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Celebrating LGBTIQ history month in Eastern Europe and Central Asia: a journey of resilience and progress

February is LGBTIQ History Month – a time to shine a spotlight on the actions and achievements of members of the LGBTIQ community throughout history. While the recognition and celebration of history are global, it’s essential to acknowledge the unique experiences and challenges faced by LGBTIQ individuals in different regions, particularly in Eastern Europe and Central Asia (EECA).

The history of LGBTIQ rights and activism in EECA is complex and varied. Discrimination, violence, and harassment remain widespread, fueled by cultural, religious, and political factors. In some countries, laws targeting LGBTIQ individuals continue to exist, restricting their rights to freedom of expression, assembly, and association.

There are 57 organizations in the REAct system providing health services to members of the LGBTIQ community. In 2023 alone, 1,109 referrals were documented and this number remains among the leaders:

Registered casesOther countriesUkraine
Key group (people, who use drugs)1279707
Key group (people living with HIV)16831152
Key group (sex workers)1054347
Key group (LGBTIQ)1109437

Main types of perpetrators (by countries where REAct works and for all years). As a rule, violence against victims is perpetrated by private individuals.

Police516
Family, relatives300
Acquaintances173
Hate group175
Husband/wife, intimate partner137
Other specialised doctor, NOT related to HIV/AIDS and TB101
Client of sex worker82
 Employer104
Representative of the same key group72
Neighbours96
AIDS center or other doctor related to HIV/AIDS65
Business, shops, service sector56
Hospital, inpatient facility57
Homeowner or landowner42
Special law enforcement services35
Military, army25
Political representatives21
University21
Migration service (state service15
Border guards13
Media and journalists13
School10

Main types of violations (by countries where REAct operates and for all years)

Hate speech, verbal abuse913
Threatening, intimidation, harassment867
Violence by individuals based on hatred571
Extortion, blackmail260
Public outing, defamation208
Eviction, coercion to leave the residence188
Arbitrary arrest or detention167
Misuse of power by law enforcement165
Other breach of privacy151
Sexual assault/abuse148
Domestic/intimate partner violence130
Excessive use of force by law enforcement118
Destruction of property, motivated by hatred108
Dismissal, denial of employment99
Denial of protection and investigation by the police81
Refusal to provide hospital care and other medical service74
Psychological mistreatment in public health facility68

Thus, in modern Tajikistan, representatives of the LGBTIQ community face serious violations of their rights. Detentions under Article 241 of the Criminal Code (distribution of pornography) have become more frequent in the country. The grounds for such charges are personal intimate photos found on the phones of the accused or intimate correspondence. Renata’s story is an important example of the continuing struggle for rights and freedom and emphasizes the need to support and protect those who face discrimination and persecution because of their gender and sexual identity.

Kazakhstan recorded an incident involving Danara, a 25-year-old queer woman and LGBTIQ activist. Her story was a powerful example of the struggle to ensure equal rights and non-discrimination in the workplace, regardless of their sexual orientation.

In Armenia, a trans woman, activist, and employee of a local NGO was attacked. Thanks to her courage and determination, her attacker was apprehended and a criminal case was opened. Her story served as a reminder that everyone can and should fight for their rights and the rights of others.

However, despite these challenges, there have been significant strides towards equality and acceptance in recent years. One of the key aspects of LGBTIQ history in this region is the resilience and courage of activists who fight tirelessly for their rights from grassroots movements to organized protests. To challenge discriminatory laws and societal attitudes. The visibility of LGBTIQ issues has increased thanks in part to the efforts of activists, organizations, and allies. Pride events, film festivals, and other cultural initiatives have helped to raise awareness and foster a sense of community among LGBTIQ individuals.

Moreover, there have been notable advances in terms of legal recognition and protection for LGBTIQ rights in certain countries. For example, Estonia has legalized same-sex partnerships, while others have introduced measures to combat discrimination based on sexual orientation and gender identity.

It’s also important to recognize the role of international organizations and human rights bodies in promoting LGBTIQ rights in EECA. The European Union, the Council of Europe, and the United Nations have all called on countries in the region to respect and protect the rights of LGBTIQ individuals. These efforts help to push for legislative reforms and provide support to local activists and organizations.

By standing in solidarity with LGBTIQ individuals and supporting their rights, it is worth noting that LGBTIQ History Month provides an opportunity to honor the achievements and contributions of community in EECA, while also acknowledging the challenges it continues to face. However through activism, advocacy, and solidarity, we can strive to create a world where everyone, regardless of sexual orientation or gender identity, can live with dignity, equality, and respect.


Also read:

Tajikistan has taken the first step to protect the rights and eliminate discrimination of citizens living with HIV

Empowering social justice in Eastern Europe and Central Asia: a call to collective action

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News Response stories

Empowering social justice in Eastern Europe and Central Asia: a call to collective action

The World Social Justice Day, observed annually on February 20th, stands as a poignant reminder of the ongoing struggle against unemployment, social exclusion, and poverty. This globally recognized day, as mandated by the United Nations General Assembly, underscores the critical importance of social development and justice in fostering peace and security within and among nations. As we navigate through the complexities of the modern world, it is increasingly evident that social development and justice are not only fundamental rights but also indispensable prerequisites for sustainable peace and prosperity. As the International Labour Organization points out in its latest World Employment and Social Outlook report, as of 2023

– 241 million workers lived in extreme poverty. 

– 423 million workers lived in moderate poverty. 

These alarming numbers underscore the urgent need for concerted efforts to address the root causes of working poverty and boost economic opportunities globally.

It resonates profoundly across Eastern Europe and Central Asia (EECA) as well, where socio-economic disparities, conflicts, and institutional weaknesses have strained the fabric of social cohesion. Against this backdrop, there is a pressing need to galvanize efforts towards fostering a more inclusive and equitable society.

As we approach the halfway mark towards realizing the ambitious goals of the 2030 Agenda, it becomes imperative to intensify our endeavors toward promoting inclusive and sustainable economic growth, employment, and decent work for all. Central to this endeavor are the four interconnected dimensions of social justice: ensuring universal human rights and capabilities, facilitating equal access to opportunities for employment and productive activity, promoting fair distribution outcomes, and facilitating just transitions amidst significant societal transformations.

Despite pockets of resilience observed in labor markets during the preceding year, the global economic landscape remains fraught with uncertainties, exacerbating structural inequalities and leaving millions marginalized. Projections indicate a further deterioration in the global unemployment rate in the 2024 year, with EECA bearing a disproportionate burden. Alarmingly, millions within this region continue to grapple with extreme or moderate poverty, highlighting the urgent need for targeted interventions to address the root causes of working poverty and enhance economic opportunities.

In response to these challenges, governments across EECA must prioritize initiatives aimed at bolstering domestic economies, fostering regional cooperation, and providing targeted support to vulnerable economies. Furthermore, there is a pressing need for a comprehensive approach that leverages education, social protection, and environmental sustainability as catalysts for transformative change.

In the context of the rights of working representatives from key groups such as people living with HIV, sex workers, and LGBT+ individuals, there is a need for special attention to their vulnerability and protection of their rights in the workplace. In many countries in EECA, these groups face systematic discrimination and stigma, which creates additional barriers to obtaining decent employment and protection in the labor market.

Kyrgyzstan:

Case: A woman was fired because of a history of incarceration and drug use, although she had already been reinstated. After she was accused of stealing a cell phone, she was fired and deprived of her full salary.

Solution: The client was provided legal advice by REActors and accompanied at her place of employment. After negotiations and the presentation of camera video proving her innocence, she was reinstated and received compensation for moral damages.

Kazakhstan:

Case: A man living with HIV came to REActors after he was denied employment (as a massage therapist) at a private medical center. He was rejected because of his HIV+ status and was also neglected.

Solution: The client was counseled on the rights of PLHIV patients and the Labor Law of the Republic of Kazakhstan. The REActors accompanied him to the medical center, where they drafted a pre-trial statement and spoke with the head doctor. After explanations, they apologized and offered him a job (but the man refused).

Azerbaijan:

Case: REActors were approached by a client who was working on a construction site. He was supposed to be paid 15 manat per day (about 8 euros), but he received only 5 manat and the remaining 10 manat was to be paid every 2 weeks. At the end of the term, he was fired and paid nothing, with the excuse that he was from a community of people, who use drugs.

Solution: After consulting with a lawyer, the REActors met with the foreman and explained to him that illegal dismissal is punishable, regardless of whether the worker was officially employed or not. He agreed to pay the man 140 manat and the client dropped further complaints.

In light of these (and other) cases, regional and national human rights programs should include measures to protect the rights of workers from these key groups. This includes ensuring workplaces free from discrimination based on HIV status, sexual orientation, or gender identity, as well as ensuring equal access to employment opportunities and social protection.

Human rights organizations and government bodies should collaborate to develop and implement policies aimed at strengthening the rights of workers from key groups. This may involve awareness campaigns about workplace rights, training for employers and employees on non-discrimination principles, and creating mechanisms for recourse for rights protection (as REAct instrument).

To ensure the successful integration of these groups into the work environment, attention must also be paid to their specific needs and vulnerabilities. This may include providing access to HIV and LGBT+-related medical services, as well as creating safe and supportive working conditions for sex workers.

The commemoration of the 2024 World Day of Social Justice serves as a rallying cry for renewed commitment and collective action. By bridging existing divides and forging strategic alliances in support of the Global Coalition for Social Justice, societies can unlock their full potential and pave the way for sustained reductions in poverty and inequality. Moreover, by fostering inclusive growth and social cohesion, these efforts can contribute significantly to peace, stability, and intergenerational solidarity across the region.

In EECA, the imperative to advance social justice transcends mere moral obligation; it is a strategic one and essential for building resilient and equitable societies capable of withstanding the myriad challenges of the 21st century. Adopting a multidimensional approach to protecting the rights of working representatives from key groups will not only ensure equal opportunities in the labor market but also contribute to creating a more just and inclusive society of this diverse region.


Also read:

Tajikistan has taken the first step to protect the rights and eliminate discrimination of citizens living with HIV

Drug policy of zero tolerance and double standard practices. ENPUD analytical paper on the situation in Kazakhstan

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Response stories

Isolation, denial and victory: the case in a dental clinic in Kazakhstan

The symptoms of periodontitis forced Saule (name changed) to seek help at a dental clinic recommended by a friend. However, at the first visit, the doctor began to investigate not only the condition of her teeth but also Saule’s HIV and hepatitis status. Upon learning of her infectious diagnosis, the doctor refused treatment, citing “inability to provide services” because of Saule’s status.

The girl’s surprise increased when her friend, who had applied for a similar service, received it without problems. When Saule learned that the doctor not only refused treatment but also advised her friend to stop communicating, citing contagiousness, she decided to look into the situation.

The doctor argued that the clinic lacked the necessary equipment, tools, and protective clothing to work with HIV-positive people. Faced with such discrimination, the girl turned to REActor for support, who provided an HIV training module and explained Saule’s rights.

The next day, the REActor visited the clinic and spoke with the doctor about the inadmissibility of disclosing information about HIV-positive patients and the obligations of medical staff towards HIV-positive people.

The clinic apologized, provided dental care to Saule, and ensured that such violations would not happen again.

This story emphasizes the importance of respecting patients’ rights, denouncing discrimination, and the need to educate medical staff about HIV infection. Fighting for equal rights to health care is a key element in creating an inclusive and tolerant healthcare environment.


Also read:

Denial of hospitalization: story of the fight against discrimination and stigma in Kazakhstan

Eviction from a dormitory due to HIV+ status in Kazakhstan

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Response stories

Fighting for rights: confronting discrimination based on TB in Kazakhstan

The story of Marat (name changed), an electrician from Kazakhstan, was a testament to injustice and discrimination in the workplace due to illness. The difficulties began when his health deteriorated, leading to a diagnosis of tuberculosis. However, when he returned to work after successful treatment, he was in for an unpleasant surprise.

For the past two months, Marat had been experiencing severe symptoms of TB: coughing, fever, loss of appetite, and weight loss. Concerned about his condition, he went to the doctor, which eventually led to the diagnosis. After active treatment and return to work, Marat faced dismissal due to TB and denial of benefits.

Intervening in the situation, the REActor and the TB lawyer advocated on Marat’s side. They visited the company, negotiated with the director, and explained the laws governing temporary disability and workers’ rights. Referring to the Government Decree and Article 55 of the Labor Code of the Republic of Kazakhstan, they emphasized the unacceptability of dismissal due to TB.

As a result of successful negotiations, Marat was reinstated at work and paid one month’s temporary disability allowance. The director pledged to avoid similar violations in the future.

This story emphasizes the need to respect workers’ rights and the inadmissibility of discrimination based on illness. Confronting such situations requires awareness of rights, strong intervention by public bodies, and an unwavering fight for labor justice. Everyone, regardless of their health, deserves respect and equality in the workplace.


Also read:

Denial of hospitalization: story of the fight against discrimination and stigma in Kazakhstan

Eviction from a dormitory due to HIV+ status in Kazakhstan

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Response stories

Alarming trends against the background of domestic violence: the story of Lana from Georgia

During 2023, national REActors in Georgia documented 13 cases of violence in which individuals were punished through courts or law enforcement agencies. One such story was the fate of 30-year-old Lana (name changed), a pregnant woman engaged in sex work.

Lana, living with her husband and mother-in-law, faced an unpleasant situation that dramatically changed her life. Four months pregnant, she was assaulted by her husband, who, blinded by jealousy and mistakenly believing that the child was not his, inflicted severe bodily harm on her.

Lana sought help from the REActor. With Lana’s consent, he called the police, and the husband, the perpetrator of the assault, was arrested. The pregnant woman herself, alas, required transfer to a clinic for medical care. 

This case is just one of many that emphasize the urgency of the problem of domestic violence and the importance of community solidarity in the fight against this phenomenon.


Also read:

Protecting the rights of transgender women in Tajikistan

Incident in Moldova with disclosure of medical information

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Response stories

Overcoming stigma and discrimination in maternity hospitals in Kazakhstan

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.


Also read:

The case of a doctor in Moldova: the struggle for tolerance and professional ethics

Incident in Moldova with disclosure of medical information

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Addressing legal barriers and advocating for HIV decriminalization: insights from REAct’s data

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.


Also read:

Through the lens of REAct’s work: PrEP in the context of human rights, key populations, and access challenges

ECOM: Invisible Voices: Regional report on violations of the right to health of LGBT people in the region of Eastern Europe and Central Asia in 2022

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Response stories

Fighting stereotypes and fears: the story of Sylvia from Moldova

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.


Also read:

The case of a doctor in Moldova: the struggle for tolerance and professional ethics

Incident in Moldova with disclosure of medical information

Categories
Response stories

Bosnia and Herzegovina: preserving education through health challenges 

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.


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Progress in Addressing Discrimination and Promoting HIV Awareness in North Macedonia

Criminal proceedings of the case on trans* person’s beating continue in Armenia

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News Useful materials

Through the lens of REAct’s work: PrEP in the context of human rights, key populations, and access challenges

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.


Also read:

ECOM: Invisible Voices: Regional report on violations of the right to health of LGBT people in the region of Eastern Europe and Central Asia in 2022

A REActor in Tajikistan spoke out against violence and lynching

Categories
Response stories

Fighting for one’s rights and the rights of others: the story of an attack on a trans woman in Armenia

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.


Also read:

Protecting the rights of transgender women in Tajikistan

Incident in Moldova with disclosure of medical information

Categories
Response stories

Protecting medical confidentiality in Uzbekistan

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.

Original Source (in Russian)


Also read:

Protecting the rights of transgender women in Tajikistan

Incident in Moldova with disclosure of medical information

Categories
Response stories

Armenia: a long way to restore the rights of the victim

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.


Original Source

Original Source

Original Source

Original Source

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Progress in Addressing Discrimination and Promoting HIV Awareness in North Macedonia

Criminal proceedings of the case on trans* person’s beating continue in Armenia

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Response stories

Protecting the rights of transgender women in Tajikistan

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.


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Triumph of Law in Tajikistan: Rustam’s story of fighting for justice

Tajikistan: Overcoming stigma and restoring family relationships

Categories
Response stories

The case of a doctor in Moldova: the struggle for tolerance and professional ethics

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.


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Protecting the rights of transgender women in Tajikistan

Incident in Moldova with disclosure of medical information

Categories
Response stories

Ali’s story: overcoming barriers to accessing health care in Kazakhstan

Ali (name changed), a man living with HIV and Hepatitis C, approached REActor based on a previous successful counseling experience. This time, the situation required an intervention in accessing medical care.

From the outset, Ali encountered difficulties at the polyclinic, where he was denied Hepatitis C testing and treatment due to lack of insurance. Not only that, but the front desk staff was dismissive and arrogant because of his HIV status.

The REActor provided a detailed counseling session, explaining to Ali his rights as a representative of PLHIV community patient. He highlighted the treatment algorithm for hepatitis C, classifying it as a socially significant disease that falls under the guaranteed scope of free medical care.

Accompanying Ali to the polyclinic for primary health care (PHC), the REActor met with the receptionists. After a detailed conversation, incompetence, and denial of treatment for Hepatitis C, despite its inclusion in the guaranteed scope of free medical care at PHC, was revealed.

REActor emphasized that hepatitis C is a socially significant disease in the list of the Republic of Kazakhstan and falls under free treatment. The situation was resolved and the patient is now being evaluated for further treatment for hepatitis C.

This story emphasizes the importance of active support from REActors in removing barriers and ensuring equal access to health services for all, regardless of health status.


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Overcoming stigma and discrimination in maternity hospitals in Kazakhstan

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Response stories

Incident in Moldova with disclosure of medical information

A pregnant patient of 18 years of age, 33 weeks pregnant, was registered at the Medical Center of the XX district of the XX village. Roxana (name changed) has been registered with a psychiatrist since childhood, and there is a document confirming her incapacity. The medical staff of the district where the girl is registered conducted examinations, including markers for HIV infection. However, after receiving information about the positive result, the personnel who were involved in the diagnosis of the first HIV test could not keep the confidentiality of the patient’s result, and the information spread among the villagers.

A social worker from the Positive Initiative NGO traveled to the village to accompany the patient to the city to give and receive the final result. The health center requested assistance in accompanying Roxana from the organization, as the NGO is engaged in psychosocial support of people with increased risk of infection, as well as people living with HIV.

Upon arrival, the social worker of Positive Initiative received information from the nurse of XX village that the pregnant woman was not currently present at her place of residence. The nurse took a social assistant from the village administration with her and started searching for her. They later found her in an abandoned house at the edge of the village. The social assistant questioned the girl about what had happened. The pregnant woman said that the day before she had met a relative in the village, who told her that she had HIV infection and her baby would be taken away from her. The girl was frightened and hid, which is natural for her mental state. Also, the owner of the house where the pregnant woman was living at the time told the Positive Initiative staff member that if the girl had AIDS, she was against her living in the house. That same day, a relative of the pregnant woman told paralegal that the previous evening, residents had discussed that the girl had AIDS at the village store. The final diagnosis had not yet been confirmed at that time.

At this point, the girl gave birth and was found temporary accommodation at Misiunea Socială Diaconia a Mitropoliei Basarabiei, where she will be fully cared for for a year and made sure that she takes ART and gives the baby everything it needs.

As a result, a complaint was sent to the Equality Council of the Republic of Moldova about the disclosure of confidential data related to the person’s health condition. A meeting was organized with the head of the village, social assistant and family doctor, where the beneficiary is registered. At the meeting, the issue of violation of her rights was raised and the consequences of such actions were communicated to civil servants. A response to the request submitted to the Equality Council remains pending.


Also read:

Protecting the rights of transgender women in Tajikistan

Armenia: a long way to restore the rights of the victim

Categories
Response stories

Tajikistan: Overcoming stigma and restoring family relationships

Vasfiya (name changed) came to REActor for help. She was 38 years old and living with her husband, both of whom are PLHIV. She found out about the paralegal through an infectious disease doctor who provided contact information. The woman told her story: she had been living with her husband for only 6 months and this was her second marriage. It turned out that her husband, too, had known about his status since 2011, but had not started taking antiviral medication for fear of being judged.

The couple’s lives changed when the husband was sent to prison in 2012, and it wasn’t until 2018, after his condition worsened, that he began treatment. In 2022, he was released and met his wife at the AIDS Center. Since then they got married and for six months they have been living in his parents’ house, where unfortunately there are constant scandals, humiliation and insults.

Vasfiya said that during her husband’s absence, his parents died and his sister registered the house in her name. However, the husband is still registered there and has the right to inherit. His sister lives in the house and constantly stigmatizes, insults and humiliates them. She tells them that they are both drug addicts and PLHIV, that he brought home an equally “wife with AIDS”. The woman does this on purpose, saying her insults loudly in the yard for all the neighbors to hear.

Vasfiya suggested that her husband contact the district police officer, but he was unwilling to pursue this option. They turned to a REActor in the hope of finding a peaceful solution to the problem.

The paralegal took up the cause and began to take action. First, she invited the woman and her husband to a counseling session to discuss all possible solutions. A series of meetings were held, during which they were given a plan of action.

The first step was to make a written statement in which they described all the insults and humiliations committed by their relative. The REActor helped them to formulate the statement correctly so that it would be as informative and effective as possible. It was then submitted to the local police department.

At the same time, the REActor recommended that they contact the AIDS Center, which had psychological support and counseling specialists. They could provide assistance with stress management and advice on how to resolve the conflict peacefully.

The next step was to engage with the husband’s sister. The paralegal decided to hold a mediation meeting to try to resolve the conflict peacefully. In this meeting, she acted as a mediator between the couple and the relative to establish a dialog and help them find a compromise solution.

During the mediation meeting, discussed all the grievances, concerns and frustrations of each party. The facilitator helped them to express their emotions and empathize with each other. Through this meeting, it became clear that the root cause of the conflict was stigmatization and misunderstanding. The husband’s sister was not sufficiently informed about HIV/AIDS and her fear and aggression were based on lack of awareness.

The paralegal provided them with educational materials about HIV/AIDS and shared success stories and examples of overcoming stigma. As a result of this meeting, all parties expressed their willingness to change their attitudes and start cooperating.

Gradually, the husband’s sister became more tolerant and understanding. She stopped stigmatizing and humiliating the client and her husband. Together they worked on realizing and overcoming stereotypes related to HIV/AIDS.

After a while, family relations began to improve. Vasfiya said that her relative began to show more sympathy and even helped them in domestic issues. She stopped talking about insults and began to interact with them in a more friendly and respectful manner.

This success story emphasizes the importance of seeking support and not saying no during difficult times. By working with professionals, it was possible to overcome stigma and make a positive difference in the lives of clients.


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Combating Discrimination Against Children with HIV in Kazakhstan Educational Institutions

Problems of HIV-positive prisoners in Azerbaijan