Access to life-saving treatment should never depend on where a person lives or which borders they have crossed.
A regional study visit is currently underway in Dushanbe, focusing on cross-border support and continuity of care for people living with HIV in migration. Healthcare officials, representatives from National AIDS Centers, and civil society leaders from Armenia, Azerbaijan, and Georgia have joined forces with the Regional Expert Group on Migration and Health to examine the pioneering practices developed in Tajikistan and Kyrgyzstan.
This dialogue comes at a crucial moment: national guidelines for transnational HIV care for migrants have already been drafted in Georgia, Armenia, and Azerbaijan and are currently undergoing governmental approval. The proven operational models from Central Asia provide a clear blueprint for how these mechanisms function on the ground, helping participating countries prepare their systems for an effective rollout.
The urgency of the issue is felt across the entire region. In Tajikistan, labor migrants account for up to a fifth of the country’s working-age population (between 500,000 and 1 million individuals), with their remittances contributing nearly 48% of national GDP. Concurrently, one in three new HIV diagnoses in the country occurs among labor migrants. Data from the latest Integrated Bio-Behavioral Surveillance (IBBS) shows an HIV prevalence of 0.7% in this group – more than triple the 0.2% rate found in the general population. A comparable trend is visible in Kyrgyzstan, where 39% of people living with HIV have a history of migration.
Once abroad, migrants face severe institutional and legal barriers. Because confirmatory ELISA screening results even from private laboratories are routinely reported to regulatory and immigration authorities, individuals risk deportation and re-entry bans. Terrified of losing their livelihoods, many avoid medical care altogether. In response, public health teams in Tajikistan and Kyrgyzstan have established safe, ethical, and pragmatic remote-care frameworks:
“During remote consultations, our citizens’ legal status in host countries is never an issue of discussion,” emphasizes Dr. Alijon Soliev, Deputy Director of the Republican Center for the Prevention and Control of HIV and Parenteral Viral Hepatitis of Tajikistan.
By combining telemedicine consultations, remote verification of lab work, and the distribution of up to a one-year supply of antiretroviral therapy (ART) via designated representatives, Tajikistan alone ensures that at least 600 individuals continue their treatment uninterrupted while living and working abroad. Clinical experience confirms the strength of this strategy: migrants who proactively reach out for therapy while overseas exhibit remarkably high rates of treatment adherence.
Over the two-day visit, participants work alongside specialists from Tajikistan and Kyrgyzstan, including clinical experts from the Kyrgyz Republican Center for the Control of Bloodborne Viral Hepatitis and HIV- to review the complete care pathway: cross-border drug logistics, regulatory frameworks, financial sustainability, and the role of grassroots organizations. Field visits include leading Tajikistani community organizations, such as SPIN Plus and the Tajik Network of Women Living with HIV (TNW Plus). Marking an important operational milestone, the Ministry of Health of Azerbaijan and the Republican AIDS Center of Tajikistan signed a formal Memorandum of Understanding on cross-border cooperation in HIV surveillance, diagnostics, and treatment.
The ultimate goal of this joint initiative is to consolidate lessons learned into a practical regional roadmap. Because viruses recognize no borders, the systems that protect human health and guarantee uninterrupted treatment must be just as boundary-free.
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