On November 30, 2023, a meeting was held to discuss issues on mandatory social health insurance (MSHI) from community representatives with representatives of the Non-Public Joint Stock Company “FSMS” and the Drug Policy Department of the Ministry of Health of the Republic of Kazakhstan.
During the meeting, topical topics and issues related to compulsory health insurance, namely:
– lack of possibility to take tests and perform abortion without paying for MSHI.
– access of people who use drugs to the guaranteed volumes of free medical care and diagnosis of diseases among citizens in prison.
The appeals gathered through the REAct tool were used during one of the presentations on barriers to accessing health services for people who inject drugs.
The participants of the meeting were able to express their opinions and share their experiences in this area. This allowed to creation of an atmosphere of open dialog and mutual understanding between different stakeholders.
Representatives of the NAO “FSMS” and the Drug Policy Department of the Ministry of Health of the Republic of Kazakhstan presented their positions and answered the questions of the meeting participants. Special attention was paid to the issues of accessibility and quality of medical care for people from key population groups.
The participants of the meeting discussed possible ways to improve the system, a good proposal was to introduce an “insurance amnesty” for people undergoing long-term treatment and rehabilitation.
In general, the meeting was very useful and productive for all participants. Different points of view were expressed, common ways of cooperation were found and actions to improve the system of compulsory health insurance were defined. This allows us to hope for positive changes in this area and improve the availability and quality of medical care for all citizens of the Republic of Kazakhstan.
The event was organized by the Association of Legal Entities “Kazakhstan Union of People Living with HIV”.
On November 16, World Tolerance Day is commemorated globally, a day that holds special significance for the National Trans Coalition Human Rights NGO (NTC) as it coincides with the organization’s anniversary. Under the theme “Celebrate diversity!”, this year’s event convened approximately 200 representatives from state institutions, diplomatic missions, international and local organizations, communities, and various stakeholders.
The commemoration began with welcoming speeches and congratulatory notes, followed by the NTC team presenting the organization’s accomplishments over the past year. They shared the annual report, highlighting statistics on human rights violations, instances of stigma and discrimination, as well as cases of violence stemming from intolerance. After the formal segment of the event, participants engaged in treatment sessions, free-flowing conversations, and discussions.
The primary focus of NTC remains the eradication of intolerance directed towards trans*, non-binary, and gender-diverse individuals in Armenia. As the organization celebrates another year of resilience, unity, and solidarity, they take a moment to reflect on those lost, acknowledging their strength in the face of adversity. A firm commitment is made to combat transphobia, aspiring to contribute to the creation of a better, safer, and more inclusive world for everyone.
Expressing gratitude for the journey thus far, the NTC remains steadfast in its dedication to the cause and a home for many.
TOC (Association for sustainable communities development) in cooperation with the Center for Social Work from Zaječar in the previous period worked on solving the problem of treating an HIV positive patient, a beneficiary of this Center.
At the invitation of the Center for Social Work, a meeting of this institution and the TOC team was held on the topic of solving the problems of their beneficiary. On that occasion, it was explained by the representative of the Center for Social Work that they had a beneficiary who had attempted suicide and that during treatment and rehabilitation of injuries in the hospital, this beneficiary found out his HIV status. Given that the health institutions tried to provide only basic help to the patient and then let him go to home treatment, the Center for Social Work contacted the TOC team with the idea that this user should first receive adequate HIV therapy and then appropriate housing. In cooperation with the Infectious Disease Clinic of the Clinical Center Kragujevac and the Health Center Zaječar, this person was prescribed adequate therapy and the treatment process began. Before the therapy itself, in cooperation with the Center for Social Work and the doctors of the infectious department of the Health Center Zaječar, the TOC team conducted a voluntary confidential counseling service, during which a conversation was held with the clientabout the importance of applying antiretroviral therapy for HIV.
After medical care, the Center for Social Work worked to provide adequate accommodation for this beneficiary, given that he has no family and would remain on the streets after recovering in the hospital. He is currently in the gerontological center in Niš, where he will be provided with all necessary care. The TOC team worked to provide adequate and necessary HIV therapy, which the beneficiary regularly receives under medical supervision. Through regular communication with the Infectious Diseases Clinic of the University Clinical Center Niš, on whose territory the beneficiary is currently located, TOC works on the continuous procurement of antiretroviral drugs for HIV necessary for the beneficiary’s further treatment. The Center for Social Work has recognized TOC as a safe partner that can be turned to to adequately help its beneficiary, and in connection with the treatment of HIV infection.
In the world of medicine, despite the high standards of professionalism imposed, there is
sometimes a problem of stigmatization by healthcare providers towards their patients, especially those from key populations. This internal stigma can manifest itself in the form of biased opinions, lack of empathy, avoidance, and even disclosure of confidential information. Such behavior constitutes moral violence against the person seeking help and should not go unnoticed or unpunished. Before International AIDS Day on December 1, it is particularly important to remember that stigma creates barriers to effective prevention and treatment, and prioritizing efforts to overcome it (including within the medical community) and create a more supportive environment for all is a key factor in achieving the 95-95-95 goals.
Gulmira (name changed), a client living with HIV, went to give birth in a maternity hospital. However, from the very beginning, she encountered an unpleasant attitude on the part of medical staff.
Upon arrival at the facility, she had to repeatedly explain that she was not from a community of people who use drugs and was not a sex worker and that she did not have such friends. But this did not change the situation. During labor, the midwife said that people like Gulmira, «…get sick and give birth to disabled people». And when the process of stitching up after a cesarean section was underway, she told Gulmira: “God forbid you to twitch and I’ll inject you, you’re gonna be in a lot of trouble! I’m tired of running to take tests after people like you”. It was insulting and humiliating. While being transferred to the ward, Gulmira noticed the unkind and curious looks of the nurses. These four days in the maternity ward seemed to her as if she was in some kind of Kunstkammer.
Together with a doctor from the AIDS Center, the REActor decided to intervene. They went to the maternity center and educated the head of the ward, recalling Article 76 of the Code of the Republic of Kazakhstan “On the Health of the People and the Health Care System”, which guarantees the protection of citizens from any form of discrimination and stigmatization due to the presence of any disease.
The REActor also conducted a preventive talk with the medical staff on the topic of stigma and discrimination against people living with HIV. She emphasized the importance of understanding, supporting, and treating every patient impartially, regardless of their HIV status.
This story emphasizes that stigma and discrimination in healthcare settings can seriously affect a patient’s physical and emotional well-being. The intervention of the REActor and the AIDS Center doctor helped to change attitudes and create a more supportive environment for Gulmira and other people living with HIV.
The role of judges in addressing critical health and social issues is pivotal. The justice system can either hinder or facilitate social and public health efforts to ensure equitable healthcare, ultimately contributing to the achievement of universal health coverage with inclusivity. The establishment of an independent, impartial, accountable, and professional judicial system, coupled with the protection of fundamental rights, is increasingly becoming a focal point of discussion in regions where certain countries are aspiring to join the European Union.
The EECA Judges’ Forum on HIV, Human Rights, and the Law, scheduled for November 27-28, 2023, in Chisinau, Moldova, presents a significant platform for discussing crucial issues backed by the United Nations Development Programme (UNDP). REAct, as an instrument dedicated to human rights, has compiled data shedding light on the judicial system’s role in addressing key challenges.
Legal hurdles:
Between 2019 and 2023, over 20,000 appeals related to human rights violations among key populations were documented in 14 countries of the region. However, only 0.5% of these appeals found resolution through legal proceedings, emphasizing the challenges in accessing justice. Bureaucratic complexities, financial difficulties, and a lack of trust in the justice system contribute to victims refraining from defending their rights.
Barriers to accessing justice:
Victims face obstacles due to complexities in the state-guaranteed free legal assistance system, with issues such as lack of interest, bribery, and the absence of state-appointed lawyers during investigative actions. Courts’ tendencies to side with the prosecution in cases involving vulnerable populations deter victims from pursuing justice. Moreover, court bailiffs, particularly in Kyrgyzstan, are ineffective in collecting alimony, impacting women, who constitute 95% of victims in such cases.
HIV criminalization: situation analysis:
The disclosure of HIV status, and in Uzbekistan, sexual orientation, can trigger criminal cases, irrespective of intent or adherence to antiretroviral therapy (ART). Investigations often violate privacy rights, with statements coerced under pressure from law enforcement. In Tajikistan, 40 appeals under Article 125 were received, resulting in limited positive outcomes, and Uzbekistan, one trial led to a two-year imprisonment despite legal support.
Advocacy for HIV decriminalization:
Efforts toward HIV decriminalization have gained momentum. In 2022, an alternative report to CEDAW on Uzbekistan recommended repealing laws criminalizing HIV. In 2023, draft laws proposing legal changes to reduce criminalization are being developed in Kazakhstan, Georgia, Uzbekistan, and Kyrgyzstan. These include repealing specific articles and transferring offenses to the framework of general crimes, reflecting a strategic shift.
Future actions:
Looking ahead to 2024, these proposed legal changes will be submitted for public consultation, involving high-level discussions and negotiations with parliamentary members, ministries, and ombudsmen. The aim is to progressively reduce the criminalization of people living with HIV and key populations, fostering a legal environment that aligns with human rights principles.
Drug use criminalization: situation analysis
Law enforcement often uses unrelated articles like “breach of public order” to pursue people, who use drugs, leading to unjustified criminalization. Russia’s repressive drug policy extends its influence to regions like Transnistria, where cases of criminalization without intent to sell have been recorded.
Drug use decriminalization: advocacy and progress
Efforts toward drug use decriminalization have gained momentum. In 2022, the EECA Commission on Drug Policy (ECECACD) initiated its work, outlining guiding principles for effective and humane drug policies. In 2023, Kyrgyzstan, Georgia, and Moldova developed drug policy road-maps, focusing on repealing specific articles and introducing alternatives to punishment. High-level country visits facilitated progress in Lithuania, Kyrgyzstan, and Moldova, while an OHCHR report in 2023 highlighted drug use challenges in the region.
Same-sex criminalization and discrimination
Instances of discrimination persist, such as classifying a same-sex kiss as disorderly conduct in Uzbekistan and persecuting gay men in Tajikistan. A violent attack on a trans* woman faced judicial denial in Kazakhstan. Responses include case submissions to OSCE, alternative reports, and statements on LGBT discrimination in Central Asia during the High-Level Political Forum on Sustainable Development.
Sex work criminalization: uncovering injustices
In Kyrgyzstan, despite sex work not being criminalized, sex workers face pursuit, fines, and detainment for non-compliance or disorderly conduct. Extortion is prevalent, with 314 appeals reporting bribes by local police officers. In Uzbekistan, sex work is considered an aggravating circumstance, leading to severe sentences. Detentions involve compulsory HIV and STI testing, often with the purpose of extortion. Crimes involving sexual assault against sex workers, especially by police officers, are challenging to bring to court due to the lack of necessary infrastructure and the difficulty of proving allegations.
Women in focus: addressing sexual assault challenges
Crimes involving sexual assault, particularly when the victim is a sex worker and the perpetrator is a police officer, pose significant challenges in Central Asian countries. The absence of ratification of the Istanbul Convention further compounds these challenges.
Conclusion and next steps:
The data presented by REAct at the EECA Judges’ Forum highlights the pressing need to confront legal obstacles, champion HIV decriminalization, and foster a justice system that protects the rights of individuals and key populations grappling with HIV.
Examining the intricate legal challenges across the EECA region underscores the necessity for a holistic strategy. Advocacy initiatives for drug use decriminalization, combatting discrimination, and ensuring justice for vulnerable groups must persist as overarching priorities. Looking ahead to 2024, the emphasis should shift toward enacting legislative changes aimed at diminishing criminalization across diverse spheres. This approach aims to cultivate a legal landscape that not only adheres to human rights principles but also champions inclusivity.
Zurab (name changed) from Georgia is a participant in a methadone program that supports people with drug dependence problems. For the past four years, Zurab has been actively using the services of a local nongovernmental organization (NGO) that provides this service. One day he found himself at the service center in the company of two of his friends, where they received the necessary assistance as well as consumables from social workers. The beneficiaries were given cards with unique codes and the logo of the harm reduction network, as well as the addresses of the service centers.
A few blocks later, however, Zurab and his friends were stopped by police. Demanding to check the contents of their bags, the police conducted the incident right on the street, using insulting words and physical violence against all three of them.
The problem arose over an ampoule of naloxone, a life-saving medication to prevent overdoses. Zurab explained its purpose, but the police officers did not understand the situation. The man asked to call a social worker, who was also a REACTOR.
Within hours of Zurab’s arrest, the paralegal was contacted, arrived on the scene promptly, and provided detailed information about naloxone. Thanks to the paralegal’s efforts, Zurab was released.
Zurab’s story highlights not only the importance of methadone programs in Georgia but also the need for law enforcement to be trained in harm reduction. The story of this case underscores the difficulties that can arise in the daily lives of participants in such programs and the urgent need to protect their rights and health.
In 2023, 20 cases were reported in Uzbekistan of people living with HIV being suspected, questioned, and prosecuted under Article 113 of the Criminal Code. Most of these cases are successfully resolved due to the active participation of stakeholders in the pre-trial investigation. However, one particular case stands out as a court decision that raises serious questions about fairness and respect for human rights.
This controversial case involves the prosecution of Lola (name changed) under Article 113 of the Criminal Code of the Republic of Uzbekistan, which involves willful HIV infection. The client insists on her innocence, denying the existence of sexual contacts that, according to the prosecution, could have led to the infection.
Pressured by the district police officer, Lola claims that he forced her acquaintance to sign a statement about a sexual encounter. The friends were physically assaulted, which was a factor in the conviction. The client exercised her right to counsel and was provided with friendly counsel for her defense.
The negligent investigation and trial resulted in the court failing to consider all of the evidence of innocence presented by Lola and sentencing Lola to two years in a general population facility.
REActors took Lola’s case, providing her with professional legal assistance. After the appeal, the client was referred to an experienced lawyer who carried out the necessary investigative measures. Nevertheless, the court did not take into account the evidence collected, which creates grounds for reconsideration of this decision.
Lola continues to fight for her innocence, seeking legal defense and hoping for a review of the court decision. This case raises important questions about justice, respect for human rights, and the need for careful consideration of each case, especially in the context of infectious diseases, where allegations can have serious consequences for the lives and freedom of people living with HIV.
Ashot (name changed), who had been living with HIV for four years and was on antiretroviral therapy (ARV), went to a dental clinic to get implants. He chose this medical facility because it was considered one of the best in the city.
At the consultation with the doctor, Ashot discussed his plans and they agreed on subsequent visits to the clinic. After the consultation, the client was promised a questionnaire. In the process of filling out the questionnaire, Ashot indicated “YES” to the question about HIV infection.
However, the next day, Ashot was refused treatment, namely implantation. An employee of the clinic informed him over the phone that implants are not performed for “patients with AIDS”. This statement became the basis for Ashot’s appeal to the NGO New Generation.
REActors from the NGO New Generation accepted Ashot’s case. A paralegal representing the organization contacted the clinic, introducing himself as a client who wanted to have a tooth extracted. During the conversation, he specified that he was a member of the community of people living with HIV. In response, he was told to report in person to the medical center.
The REActor then forwarded the case to the organization’s lawyer, who is currently investigating the case. New Generation is committed to addressing this discriminatory situation and supporting the rights of people living with HIV.
The case is currently under investigation and the organization’s lawyer is actively working to resolve the case. REActors are also providing support to Ashot in the process of litigation and protection of his rights.
New Generationemphasizes that discrimination based on HIV status is unacceptable and contrary to the principles of equality and human rights. The organization will continue its work to protect the rights and interests of people facing discrimination in the medical field.
Zeinab’s (name changed) story is just one of many such cases. Married at seventeen, she faced difficulties when her husband left for Russia, leaving her alone with a child and no means of livelihood. Attempts to get support from her parents proved futile, and Zeinab was forced to turn to sex work. When her landlord found out about her activities, he demanded that she move out.
It was at this point that REActors intervened after hearing about the situation from other sex workers. Working with the NGO Clean World, they organized a shelter for Zeinab and her child, providing not only shelter and food but also free services for victims of domestic and sexual violence. A lawyer was engaged to resolve the eviction issue. Despite the lack of a lease, sanctions against the landlord were not possible.
Zeinab also began vocational training aimed at her eventual reintegration into society. The shelter provided her with the opportunity to acquire the skills needed to live independently. Despite her difficulties, she remains hopeful for a brighter future.
The challenges facing women in Azerbaijan are often related to early marriage, limited access to education, and high unemployment. Involvement in sex work becomes a frequent response to these factors. It is therefore important to continue to fight for women’s rights and provide support and alternatives for those who want to change their lives. The intervention of NGOs and REActors undoubtedly plays a key role in this process.
Sylvia (name changed) discovered her HIV-positive status during pregnancy. A visit to her family doctor turned into an unpleasant experience for her, with medical staff discriminating and stigmatizing her. Instead of support and professional help, she was given incorrect information about HIV infection, which only increased her fear and anxiety.
In addition, she was forcibly sent for an abortion, which was a difficult experience for her. Following this event, the woman was referred to a specialized medical facility for hospitalization and to receive antiretroviral therapy (ART), which is necessary to maintain her health and prevent HIV transmission.
The response to the incident was swift and decisive. The case was referred to a legal expert and an application to the Equality Council was being prepared to punish those responsible and prevent similar situations in the future. However, Sylvia encountered resistance from her spouse and they decided not to pursue the case to a conclusion.
At the moment, the client continues to struggle not only with HIV, but also with the self-stigma caused by the events. She finds support in specialized organizations and works with the help of professionals to overcome her fears and doubts. Her story is a reminder of the importance of tolerance, professionalism and solidarity in the medical field.
In a world where the right to education is paramount, there are times when exceptional circumstances test the limits of compassion and flexibility within the educational system. The story of a 14-year-old girl with disabilities and her unwavering determination, combined with REActor ‘s intervention and an exceptional decision by the school board, is a success story that exemplifies the triumph of resilience and compassion in the face of adversity.
The mother of a 14-year-old girl, an excellent student, found herself in a challenging predicament. Her daughter had spent a considerable amount of time in the hospital due to chronic illnesses, causing her to miss a significant number of school days. Faced with the legal consequence of grade repetition due to her daughter’s extensive absences, the desperate and frustrated mother turned to REActor for support and assistance. REActor understood the unique circumstances of this case and recognized the girl’s fundamental right to education. He proposed a solution to the mother: to approach the school board and request an exception based on the extraordinary circumstances.
The school board convened to discuss the case, and what followed was a significant decision that would have a positive impact on the girl’s educational journey. The school board decided to allow the girl to attend online classes prepared by her teachers. This innovative approach, a first for the school, would enable her to keep up with her studies and take her exams, all from her hospital room.
This groundbreaking decision to make online education mandatory was initiated by REActor’s advocacy. It not only secured the girl’s access to education but also pioneered an innovative educational approach previously unexplored by the school.
This success story underscores the importance of recognizing and upholding the fundamental right to education for every child, regardless of their circumstances. It showcases the flexibility and compassion that the educational system can demonstrate when faced with exceptional challenges.
This case is a prime example of how considering exceptional cases and thinking outside the box can lead to remarkable outcomes. It serves as an inspiration for educators, parents, and policymakers, emphasizing that, in the pursuit of knowledge and education, compassion should always have a place.
On October 23, 2023, an important event was held in the Republic of Tajikistan – a meeting of the technical working group on monitoring and evaluation in the field of HIV/AIDS, tuberculosis, and malaria prevention. The main objective of the event was to review in detail the implementation and scale-up of the Community-Led Monitoring (CLM) method in the country with the participation of community-based organizations.
This important meeting was attended by key representatives and decision-makers working to improve the quality and accountability of programs aimed at combating HIV/AIDS and TB in the Republic of Tajikistan. Mr. Avgonov, Executive Secretary of the National Coordination Committee for AIDS, Tuberculosis, and Malaria, shared important reports and initiatives.
In addition, presentations were given at the meeting, including “Overview of community monitoring and current status of CLM implementation in Tajikistan” by Ms. Boltaeva, Consultant. The results of the Tajik Network of Women Living with HIV regarding CLM implementation were also presented by Ms. Khaidarova.
It should be noted that this meeting focused on the introduction and expansion of the CLM method in the Republic of Tajikistan. This method, based on the active participation of community organizations, plays an important role in monitoring and evaluation of HIV/AIDS, tuberculosis, and malaria prevention programs and is a priority for the development of the strategy to combat these diseases.
This technical working group meeting provided a unique opportunity for participants to discuss topical issues and share experiences in the fight against HIV/AIDS, tuberculosis, and malaria in Tajikistan. The focus on the introduction and expansion of the CLM method emphasized the importance of the involvement of community organizations in this process and the development of strategies for future actions in this area. These efforts are expected to contribute to improved results and increased effectiveness in the fight against HIV/AIDS, tuberculosis, and malaria in the Republic of Tajikistan.
Pre-exposure prophylaxis (PrEP) is a groundbreaking biomedical HIV prevention strategy that has the potential to significantly reduce the transmission of HIV among key populations at high risk. While PrEP offers great promise, it is essential to examine its implementation in the context of human rights and address the unique challenges faced by key populations in accessing this vital preventive tool in our region.
PrEP and Human Rights:
The Right to Health: Access to PrEP is a fundamental component of the right to health. Governments and healthcare systems must ensure that PrEP is affordable, accessible, and available to all individuals at risk of HIV infection.
Non-Discrimination and Equality: Stigma and discrimination against key populations, including men who have sex with men, sex workers, transgender individuals, and people who inject drugs, must be addressed. These populations are disproportionately affected by HIV and should not face discrimination when seeking PrEP.
Informed Consent: Ensuring informed consent is crucial when providing PrEP. Individuals should be fully informed about the benefits, potential side effects, and the importance of adherence to PrEP regimens.
Looking through the lens of REAct’s work, we see the following trends in issues related to access to PrEP:
– Clients are afraid to request PrEP due to the risk of disclosure of sexual orientation.
– Awareness c availability at the community level is low.
– Receiving of PrEP within state institutions is complicated:
Case: Georgia. The REActor referred the beneficiary A. (name changed) to the PrEP program, and he went to the doctor. A. had to wait for a long time and doctor still couldn’t receive a patient. He called him for the next day but couldn’t get him either. А. called the REActor and asked for help. The paralegal accompanied him to another doctor, the client received a consultation the same day and joined the program.
– PrEP associated with MSM:
Case: Kazakhstan. The client C. (name changed) approached the HIV Center to obtain PrEP. However, since he did not disclose that he was engaged in sexual activity with men, the medical staff refused to provide the medication, stating that C. “does not fall into any target group.” At the same time, according to the clinical treatment protocol for HIV in Kazakhstan (No. 180 of March 17, 2023), one of the grounds for providing PrEP is a client’s request for it.
The REActors submitted a complaint addressed to the Director of the HIV Center, the Director of the Kazakh National Center for Dermatology and Infectious Diseases, and the Head of the city’s health department. With this complaint, the client met with the Head of HIV prevention at the HIV Center. After the discussion, the Head of HIV prevention agreed with the arguments presented in the complaint, and C. received PrEP on the same day.
– Availability of PrEP for migrants:
Case: Bosnia and Herzegovina. In August 2023, the REActor was contacted by a foreign citizen N. (name changed) inquiring about the possibility of HIV, hepatitis B, and C testing and where it could be conducted. REActor directed him to the nearest Voluntary Counseling and Testing (VCT) center. However, N. explained that he had already contacted them previously and faced language barriers while communicating with the medical staff. Moreover, they refused to conduct the tests, citing the reason that being a foreign citizen made him ineligible. Additionally, when N. asked if he could obtain PrEP in Bosnia and Herzegovina, they informed him that PrEP was not available anywhere in the country. REActor clarified that the information provided by the VCT medical staff was inaccurate. He assured the foreign citizen that testing could be performed regardless of nationality, and it was free and anonymous. He also mentioned that Partnerships in Health had facilitated the import of PrEP, and N. could receive it after completing the necessary tests. The REActor contacted the Infectious Diseases Department of the Clinical Center in Tuzla, explaining the situation to the foreign citizen. A testing appointment was scheduled, and all arrangements were made with the medical staff for testing, counseling, and the provision of PrEP. The client was informed about the scheduled appointment. N. asked the REActor if he could bring another person along, so the REActor arranged another appointment accordingly.
What can be done shortly to eliminate the crucial barriers?
• Cost and Affordability: The cost of PrEP can be a significant barrier to access. Advocacy is needed to reduce the cost and make PrEP affordable through insurance or government subsidies.
• Healthcare Provider Knowledge: Many healthcare providers may lack awareness or understanding of PrEP. Training and education are essential to ensure accurate information is provided.
• Supply Chain and Distribution: Ensuring a consistent supply of PrEP, especially in resource-limited settings, can be challenging. Addressing supply chain issues is crucial.
• Adherence and Follow-up: PrEP is most effective when taken consistently. Providing support for adherence and regular follow-up is essential for its success.
PrEP is a groundbreaking tool in the fight against HIV, but its successful implementation must consider human rights, the unique needs of key populations, and the elimination of barriers to access. Advocacy, education, and policy changes are essential to realize the full potential of PrEP in reducing the global HIV epidemic while upholding the rights and dignity of all individuals.
One summer day in the life of Karine (name changed), an event occurred that was a testament to her courage. Karine, a trans woman, activist, and employee of the NGO New Generation, was working to provide HIV testing and counseling. However, she faced a challenge that she had to take on.
While doing her job, Karine was attacked by a stranger. The man, possibly after learning that Karine was a trans woman, began to insult her and interfere with her HIV prevention activities. Despite the aggression and threats, the NGO New Generation staff decided to keep their cool and leave the testing site.
However, at that moment the situation took an even more frightening turn. The attacker didn’t just stop at words. He attacked Karine, inflicting grievous bodily harm. The person being tested rushed away from the scene, leaving Karine alone. However, the client did not give up in the face of aggression. She immediately contacted the police, and law enforcement officials arrived at the scene. The attacker was detained and a criminal case was opened. It is unclear at this stage whether Karine and the attacker were acquaintances or whether it was a random attack.
Legal support for Karine is being provided by an NGO. With the participation of REActors, it was possible to record the crime and ensure the initiation of criminal proceedings. Thanks to the assistance of paralegals, Karine was sent for a forensic medical examination. The criminal case is currently under review.
The story serves as a reminder of the importance of human rights and the protection of those facing violence and discrimination. The client’s fearless behavior and determination raise an important point about the importance of continuing to fight for equal rights and justice. And that everyone can fight for their rights and the rights of others.
The story of a client who faced illegal disclosure of his HIV status by his wife and mother-in-law during divorce proceedings. REActors assisted in restoring his reputation and preventing a breach of medical confidentiality.
There are situations in the world where privacy and health are subjected to illegal actions and unkind acts by loved ones. Oydin’s (name changed) story is one of fighting for his rights and defending his honor when his HIV status becomes the subject of discussion and disclosure during a divorce.
When the client contacted REActors, he found himself in a terrible situation. His wife and mother-in-law were actively spreading false information about him, including information about his HIV status. This was not only damaging to his honor but also represented a serious breach of medical confidentiality. It was important to urgently intervene and help the client restore his reputation and protect his rights.
The first step was to provide the client with psychological support as he needed help and understanding to cope with this difficult situation. The client was then counseled on the rights and responsibilities of people living with HIV and what laws and regulations govern their rights and confidentiality.
The client was then referred to a legal specialist specializing in such cases. Together with the lawyer, a plan of action was developed. An explanatory conversation was held with the relatives who spread false information and told about his HIV status about possible administrative responsibility for disclosure of medical confidentiality. After that, their attacks with slander and dissemination of his HIV status stopped.
Oydin’s story is an example of how REActors help people fight for their rights and protect their honor, especially when faced with violations of medical confidentiality. The combined efforts of the client, psychologist, and lawyer enabled him to restore his reputation and prevent long-term damage to his life. This story is a reminder of the importance of protecting privacy and a person’s right to medical confidentiality.
In 2020, the Republic of Armenia citizen A.A. (name was changed) applied to New Generation Humanitarian NGO. The latter reported that he and his friends were in their country house. A group of people attacked the house and them, demanding to leave in connection with the alleged sexual orientation and gender identity of A.A and his friends. An argument started, after which those people hit different parts of A.A.’s body with their hands, feet and stones, causing bodily injuries around the head. On the same day, A.A. submitted a report on the incident to the RA Police. A forensic medical examination has been appointed. The attorney of New Generation Humanitarian NGO, Ara Gharagyozyan, was involved in the case.
According to the prepared materials based on the report, a criminal case was initiated under Article 117 of the Republic of Armenia a Criminal Code; it was sent to the Investigation Division of the Investigation Committee for preliminary investigation.
In 2020, the Investigation Division made a decision to accept the criminal case. A.A. was recognized as a victim. The case is under investigation.
Sergey Gabrielyan, the President of New Generation Humanitarian NGO, says that despite the revolution in Armenia, discrimination is still perpetrated due to the real or presumed sexual orientation of individuals and gender identity, which is not properly qualified by law enforcement agencies, but is qualified with articles of lenient punishment. New Generation Humanitarian NGO will be consistent in ensuring a fair trial and non-discrimination.
Clarification
Infliction of a willful bodily injury or other damage to health which caused short-term health disorder or insignificant loss of the capacity to work is punished with a fine in the amount of 50 to 100 minimal salaries, or with arrest for up to 2 months.
Case development
In 2021 the preliminary investigation of the case ended and the case was sent to court. The judge of the Court of General Jurisdiction made a decision about setting the case for hearing.
A forensic psychological examination was assigned to one of the accused – G.S. According to the forensic medical report the accused is considered partially sane and is subject to criminal liability.
The court hearings were scheduled mainly with 3-month breaks, about which the Organization’s attorney Ara Gharagyozyan filed a complaint to the RA Ministry of Justice.
In 2022, the first court hearing on the case of A.A. who had been beaten by G.M. and S.H. During the hearing, the defense filed a motion to terminate the criminal prosecution on the grounds that the statute of limitations had expired. The accusing prosecutor did not object to the motion. The attorney of New Generation Humanitarian NGO Ara Gharagyozyan presented a corresponding objection in the case. The verdict was announced by the court on the same day. According to the court decision, the case was terminated and the criminal prosecution was stopped on the grounds of expiration of the statute of limitations.
New Generation Humanitarian NGO considers that: • Deliberate inaction was shown by the judge, allowing guilty persons to avoid criminal liability. As a result of all this, a number of rights of the victim defined by the ECHR were violated, such as a fair trial, respect for personal and family life, etc. • Hate crime has not been investigated by the state, which has led to a violation of the victim’s right to abstain from cruel-treatment.
The organization decided to pursue the restoration of the rights of the victim. Ara Gharagyozyan, attorney of New Generation submitted a petition of appeal to the Court of Appeal of the Republic of Armenia.
After exhausting all domestic court instances of the case, according to the initially planned strategy, the attorney of the case lodged the relevant application with the ECHR on June 9, 2023.
The application included complaints on the violations of Article 6.3, Part 1, Article 8.1, and Article 14.1 of the ECHR.
In modern Tajikistan, as in many countries, transgender people face serious violations of their rights, including discrimination and harassment. In this context, we consider a case that illustrates the struggle of the LGBT community in Tajikistan for their rights and freedom.
The story of Renata (name changed) provides an important example. Renata decided to return to her home country from Russia, where she was working and living, in order to change her gender status in a new passport. However, her plans were seriously disrupted upon arrival. Police officers took an interest in her personal life when Renata went to the police station to support her friend who had been detained. After the law enforcers learned that she was transgender, obsessive intense interrogation activities began and her cell phone, which contained many personal details, was seized. Although Renata was subsequently released, they did not return her phone to her and continued to monitor its contents. The client was subsequently invited back to the station and accused of sending pornography, which was actually pictures of the breast surgery process sent to her by her friend.
REActors were able to provide Renata with legal protection by finding a lawyer willing to take on her case and defend her rights. Moreover, Renata did not have sufficient financial means to leave the country, as she did not believe in a positive outcome of the trial. As a consequence, the transgender woman decided to leave her phone and seek help in finding financial means to leave the country. REActors decided to express official support on behalf of the community organization and sent a letter to friendly non-governmental organizations, including ECOM. In response, they expressed their willingness to provide financial support in the amount of 750 USD, which made it possible for Renata to purchase a ticket and leave Tajikistan.
Thanks to the funds received, Renata was able to start a new life in St. Petersburg. Two months later, the case against her was closed and her personal belongings were returned to her and mailed back to Russia. REActors are proud to have been able to help Renata overcome the difficulties she faced and to protect her right to freedom and self-expression according to her own wishes. This case highlights the importance of protecting the rights of transgender people and supporting them in their struggle for equality and freedom.
Renata is currently in Russia, but her life here has become much more difficult due to the introduction of new laws concerning the LGBTQ+ community. These laws create unacceptable conditions for transgender people and members of the LGBTQ+ community in general. In an effort to ensure her safety and a favorable psychosocial state, Renata is looking to relocate to another country where she can live and express herself fully.
Renata expressed her deep gratitude for the support provided by the REActors during difficult moments in her life. This support was crucial for her and enabled her to start a new chapter in her life, protecting her right to freedom and self-expression. Currently in search of a better place for her life, Renata remains in contact with the organization, which continues to support her from afar and stands by her side during this important transition period.
This case highlights the importance of continuing to fight for the rights and freedom of the LGBTQ+ community in different countries, as well as the need to support and protect those who face discrimination and persecution because of their gender and sexual identity.
A direct video message by a pediatrician appeared on social media, expressing hate speech towards the LGBT+ community. He claimed that they are unnatural, suffer from mental illness and that their “stupid propaganda” is inconsistent with physiological laws and Christian values. The doctor expressed this as his personal viewpoint, however, claiming it was an opinion consistent with his status as a specialist.
“People who disagree with my attitude towards homosexuals and all this propaganda that goes against physiological and natural laws and Christian values, let them not support me. We have different values. This is my position on ‘nonsense’. Sexual intercourse, in my opinion, is for the continuation of the human race, not for pleasure. Pleasure is an added incentive for humans to strive to have children and ensure the existence of our species on Earth, not for debauchery and pleasure. I will only support humans when I see that sexual intercourse between two women or two men results in the birth of children. Show me such and then I will change my position. Until then, it is a mental illness to me and such people should go to psychiatrists for treatment. Do not allow yourself to be misled and manipulated. If you do not share my point of view, do not come to me for counseling. I wish you health and mental wellbeing,” the doctor said on his TikTok account. He later held a live stream, continuing to express his anti-LGBT+ views for more than an hour.
The organization “GENDERDOC-M”, which registered and is investigating the case, submitted an application to the Equality Council. According to the decision, further action will be taken to review the incident and establish the appropriate consequences.
