups remains relevant (in terms of the number of recorded cases of rights violations, it is the representatives of law enforcement agencies who are next to medical personnel). In 2024, situations are recorded when patients of substitution maintenance therapy programs are stopped and deprived of medications, even in the presence of all supporting documents and certificates of SMT program participants.
Uzbekistan
According to the data registered in the REAct database, in 2024, Uzbekistan recorded serious problems related to violations of the rights of people living with HIV and key populations. The collected cases indicate that the most frequent violations come from representatives of state structures, family members, medical institutions, and the workplace.
Thus, state bodies that should ensure support and protection of the rights of PLHIV and key groups, often demonstrate discriminatory behavior. This is expressed in the form of denial of social assistance, stigmatization, and violation of confidentiality. Community members often find themselves in difficult life situations without the necessary support.
However, significant positive steps at the highest levels of government should be noted: recent changes in Uzbekistan’s labor legislation open new opportunities for people living with HIV. Thanks to the efforts of REAct partners and the political will of the authorities, the list of professions prohibited for people living with HIV has been revised. The order of the Ministry of Health, which came into force on February 19, 2024, will allow many to support themselves and their families, supporting financial independence and social development.
Balkan region
Albania
In 2024, Albania’s national REActors made significant progress in their efforts to protect and support the human rights of key populations. An operational plan to register cases in the REAct system was successfully implemented and two separate consultants were appointed to manage the process. Round tables were held for NGOs and representatives of key groups to discuss challenges in implementing human rights protection measures. Four strategic cases were recorded, three of which were resolved positively and one is still pending.
Nevertheless, some challenges remain. Strong stigmatization continues to prevent people from reporting human rights violations, and fear of retaliation prevents many from reporting to the police. Insufficient funding and human resources limit the capacity to support reported cases. Lack of trust in institutions also hinders reporting and cooperation.
Key findings of the study point to the ongoing need for advocacy and support for people living with HIV (PLHIV) and members of the LGBTIQ+ community. Unauthorized disclosure of HIV status by medical personnel remains an acute problem, along with discrimination based on sexual orientation and gender identity, which affects LGBTIQ+ people in a variety of ways, including termination of disability payments by social state institutions, loss of employment due to disclosure of HIV status, and denial of access to health services.
The immediate plans of Albania’s national REActors include developing a work plan with clear goals, timelines, and measurable outcomes, and collaborating with NGOs and affected people to obtain quality information. Also, facilitating discussions on human rights issues with politicians and community leaders, advocacy for policy change, and building alliances with human rights organizations.
Bosnia and Herzegovina
In 2023, the President of Republika Srpska (part of Bosnia and Herzegovina) announced the imminent adoption of a law on foreign agents. It could oblige all local NGOs receiving foreign funding to declare their financial transactions and activities, following the Russian and Georgian models. Attempts to adopt such a law had been made since 2015, but under public pressure and external factors, the authorities abandoned these plans. On May 28, it became known that the government still withdrew the bill on “foreign agents” from Parliament this time as well. The decision was announced by the Minister of Justice and deputy Prime Minister, but he did not give the reason. And although this issue has been closed, it should be understood that it may not last long. The adoption of such a law can seriously affect the programs of service providers and human rights organizations, as it significantly complicates their work, requiring additional reports and creating an atmosphere of distrust. This could lead to a reduction in foreign funding and services, and therefore negatively affect support for vulnerable groups, depriving them of those most in need.
In 2023 and early 2024, REActors in Montenegro often faced client complaints related to the shortage of medical staff and the inability of the health system to meet the needs of many people from vulnerable communities. A critical issue was the lack of ART, leaving patients without life-saving treatment.
For example, earlier this year, REActors received a complaint from a man about a significant delay in receiving needed treatment despite following protocol for pre-ordering therapy. The client was deprived of ART for more than ten days, revealing serious deficiencies in the medical system. REActors responded by informing him of his rights, investigating the reasons for the delay, and advising the client to make a formal complaint to the Ombudsman. This incident highlighted the need for strict adherence to medical protocols and effective communication within the health system.
Another major issue was the challenges associated with the Opioid Substitution Therapy program (OST). Earlier in the year, another client reported insufficient psychological counseling within the OST program. The man’s main complaints related to infrequent and brief sessions with the psychologist, as well as the distracting environment in the crowded waiting room. In response, REActors contacted the mental health clinic to address these concerns and offered the client access to their counseling center, providing a better environment for psychological support.
REActors in Montenegro strive to create a more favorable environment for people to seek help and solve their problems, as many of the clients are unaware of their rights and do not know how to act in situations where their rights are violated. The fear of stigmatization associated with discussing personal problems also remains a significant barrier to seeking help. Reactors are focused on finding effective strategies to promote the rights documentation system itself and to expand their services to provide timely and adequate support to community members.
Northern Macedonia
In 2024, REActors’ analysis revealed alarming trends of discrimination and human rights violations, particularly against people living with HIV (PLHIV). Recorded referrals highlight systemic problems in health facilities where PLHIV face insurmountable barriers, such as inappropriate disclosure of their HIV status and denial of necessary health services. This systemic discrimination often forces PLHIV to go to separate health facilities, maintaining stigma and preventing them from receiving comprehensive health care.
To address these challenges, REActors in Northern Macedonia have developed comprehensive initiatives. These include educating healthcare providers through training, raising public awareness to combat stigma and misconceptions about HIV, and providing legal support to effectively combat discriminatory practices. Through advocacy for systemic change and strengthening the rights of PLHIV, REActors seek to create a more equitable healthcare environment where all people are treated with dignity and impartiality, regardless of their HIV status.
Serbia
Significant progress has been made in Serbia over the past three years. Three national REActors have started work and the REAct system has been presented at two national HIV conferences. A successful lawsuit was filed against two individuals accused of disclosing personal and family information, resulting in the completion of the trial and two verdicts. Notably, 28% of cases were favorably resolved, 17% were pending, and there were two success stories and two strategic cases. A total of 46 cases were disposed of, with 11 in 2022, 24 in 2023 and 11 in 2024.
Despite these achievements, some challenges remain. Clients who report rights violations often need urgent support, including legal and psychological assistance, but there are insufficient financial resources to provide these services. In addition, motivating people to report human rights violations remains a challenge, as well as combating discrimination by the institutions that are supposed to protect citizens.
Key findings show that the highest number of reported human rights violations are related to HIV status and LGBTIQ+ issues, with the number of violations of LGBTIQ+ rights increasing. In addition, there is a notable inconsistency in Serbian laws, such as anti-discrimination and criminal laws. Many reported cases involve psychological violence, hate speech, threats, and harassment. Another acute problem is the increase in violence against women and femicide; however, women rarely seek help.
In the future, national REActors plan to strengthen advocacy work among key populations through the media and social networks, strengthen cooperation with organizations that can provide much-needed legal and psychological support, organize training on how to recognize human rights violations and how to protect against them and advocate for increased support for key populations.
The LGBTQIA+ community in Kazakhstan is going through a difficult and tense period. Late last year, a local NGO published a social video on Instagram featuring queer couples, which attracted public attention, garnering over 6,400 views. The video resonated widely, receiving both positive feedback and negative comments, many of which contained hate speech.
In May 2024, a petition entitled “We are against open and hidden propaganda of LGBT in the Republic of Kazakhstan!” appeared on the portal “E-Petition.kz”. The initiative was authored by the anti-gender group “Kazakhstan Union of Parents”, which previously actively opposed vaccination during the pandemic, as well as the law on domestic violence and tougher punishment for bullying. The petition gathered 50,000 signatures in a short period – less than two weeks – the required number for it to be considered by the Ministry of Culture and Information. The rapid mobilization of signatures raised questions, as according to eyewitness reports and screenshots, civil servants and quasi-government employees were coerced into signing the petition along with another initiative to ban gambling among officials. One queer activist noted that the surge in signature-gathering activity took place during working hours, which heightened suspicions.
After the petition was accepted for review, a working group began to form to discuss its implications. Many LGBTQIA+ activists, human rights defenders, and lawyers applied to join the group. However, according to the authorities, due to the limited submission deadline – only 10 days – and technical reasons, a significant number of applicants were not selected. As a result, of the 51 people included in the working group, more than 40 supported the adoption of the petition, while only 7 opposed it.
The first meeting of the working group was held on June 21, and the process continued through early August. At these meetings, supporters of the petition actively used hate speech and discriminatory language. Even though the petition violated several international conventions on civil and political rights, the majority of the group’s participants were in favor of its adoption.
Against this backdrop, the LGBTQIA+ community and human rights defenders mobilized. Organizations (including those with national REActors) actively assisted victims by engaging the media and international partners, as well as providing legal advice on how to file complaints and challenge the petition through administrative procedures. Although most members of the working group supported the discriminatory measures, activists and human rights defenders united to form a strong front of opposition.
The petition drew attention to the problem of discrimination against LGBTQIA+ people in Kazakhstan, becoming an important catalyst for further struggle for their rights. This story demonstrates how the unity and determination of activists can help to counter the tide of discrimination and stand up for the rights of people. While the final results of the fight are not yet known, one thing is clear – the LGBTQIA+ community is not alone, and it has strong support.
Gularus (name changed), a 40-year-old woman from Tajikistan living with HIV, faced discrimination and abuse from her family. An unemployed, divorced mother of three, she was forced to live with her parents and the families of her younger brothers. However, instead of support, she endured daily humiliation and violence that became an integral part of her life.
Gularus’ family, upon learning of her HIV status, began to insult and humiliate her systematically. They called her “AIDS patient” and called her contagious. Due to the fear of the disease and lack of knowledge about HIV, her family forbade her to have contact with her children, who in turn were not even allowed to enter her room. In addition, strict rules were imposed in the house: Gularus could not sit at the common table with the rest of the family, had to use separate dishes, and was not allowed access to the common bathroom.
In addition to discrimination, the woman was a victim of physical violence. When she asked her younger brother to use an iron, he beat her. An additional source of pressure came from her brother’s wife, who insisted on evicting Gularus and her children.
Despite the constant humiliation and violence, the woman tolerated it for the sake of her children, who were in the same environment. However, she did not know how to protect her rights and improve her family situation, so she sought help from REActors.
The REActors provided Gularus with comprehensive support. Firstly, they provided her with psycho-emotional support, which enabled her to gain the inner strength to fight for her rights. They also explained her rights as a woman living with HIV and how she could protect herself from discrimination. Gularus was invited to the organization’s office, where she received consultations with a coordinator, a psychologist, and a lawyer. The specialists also suggested that she participate in a support group where she could communicate with other people living with HIV and receive useful advice and moral support.
Although Gularus had the option of filing a report with law enforcement, she chose not to do so for fear of escalating conflict within her family. Instead, she agreed to a mediation meeting with the family with the participation of the REActorand her family members. During this meeting, the family was provided with accurate information about HIV, its treatment, and the concept of “H=H” (Undetectable = Untransmissible). This principle states that a person with an undetectable viral load taking antiretroviral therapy cannot transmit the virus to others. It was emphasized that prejudice towards people living with HIV was based on ignorance, and the family had to realize that their actions not only violated the rights of Gularus but could have legal consequences.
Special attention was paid to the need for emotional and moral support from the family. The speakers also explained that illegal disclosure of HIV status and violation of the rights of people living with HIV are punishable by law. At the end of the meeting, Gularus was given the contact information of the Women and Family Committee hotline for further support and assistance.
Although Gularus’ situation remained difficult, the first step towards resolution had been taken: her family received accurate information about HIV and began to realize the importance of changing attitudes.
12-13 June, 2024, Sarajevo hosted an important meeting of REActors from Albania, Bosnia and Herzegovina, Montenegro, Northern Macedonia, and Serbian, within the framework of the SOS 2.0 Regional Program 2022-2024, focusing on the sustainability of the HIV response in these five countries of South Eastern Europe. The event, organized by the South Eastern Europe Regional TB and HIV Community Network (SEE RCN)together with the Alliance for Public Health, brought together 40 participants, including national REActors and pre-exposure prophylaxis (PrEP) experts.
On the first day of the meeting, participants discussed the goals, objectives, and expected outcomes of the event. The REAct section provided an overview of the program’s achievements and discussed the challenges faced by the teams between 2022 and 2024. Each of the five countries presented their challenges and problem areas, followed by recommendations for improving the program at the national level. Participants also brainstormed on how to promote REAct and increase client outreach, discussed strategic cases and advocacy methods, and well as how to achieve sustainability of the REAct program in the Southeast Europe region.
At the same time, another section discussed the current situation with PrEP implementation in five countries of the region. The experience and achievements of PrEP programs over the last two years, clinical aspects of pre-exposure prophylaxis use, and the development and discussion of PrEP protocols were reviewed.
The second day of the meeting focused on discussing the progress, challenges, and plans for REAct and PrEP implementation. Representatives from each country shared their successes and challenges and provided recommendations for improvement. Fast Track Cities initiative, ARV price reduction, self-testing and decentralized testing, and social contract mechanisms were also touched upon. Each of these topics was discussed taking into account progress, challenges, and plans, with mandatory feedback from country representatives and the development of recommendations.
Victoria Kalyniuk, REAct Regional Coordinator, participated in this meeting and emphasized the importance of using REAct to improve the situation with gender barriers in the Balkans: “The country presentations and our discussions demonstrated that the use of REAct has a huge potential to overcome gender barriers in access to services for key groups. Thus, the research conducted by theEurasian Women’s Network on AIDS shows how difficult the situation remains in the region of South Eastern Europe and how important it is to implement REAct in new areas to improve this situation and ensure equal access to necessary services for all”.
The meeting concluded with final discussions and identification of the next steps. The event was an important step towards strengthening the sustainability and effectiveness of the HIV response in the South Eastern Europe region, providing participants with an opportunity to share experiences, discuss current challenges, and develop strategies for further improvements.
In the late hours of the night, Elira (name changed), a transgender girl, was walking through the area N in her city. It was a time when the streets were quiet, and the usual hustle and bustle of the city had died down. As she walked, an unknown man noticed her and approached.
Initially, the perpetrator sought sexual favors from Elira. When she refused, the situation quickly escalated. The man’s demeanor changed, and he began to threaten and intimidate her. His words and actions were so severe that Elira was left in a terrible emotional state, visibly shaken and distressed.
Recognizing the seriousness of the incident, Elira reached out for help, and her case was promptly taken up by the REActors. The incident details were meticulously documented. The case is currently being resolved, with the REActors working diligently to ensure that Elira receives the justice and support she deserves.
This incident highlights the dangers and emotional trauma that LGBTIQ+ individuals, like Elira, can face simply for being themselves. It underscores the urgent need for greater protection, support, and awareness to ensure the safety and well-being of vulnerable communities in our society.
Aleksandar (name changed), from North Macedonia, who is living with HIV and has an undetectable viral load due to antiretroviral therapy (ART), was referred to a gastroenterohepatology clinic because of long-standing gastritis problems.
During the initial consultation, the gastroenterologist took Aleksandar’s medical history and determined that a colonoscopy was necessary to investigate his gastritis issues further. However, when Aleksandar informed the doctor about his ART regimen and undetectable viral load, the doctor reconsidered and decided to prescribe oral medication instead. The doctor suggested that it would be better to attempt to resolve the problem with tablets first. He advised Aleksandar that if the tablet therapy did not help within a month, then a colonoscopy would be required. The doctor pointed out that a colonoscopy could not be performed at their clinic because of Aleksandar’s HIV status. Instead, he recommended that the procedure should be done at the Infectious Disease Clinic, citing that such interventions had been performed there in the past.
After a month of tablet therapy, Aleksandar’s symptoms persisted. He was informed that the Infectious Disease Clinic no longer performed colonoscopies. Faced with this situation, Aleksandar decided to undergo a colonoscopy at a private health facility without disclosing his HIV status.
At the begining of the year, REActors received a complaint from Luka (name changed) regarding the insufficient psychological counseling provided in the OST program. Luka’s primary concerns were the infrequent and brief sessions with the psychologist, along with the distracting environment in the overcrowded waiting area. He believed these conditions detracted from the quality of care he was entitled to.
Following up on Luka’s complaint, REActors’ team collaborated with the psychiatric clinic to evaluate the situation. The clinic’s psychiatric staff acknowledged the operational difficulties, noting the challenge of serving a large client base while ensuring personalized psychological support.
To address this issue, REActors offered Luka access to their counseling center, associated with the day center forpeople, who use psychoactive substances. This solution ensures that Luka receives the necessary psychological support in a more conducive environment, coordinated with the psychiatric clinic, thereby providing a tailored approach to meet his needs within REActors’ service framework.
Lyubov (name changed) is a woman living with HIV who used to inject drugs in the past. She is in a civil marriage with a man who is also HIV-positive and has a history of substance use. Both are patients of the OST program. On their way home from the drop-in center, where they had received self-administered medication, the couple was stopped by police officers. They began to humiliate them, treat them rudely, pick their pockets, and search them without any reason.
Although the clients informed the police that they were taking OST and showed all the necessary documents, no one listened to them, and the couple was taken to the police station. The woman called the organization. Upon hearing about such illegal actions of the police, the REActor and a social worker of the organization came to the defense of the couple. They contacted the police by phone with the doctor who had prescribed the drugs. The doctor explained that everything was legal and that the patients had no problems with taking the drugs. After that, the couple was released.
After coming to the organization with words of gratitude, the client refused to seek legal assistance because she did not believe that the police officers would be punished. She was also offered counseling by the organization’s psychologist and group training to restore her psycho-emotional state.
This story happened to Madina (name changed), a young woman, 40 years old, a representative of the community of people living with HIV, working in a store. One of her colleagues, having learned about her positive HIV status, started spreading the information among all employees. Soon the store manager found out about it and decided to fire Madina without paying her money, claiming that she could have infected everyone during her work.
The woman sought help from a REActor who provided her with counseling, after which she decided to write a statement complaining about the unjustified dismissal. The REActor together with a police officer gave a preventive talk to the store manager and staff about people with HIV status. As a result, the management paid all the money due under the contract.
Madina decided not to return to her previous job and found a new one. This case shows the importance of determination in fighting for one’s rights and against discrimination.
An incident that occurred last year and had a continuation in early 2024 related to Aruzhan (name changed). They are 21 years old, non-binary person, LGBTIQ+ activist. A university student saw Aruzhan’s recent posts regarding their civic activities and the attacks associated with them. This student, who was part of a group that had previously cyberbullying and threatening Aruzhan with violence because of their participation in a Pride Flag community event, began posting insults and threats again in a closed group on Telegram under an anonymous nickname.
The insults included derogatory terms and phrases, as well as threats of violence, such as “I’m itching to smack him in the back alley”. Aruzhan’s friend who was a member of the group forwarded screenshots of the messages. The client, despite the fact that they were now out of the attacker’s reach, were very worried about their safety and feared that they might be found and harmed.
This situation is an example of cyber-bullying and threats that violate the human rights to safe existence and protection from discrimination, in particular against LGBTIQ+ persons, and can also have significant psychological and physical consequences.
To protect their rights, Aruzhan sought the help of REActors. In response to the threats and cyberbullying, the REActors prepared and wrote a complaint to the university administration. Cyberbullying and threats of violence are prohibited by law and should be prosecuted. It is important that educational institutions and other institutions protect their students from such actions and create a safe environment for all, regardless of their gender identity and sexual orientation.
Alisa (name changed) contacted the National REActors by phone, asking for help because she was feeling unwell due to substance use. After speaking with the girl, it was recommended to call an ambulance for medical services. On the advice of the REActors, her boyfriend called the paramedics. However, instead of providing prompt assistance, police officers arrived and started to draw up a protocol. As a result, Alisa was fined 1500 lei (85 USD). To her indignation and explanations about her inability to pay the fine, the police officers replied that they could have issued a fine of 5000 lei (284 dollars).
In this case, REActors filed a complaint with the Equality Council to establish discrimination. As a result, the situation was resolved in favor of the client, the fine was challenged and Alisa was exempted from paying it.
This case highlights the need to raise awareness of the rights of key groups and the importance of standing up for their rights regardless of pressure.
This case raises important questions about professional ethics, equality, and respect for every patient, regardless of their medical status.
Artur (name changed) addressed the national REActors of Azerbaijan. His story began with an ordinary visit to the dentist, which turned into a series of unpleasant events. The man went to the dentist because his tooth had broken. He hoped for quick and quality help. The doctor took measurements and explained that the only would be ready in a few days. Arthur made an advance payment for the work.
A few days later, the man returned for the finished clay. To his surprise, the dentist said that it was ready, but refused to install it. The reason why the dentist did not want to complete the work was the following: while waiting for the only to be ready, Artur shared with him that on a particular day, he needed to pick up his ART because he was a representative of the community of people living with HIV. The man tried to return the money, but his requests were ignored and he was chased out of the office. In desperation and not knowing where to turn for justice, Artem decided to tell his story to the national REActors of Azerbaijan. The case was taken up by them to achieve justice and solve the client’s problem.
In January 2024, REActors received a complaint from Mateo (name changed) regarding a significant infringement on his right to access necessary treatment. Despite adhering to the protocol for early medication requisition at the designated pharmacy, Mateo was deprived of his essential ART for over ten days.
The gravity of this situation is underscored by the fact that Mateo had requested the medication a week in advance, yet it was not provided on time. REActors’ immediate response involved educating Mateo about his rights and the measures available to protect those rights in such scenarios. It is imperative for patients undergoing critical treatments like HIV therapy to be knowledgeable about their rights.
REActors also launched an independent investigation to ascertain the causes behind the medication delay. Their goal was to collaborate with pharmacy staff and relevant authorities to prevent such issues in the future. In Montenegro, HIV therapy distribution is centralized through a single pharmacy, which is staffed with trained professionals.
Mateo was then advised to file a formal complaint with the ombudsman for patient rights. This step is crucial in addressing such issues and improving healthcare service delivery. This incident highlights the importance of strict adherence to medical protocols and clear communication between healthcare providers and patients. Timely delivery of medication is vital for patients, emphasizing the need for effective resolution mechanisms within the healthcare system.
Zaira (name changed), a 28-year-old woman living with HIV, approached the national REActors on the recommendation of a friend who had heard about their work through social media. The friend said that all services, including legal counseling, were free of charge.
In 2021, Zaira and her friends went to Russia to earn money. She got a job in a bakery and at the same time prepared documents and took the necessary tests. A few days later, she was called to work and informed that she had HIV and was asked to leave the workplace. Zaira planned to go home, but instead, she moved to another city and started working illegally, not believing in her diagnosis.
In the end of 2023, while returning to N, she was told at the airport in Russia that she was deported for life. This news greatly upset Zaira. She shared her situation with a friend who advised her to contact REActor to consult with a lawyer.
After the woman told her story, the REActor provided her with psycho-emotional support and explained what the organization does and what services are provided. She also talked about HIV and AIDS, how the virus is transmitted, and the legal and psychological services available.
The REActor explained to Zaira that she had violated Russian law by not leaving the country promptly and was working illegally, which could have influenced the decision to deport her for life. She also noted that working in a bakery, where there is contact with sharp and cutting objects, could have put herself and others at risk.
The REActor then brought in a lawyer who discussed her legal situation with Zaira. He explained in detail that according to Russian law, migrant workers living with HIV cannot work or stay in Russia. Although this information upset the woman, she expressed her gratitude for the counseling and understanding of the situation. Zaira was also offered further psychological support and possible ways to resolve legal issues related to her status and future employment.
Yegan (name changed) wrote to the National REActor about a disturbing situation that happened to his friend. The guy went to the Republican Hospital to take tests before his nose surgery. He is from a community of people who inject drugs (PWID) and while drawing blood, the nurse noticed a blackened vein on his arm. She immediately asked if he was using drugs and the guy, trusting the health worker, answered in the affirmative.
While the blood results were still pending, the patient was sitting in the hallway. Suddenly he was approached by two police officers who, twisting his arms, took him to the station. It turned out that a nurse had called the police and informed them that a man from the PWID community was in the hospital. Yegan said his friend had been arrested and for over ten days at the time of contacting REActors, no information on his condition and whereabouts had been given to him. The case has been accepted for work.
This story highlights the serious violations of patient rights and the unacceptable disclosure of personal medical information. That a nurse felt able to call the police based on a patient’s medical information is a blatant example of ethical and confidentiality violations. Trust in medical personnel is the basis for receiving quality care, and cases like this undermine that trust.
Egan’s friend’s situation also points to the need for reform in the way people who use drugs are treated. Instead of prosecution and arrest, they should be offered medical care and support. Violation of patients’ rights and undue interference of law enforcement agencies in medical issues require attention and solution at the state level.
The situation happened to Elmira (name changed), a 25-year-old woman from a community of people who use drugs. Her life circumstances were such that she started with light substances, but soon moved on to heavier ones, and this led to addiction. A turning point in her life was the tragic death of her lover from an overdose – this made Elmira decide to stop using. Elmira turned to a REActor. Understanding her desire to quit drugs and change her situation, he helped her access opioid substitution therapy (OST) at the Republican Narcology Center (RNC). With REActor’s support, Elmira began her treatment journey.
The initial stages of treatment were incredibly challenging for Elmira. However, with perseverance and the support of the medical professionals at RNC, she managed to stabilize her condition. Her commitment to the program and the structured support it provided were crucial in helping her navigate the difficulties of withdrawal and recovery.
Today, Elmira stands on the threshold of a better life. She has found employment and has mended her relationship with her parents, rebuilding the connections that had frayed during her years of addiction. Elmira’s journey to recovery highlights the profound impact of access to effective treatment and support systems. Her story is a beacon of hope for others struggling with similar challenges, demonstrating that with the right help, it is possible to overcome addiction. Her story is a powerful testament to the transformative impact of OST and the comprehensive support offered by REActor and the NGO Struggle Against AIDS (SAAPU).
Natalia (name changed) appealed to the documentarian with a complaint against an oncologist who refused to provide medical services. The woman said that she had been referred by her doctor to an oncology clinic for examination, having an electronic referral. At the oncologist’s appointment, she verbally informed him of her HIV-positive status. The doctor refused to conduct an examination and recommended that she see a doctor at the AIDS Center.
The REActor met with the deputy chief physician to discuss the violation of her client’s rights to medical care by the hospital staff member. After listening to the situation, the deputy agreed that the patient’s rights had been violated and had a conversation with the oncologist. After that, Natalia made an appointment for a second visit.
At the appointment, the oncologist conducted the necessary examination and testing. The client received the necessary medical care, which she was initially denied, and can now continue her treatment according to the established plan.
