Dina Masalimova, a regional coordinator of Migrant Health project, told us about their attempt to create a continuous access to HIV-related services for Kyrgyz migrants in Russia.
“Migrant Health, a model of HIV prevention for migrants from Central Asia in Moscow” is an original program which involves consulting both on migration-related and HIV-related topics. It includes, at all steps, legal and medical consultations, help in getting access to HIV prevention and treatment, and support after the return to a home country.
The program is implemented by AFEW Kyrgyzstan together with partners, such as Central Asian Chain on health issues in Kyrgyzstan, and LaSky in Russia. A similar project is also ongoing in Uzbekistan and Tajikistan.
The program started in August 2020, and in half a year after its launch, it has helped more than 100 migrants from Kyrgyzstan in Moscow as well as about 200 HIV-positive people in Kyrgyzstan.
Why did it become necessary to start a project for supporting HIV-positive migrants from Kyrgyzstan?
We have a consensus among experts that migrants from Central Asian countries have higher risk of becoming infected with HIV abroad. The prevalence of HIV in Russia is much higher than in Central Asia (it is 0.2% in 15- to 49-year-old people in Central Asian countries, and 1.1% in Russia). At the same time, until 2020, in Kyrgyzstan there were no projects focused on migrants’ health. The National program on HIV does not currently cover migrants.
It is well-known that, in general, migrants in Russia face challenges in access to healthcare services. It should be noted that labor migrants are mainly young and sexually active people. This means they are more susceptible to HIV than the population in total and need more help and support.
Stigmatization and discrimination of people living with HIV in their home country are additional drivers of migration. According to our clients, in Russia, people show much more tolerance than in Kyrgyzstan, and having HIV is less stigmatized, although discrimination is still a serious barrier in the access to HIV prevention, testing, and awareness.
How do you help HIV-positive migrants who already left Kyrgyzstan and those who plan to leave for Russia?
We started during the pandemic, in August 2020, and in early months of our work, our clients were unable to leave Kyrgyzstan due to closed borders. Those who were already out of the country, were afraid to go back there, because after that it would be impossible to leave again. The main request of the community at that moment was the provision of antiretroviral therapy (ART).
Russian laws on migration are hostile towards people living with HIV. Their presence in the country is undesirable. Citizens and stateless people with HIV who have family members permanently living in Russia, are an exemption. On the contrary, no medical care and HIV-infection treatment is provided migrants. Fortunately, AIDS centers in Kyrgyzstan understand the problem and provide migrants with several-months-worth of treatment in advance. They also permit the transfer of the medications later through third parties.
It should be noted that a part of our work is to inform people planning to leave for Russia about laws and risks related to irregular migration. Our project does not support the process of migration itself. This is always their own decision and responsibility. The purpose of the Migrant Health program is to help maintain the health of Kyrgyzstan citizens while abroad.
To read recommendations of safe migration to Russia, click here.
What does a migrant need to do to receive ART in Russia?
For long-term treatment, it is essential to be registered in an AIDS center in Kyrgyzstan — that is, a person should register before leaving the country. Later, to regularly receive medications from the home country, only viral load test is needed.
Our partners in Moscow help migrants to undergo these tests in friendly clinics. We then receive the results, retrieve medications from the AIDS center, and send them to Russia. This service was very important for maintenance of migrants’ health during the pandemics.
Starting in December 2020, when the borders opened, our clients began to leave Bishkek for Moscow. There were first cases of the so-called transborder accompaniment, when we handed over a person with their needs and issues to our partners in Russia who continued the accompaniment.
Considering real examples, in March 2021 our partners in Kyrgyzstan came across a person with HIV who was preparing for migration. He had already bought a ticket to Moscow, had to fly in a week, and was unable to delay the trip. A week was enough for his case managers to help him do a test, register, and start treatment. He went to Moscow with enough ART for some time. Our colleagues continue supporting him regarding treatment compliance.
How has COVID-19 pandemic affected the Migrants’ Health project?
The pandemic obviously influenced initiation of the project. For a long time, borders with Russia were completely closed. In December 2020, flights resumed, but ticket prices were high. Many people who planned to go to Russia, could not afford it. Our partners in Migrants’ Health project from neighboring countries (Uzbekistan and Tajikistan) say that migration flows have changed direction: more migrants go to Turkey and other countries, as it is complicated or impossible to enter Russia.
Although in Turkey, there is no discriminatory law towards people with HIV, there are other challenges. In their destination countries, migrants must pay for ART from their pocket, as it is very expensive to send medications there from Kyrgyzstan.
What is the role of other NGOs in your support of migrants?
Together with our partners, we provide migrants with social accompaniment before, during, and after leaving the country. The main idea of the project is to refer migrants from Kyrgyzstan to friendly organizations in Moscow and ensure their connection with AIDS centers in the home country.
The reputatation of our community helps our work both in Kyrgyzstan and Moscow: the professional expertise and friendly attitude of LaSky team is well known and valuable. In Russia, there are friendly organizations which support HIV-positive migrants.
What are your plans regarding migrant rights protection?
Currently, we are developing a guidance for AIDS centers and train other NGOs in work with people who are about to migrate.
The number one issue we need to solve is the registration and treatment provision for our citizens who have become aware of their HIV status while staying out of Kyrgyzstan.
Nadezhda Rogozina
Photos: Freepik, 200stran
The article was prepared with support of Oxfam representative office in Russia