In everyday life, people living with HIV (PLHIV) in Uzbekistan are still often subjected to stigma, abuse and domestic violence. During the first half of 2021, within the framework of the project “Reducing Barriers Associated with Violation of Human Rights (REAct)”, implemented by the NGO “ISHONCH VA HAYOT”. 217 appeals from PLHIV and representatives of risk groups were recorded. Of these, 140 were qualified as human rights violations. In addition, 168 cases reported stigma and discrimination against people living with HIV: for example, relatives do not allow to eat at a common table, use common tableware, or even kick out of the house, and this is during the open access with scientifically proven information about the transmission HIV.
Today in Uzbekistan, despite the efforts of the government and civil society, there remains a difficult situation with public awareness of the methods of transmission, prevention and treatment of HIV, hence there are many outdated stereotypes about the infection and the ways of its transmission.
HIV-related stigma and discrimination often stems from healthcare workers who willfully or unintentionally disclose the HIV status of patients. In one of the cases registered in the REAct system, a woman was stigmatized by her neighbors due to the carelessness of the medical staff. The nurse of the family polyclinic, where the client is receiving ART, disclosed the client’s information (HIV status) because of the personal hostility and condemnation of the woman “who contracted HIV”. The nurse and the client lived in the same mahela (district), they have common acquaintances among the neighbors, to whom the nurse told the client’s status. The nurse did not have any obvious reason to divulge the secret of her patient’s diagnosis. It is assumed that the incident happened due to professional negligence and lack of complete and high-quality information about HIV infection and life with HIV.
The client turned to REActor for help and asked how this issue could be resolved. First of all, REActor informed the client about human rights issues and why it is important to defend them in the context of HIV.
The client was advised to write a statement for disclosing medical information and go to court. The woman refused out of fear that an even wider circle of people who would be involved in the trial would find out about her status. Then the client was asked to contact the chief doctor of the healthcare facility so that the distribution of confidential medical information was stopped by the staff of this medical institution. If this does not help, then REActor and the project’s lawyer have indicated their willingness to assist in drafting a complaint to the Ministry of Health on this situation.
After talking with the project staff, the client made up her mind and came to the chief doctor of the family polyclinic. The chief doctor invited a nurse and held an explanatory conversation with her with a warning of dismissal in the event of a repeated similar violation of medical ethics. The nurse apologized for her actions and confirmed that this would not happen again, as a result, the parties were reconciled.
According to the Law of the Republic of Uzbekistan on the protection of citizens’ health
Article 45. Medical secrecy:
Information about the fact of seeking medical help, the state of health of a citizen, the diagnosis of his illness and other information obtained during his examination and treatment constitute a medical secret.
It is not allowed without the consent of a citizen or his legal representative to disclose information constituting a medical secret by persons who became aware of it during training, the performance of professional, official and other duties, except for the cases established by part three of this article.
The provision of information constituting a medical secret without the consent of a citizen or his legal representative is allowed:
- for the purpose of examining and treating a citizen who, due to his condition, is unable to express his will;
- with the threat of the spread of infectious diseases, mass poisoning and injuries;
- at the request of the bodies of inquiry and investigation, the prosecutor’s office and the court in connection with an investigation or trial;
- in case of rendering assistance to a minor under the age of fourteen to inform his parents or legal representatives;
- if there are grounds for believing that harm to the health of a citizen was caused as a result of unlawful actions or an accident.
Persons to whom information constituting a medical secret has been transferred in accordance with the established procedure, along with medical and pharmaceutical workers, are liable for disclosing medical secrets in accordance with the law.
Also, the Code of the Republic of Uzbekistan on Administrative Responsibility:
Article 46. Disclosure of information that may cause moral or material damage to a citizen
Disclosure of medical or commercial secrets, secrets of correspondence and other messages, notarial actions, banking operations and savings, as well as other information that may cause moral or material damage to a citizen, his rights, freedoms and legal interests, in the absence of signs of an offense provided for in Article 461 of this Of the Code, – entails the imposition of a fine on citizens from one second to two, and on officials – from two to five basic calculated values.
Article 461. Violation of inviolability of private life
Illegal collection or dissemination of information about the private life of a person, constituting his personal or family secret, without his consent – entails the imposition of a fine from ten to forty basic calculated values.
The Uzbek government recognizes the need to combat stigma and discrimination against people, especially women living with HIV. The topic of women’s rights is highlighted in the priority of the National Development Strategy of Uzbekistan.