Kazakhstan

The Mentor programme for women in Kazakhstan was established to empower women living with or affected by HIV by connecting them with mentors who share their life experiences and provide critical support during challenging times. Co-financed by the Ministry of Foreign Affairs of the Republic of Kazakhstan and supported by UNAIDS, the program creates a safe space for women to learn, grow, and draw strength from one another. Through training seminars, support groups, and one-on-one mentoring, it helps women overcome stigma, rebuild their lives, and find their purpose. 

Meet three inspiring leaders from this programme—women who never saw themselves as heroes but are, indeed, changing lives. 

Halima

Several years ago, Halima found herself at a crisis center for women victims of domestic violence in Almaty, Kazakhstan. She was at rock bottom—diagnosed with HIV, grieving the loss of her second son, and trapped in an abusive marriage with a husband who drank heavily and often turned violent. Raised in a family that valued tradition, Halima felt compelled to keep the peace at all costs, but the weight of her daily life became unbearable. 

At her lowest point, an elderly doctor’s advice pushed her into action: “If you want your eldest son to end up in an orphanage, your husband homeless, and you in a mental hospital, you are sadly following that path.” Determined to change her fate, Halima sought help at the crisis center, which she credits with helping her climb out of the “dark hole” of depression. 

Today, Halima is helping other women in the mentoring programme. She shares her story with women, believing that her experiences can inspire others to seek life-saving HIV treatment and persevere.

At her lowest point, an elderly doctor’s advice pushed her into action: “If you want your eldest son to end up in an orphanage, your husband homeless, and you in a mental hospital, you are sadly following that path.” Determined to change her fate, Halima sought help at the crisis center, which she credits with helping her climb out of the “dark hole” of depression. 

Today, Halima is helping other women in the mentoring programme. She shares her story with women, believing that her experiences can inspire others to seek life-saving HIV treatment and persevere.

"I make sure to give each person my undivided attention so I can explain in simple terms what HIV is, what an undetectable viral load means, and how to get better,” she says.
Her work extends beyond Almaty, reaching women in rural areas where information about HIV and access to services is limited. “I have no special education, but I love learning. While I’m cleaning or mopping the floors, I listen to psychologists and doctors on my headphones,” she says, knowing that every bit of knowledge helps her make a difference. 

Lena

“This is a complex group,” says Lena from Pavlodar, Kazakhstan. She works with 17 women in a mentoring programme. Many of the women use drugs, have experienced domestic violence or have been in prison. Lena, aged 55, used drugs for over 20 years, but she has been drug-free for seven years, crediting opioid agonist maintenance therapy for helping her quit. 

“I went through all this myself. I remember how it was using drugs: I fell asleep—it’s winter. Woke up—summer,” she says. “If a person comes to therapy out of desperation, does not want to steal or torment their parents and loved ones, this programme can help them.” 

The therapy helps mitigate the need for drugs, but Lena emphasizes “it is important that peers and psychologists work with people and prepare them to leave the programme and have access to essential HIV prevention services and treatment”. 

After being released from prison nearly a year ago, Lena became a peer consultant in the women’s mentoring programme. 

“The problem for many people who use drugs is that they live with HIV and TB but cannot access available services or receive therapy,” Lena explains. Without a home or family, they are invisible to the social protection system and are often driven into desperate situations. “They need a helping hand. They are humans and live next to us."

Lena helps some people register for medical or social support facilities, and others to get treatment. She plans to meet with the akim (mayor) to propose a project to create a support system for people who are left behind. Lena believes there should be no situations where a person is alone and cannot be admitted to a home for disabled or elderly people because they are living with HIV. It is crucial to revise the laws so that everyone is allowed access to social institutions. 

Lena is dedicated to the programme. “I am reborn from this work. My eyes light up, and I feel strong and ready to help,” she says. 

Zulfiya

Zulfiya, a mother of three who has lived with HIV for nearly 20 years, uses her experience to support adolescents and young women in the program. “My task is to help them accept their diagnosis, start treatment, and stick to their medication,” she explains. She refers women to psychologists, social workers, or lawyers when additional support is needed. Zulfiya understands the denial many women face; she felt it herself two decades ago. Inspired by her son, an activist in the Teenager youth organization for adolescents living with HIV, she found her calling in guiding women who never thought HIV would touch their lives. 

Connecting women with other women in a predominantly male-dominated society is the foundation of the mentoring program. “Women in Kazakhstan are often forced to solve a wide range of problems themselves, whether it’s financial difficulties, lack of help, or protection from violence,” says Elena Rastokina, coordinator of the Mentor Programme for Women. “They are not used to uniting in women’s communities, do not know how to ask for help, and often do not know their rights.” Despite the challenges, she is immensely proud of what the mentors have achieved. “When women support each other, they find strength they never knew they had. We need each other, and together, we can change lives.” 

The mentoring programme covers 10 regions of the country. Dozens of women have received help. Some have learnt a new skill and found a job, and others have managed to accept their diagnosis and restore family ties. With help from the programme, many women who use drugs have managed to quit active drug use, improve adherence to life-saving HIV and TB treatment, and reconnect with the community.  

 For Aliya Bokazhanova, UNAIDS Country Director a.i. in Kazakhstan, these are incremental steps to empowering women from key populations. “Women living with HIV have the opportunity to develop and receive the necessary support and inspiration from experienced mentors, which contributes to their self-realization and integration into society,” she says. 

As of 2024, there are an estimated 40 000 [35 000–46 000] people living with HIV in Kazakhstan. New HIV infections are mostly among people from key populations (people who use drugs, gay men and other men who have sex with men, sex workers, and people in prisons and other closed settings). HIV prevalence among people who inject drugs is almost 7%, compared with 0.3% in the general population. 

Last year, Elina Kruglova made a bold decision. She disclosed her HIV status during the casting of a popular reality TV show in Uzbekistan.

“I disclosed my status right at the casting because the project lasted for several months, and I needed to take medicine daily,” she said. “I made the decision to be honest and mustered up the courage. I thought they wouldn't accept me, but I passed the casting," Ms Kruglova explained.

In her second-year student in the Faculty of Agricultural Economics at Tashkent State Agrarian University in Uzbekistan, she grew up in an orphanage. She was the first child living with HIV in her country to start antiretroviral (ARV) therapy seventeen years ago. Despite facing stigma, she has been taking life-saving medicine daily.

Uzbekistan struggles with HIV-related stigma and discrimination.

According to the recent Multiple Indicator Cluster Survey (MICS) in Uzbekistan, 76% of women aged 15-49 in the country would refuse to purchase vegetables from a vendor living with HIV and would not accept children living with HIV attend school with other children. Prejudice is fuelled by a lack of knowledge; only 14% of women in the same age group possess comprehensive information about HIV. Uzbekistan's HIV cases have steadily risen by 44 % in the last six years (31,088 in 2016 to an estimated 45,000 in 2022.)

Throughout the TV show, Ms Kruglova shared her experiences of being an orphan and living with HIV. Over time she became an inspiration for young people and those living with HIV.

"When the TV episode aired, I started contemplating how people would perceive me, what they would say, and how they would react,” she recalled. “Psychologists were working with us during the project, which made it easier for me to handle the pressure."  

To her surprise, people positively reacted when they recognized her on the streets, and she received numerous supportive messages from people living with HIV via Instagram.

"I am grateful for the trust they placed in me " she said.

For her, the Tashkent day-care center for children and families affected by HIV supported by UNICEF and UNAIDS played a crucial role in her life. It provided a safe haven, gave guidance throughout her childhood and teenage years. The center's support group, the professional consultations, and master classes helped her develop practical life skills. She is optimistic about the future and believes that people can change their attitudes towards HIV with the right information and education.  In her mind, hiding only makes things worse.

Aida Muravyova knows all about the power of disclosing her HIV status.

She is a 16-year-old school student in Kazakhstan and learned about her HIV status when she was 6 years old. Although advised against disclosing her status at school and extracurricular activities, Aida chose a different path.  She shared her HIV status with her classmates in school and took on the role of breaking down the myths and misconceptions surrounding HIV in front of her peers and adults.

“When I was told about my HIV diagnosis, I thought to myself, 'Okay, I have red hair, I have HIV, I take pills... what else?!'"

Ms Muravyova found solace through the Teenergizer Movement, a youth-led initiative supported by the Kazakhstan Government, UNICEF, UNAIDS and other donors. Teenergizer aims to empower young people living with HIV. It created a safe space for young women like her to connect, have fun, and share experiences without shame or stigma. The movement has reached many young people in the country, creating a ripple effect of reliable information and support.

When Teenergizer came along, Ms Muravyova invited classmates to join. "They got valid information, learned with me, and even conducted training sessions,” she said. “The most gratifying part was when one of my classmates' mothers, initially frightened by my HIV status, learned about HIV through her child's participation in Teenergizer.”

Her friend told her that her family had an open conversation, hashed out concerns, and now everything is okay.

Gender assessments conducted in several countries of Central Asia, including Kazakhstan, confirmed that gender inequality, stereotypes, customs and practices increase women’s vulnerability to HIV as well as limit their choices and expose them to socioeconomic and health difficulties.

Ms Muravyova refuses to let her HIV status define her or limit her dreams.. "I have seen many people living with HIV, but never in my field of Electrical and Aerospace Engineering... I want to change that perception and demonstrate that living with HIV can be different, cool, and interesting."

The UNAIDS Regional Policy and Equality Officer in Central Asia, Elena Kiryushina, sees role models like Elina and Aida as well as community networks as key.

“Promoting leadership among adolescent girls and young women, fostering positive masculinities in boys and men, providing care and support to adolescents living with HIV, especially those who lost parents and access to comprehensive sexuality education in and out of schools, and supporting gender-transformative approaches are essential steps to address HIV and gender-related stigma and to build foundation for the gender equality in Central Asia and beyond,” she said.

UNAIDS and partners believe empowering women and girls and challenging cultural norms is crucial to address HIV stigma and ensure equal access to support and health services.

Ms Muravyova has one mantra. “Speak, and don't be afraid!,” she said. “We are together, and together we'll make it through.”

The 2020 Kazakhstan Code on Public Health and Health Care System guaranteed the right of people living with HIV to adopt children. However, certain bylaw regulations remained that created barriers for people living with HIV to enjoy the right to adopt children. On 1 December 2022, the day the world commemorated World AIDS Day, the Ministry of Health removed this remaining barrier.

UNADS welcomes this progressive action as reaffirmation of Kazakhstan’s continuing commitment to eliminate stigma and discrimination against people living with and affected by HIV.

UNAIDS Country Director in Kazakhstan Gabriela IONASCU said, “Living with HIV is no longer seen as an impediment to adopting and raising children. By excluding HIV from the list of diseases that prevent people from adopting children or becoming guardians or foster parents, Kazakhstan is taking bold steps to advance in the right direction: ensuring human rights for all, including for people living with HIV.”

It furthermore underlines Kazakhstan’s commitment to guaranteeing human rights for all leaving no one behind, including activities under the framework of the Global Partnership for Action to Eliminate All Forms of HIV-Related Stigma and Discrimination which the Republic of Kazakhstan joined in 2021 among 30 other pilot countries.

“Similar changes in legislation were made in other eastern European and central Asian countries, including the Kyrgyz Republic, the Republic of Moldova, the Russian Federation, and Ukraine. UNAIDS reaffirms its commitment to provide technical assistance and expert support to advance progress to end AIDS in Kazakhstan and support all people living with and affected by HIV across the region,” said Eamonn Murphy, UNAIDS Deputy Executive Director and Regional Director for Eastern Europe and Central Asia

Note: The decree of the Ministry of Health of The Republic of Kazakhstan

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

The ARTiSHOCK Theatre in Almaty, Kazakhstan, recently premiered an extraordinary performance: all its actresses were women living with HIV, ex-prisoners and women who use drugs. They played the role of women who faced stigma, discrimination and violence, an echo of their own life stories.

The performance, the script for which was written by female activists, was the idea of the Revanche Center for Comprehensive Care (also known as the Revanche Foundation), supported by the UNAIDS Country Office for Kazakhstan and the Eurasian Network of Women Living with HIV.

“The idea of ​​a social theatre was a dream that has finally become a reality,” said Anna Kozlova, a social worker for the Revanche Foundation. “We decided to talk about the experience of violence. After all, it is not only physical or sexual. To be rejected by society and discriminated against is also violence, but psychological.”

Nadezhda Plyaskina, the play’s director, said that it was not easy to work with the aspiring actresses. “I was afraid: these women have such considerable life experience; what can I teach them? In addition, it was necessary to teach acting in a way that did not hurt: they are all vulnerable. Each rehearsal revealed them to me as real, amazing, wonderful people. I told them: “Play with your heart.””

And they played with their hearts, telling their stories of imprisonment, abuse, stigma, loneliness and hope. The performance was a great success and was widely covered by Kazakh media.

Ms Kozlova began using drugs when she was 17 years old, which landed her in prison for 17 years. “All women who come out of prison are already victims. They are broken, vulnerable, don’t know how to live, where to go. They need help to become strong.” Four years ago, she went to the Revanche Foundation for help, and there she found a job, a family and a purpose. “I know from my experience that things can change,” she said.

Zulfiya Saparova has been living with HIV for 15 years; she is on antiretroviral therapy and works as a peer consultant for Equal to Equal Plus. She faced abused and violence and tells her story from the stage. “My heroine in the performance comes on stage holding a frying pan. This story is imprinted in my memory: my neighbour constantly walked around with black eyes. She was beaten by a drunken husband. Once her daughter came to visit her, and a black eye appeared on the husband’s face—she had protected her mother by beating him with a frying pan.”

Natalya Kovaleva, a social worker for the Revanche Foundation, spent eight years in prison. Her last term was three years and compulsory treatment for drug addiction. Currently, she works with young people who use drugs on HIV prevention. “If it wasn’t for the Revanche Foundation, I would either be behind bars or dead,” she said. “I have a mission here.”

The heroine she plays faces physical and psychological violence, total control, prohibitions and beatings. “I don't want to arouse pity, so I played a strong, independent woman who refuses to endure bullying. All this was in my own life,” said Ms Kovaleva.

The Revanche Foundation helps women in difficult situations, including women living with HIV, women who use drugs, children who lived in orphanages and former prisoners.

Elena Bilokon, the director of the Revanche Foundation, says that her work is focused on the most vulnerable and socially unprotected women, as there are no state support programmes for them. “Yes, the state provides patients with HIV drugs, but there is no psychosocial and social support. This year alone, 285 women living with HIV applied for our help,” she added.

“There is a clear link between violence against women and HIV. Studies show that women living with HIV are more likely to have experienced violence, and women who have experienced violence are more likely to be living with HIV,” said Gabriela Ionescu, the UNAIDS Country Director for Kazakhstan. “For this reason, UNAIDS highlights the need to address violence against women as a key human rights issue and the need to provide support to the most vulnerable women, including social and psychological help.”

The next performance will take place on 1 March, Zero Discrimination Day. The activists also plan to perform the play in several prisons in Kazakhstan. 

Inspiring stories of solidarity during the COVID-19 outbreak in eastern Europe and central Asia have been shared by community leaders, businesspeople, celebrities and others. Under the umbrella of #TogetherWeWin, a series of Instagram and Facebook Live talks have shown how people are supporting each other in this difficult time. 

“The COVID-19 pandemic has become not only a challenge to health care and economies, it has also become a test for social solidarity. We have seen some amazing examples of solidarity and unity in supporting people who are left behind,” said Alexander Goliusov, Director, a.i., of the UNAIDS Regional Support Team for Eastern Europe and Central Asia.

Arusik Mkrtchyan, from Armenia, a long-time friend of UNAIDS, spoke with Narine Manukyan, chair of the AI MAYER (Armenian Mother) charity, which helped more than 300 families who lost their livelihoods during the lockdown with food and medicine. “I have always believed that charity should support people in a sustainable and long-term way, create opportunities for people to solve their problems by themselves. But in this situation, families with children with disabilities whose parents lost their jobs faced the problem of not having food to eat,” said Ms Manukyan. Ms Mkrtchyan also spoke with Hamlet Khnkoyan, who started the Let’s Help Families in Need movement, which initially helped several families in his neighbourhood with food supplies but snowballed into supporting more than 600 families.

Olya Tira, the UNAIDS Goodwill Ambassador for the Republic of Moldova, spoke with the blogger Lilu Ogovan, a founder of Together for You, Anna Racu, and Ruslan Poverga, from the Positive Initiative.

Ms Racu spoke about Together for You, which supported medical personnel by providing personal protective equipment and disinfectant, as well as purchasing other medical equipment. Aid was initially provided to ambulance stations, but, over time, hospitals that were looking after patients with COVID-19 were also helped. Mr Poverga said that the Positive Initiative, together with partners, delivered antiretroviral therapy to more than 850 people living with HIV, including 65 Moldovans who were trapped abroad during the lockdown. “The crisis forces people to be creative. People stopped thinking in terms of “possible” and “impossible”, we just know that it is necessary to do this and that’s it, and the question is only how exactly we will achieve what we want. And I am very glad that, thanks to our partners as well, we have succeeded,” Mr Poverga said.

In Belarus, there was a live broadcast by Yuri Tkachuk, a singer, television presenter and member of the country’s UNAIDS Red Ribbon Team. UNAIDS Goodwill Ambassador Svetlana Borovskaya, along with television journalist and producer Irina Rombalskaya, as well as representatives of the People Plus community organization, Tatyana Zhuravskaya and Anatoly Leshenok, and Julia Stoke from the Positive Movement, discussed the theory of small actions.

“I believe in this theory. Even when it looks like you do not have a lot of time and financial resources, you can still help substantially. For myself, I chose the path of one good deed a day,” said Ms Rombalskaya, who is buying food and medicine for older people during the lockdown. Ms Zhuravskaya and Mr Leshenok organized the delivery of antiretroviral therapy and helped Belarusians who were outside the country when the border was closed to obtain antiretroviral therapy.

In Kazakhstan, a Facebook Live stream was hosted by Adele Smith, a television presenter and head of the Charity Warehouse project. She talked to Aruzhan Sain, the Commissioner for Children’s Rights in Kazakhstan and founder of the Volunteer Charity Foundation, which helped children with serious illnesses during the COVID-19 outbreak when, due to the closure of the border, there was a significant shortage of medicines and medical supplies. Volunteers found and purchased medical equipment and medicines and delivered them to children’s hospitals, with the foundation later expanding its work to other medical institutions.

Konstantin Avershin, a businessman and leader of the I’m Alma-Ata movement in Kazakhstan, initiated the Who If Not Me challenge, aimed at helping people in need. Assistance was provided in various areas, from the supply of personal protective equipment to doctors to legal support for victims of domestic violence. The challenge brought together 14 cities in Kazakhstan, many volunteer networks operating in the country and the government.

Elena Bilokon, the founder of the Community of Women Living with HIV in Kazakhstan, also joined the broadcast and spoke about her story of supporting people from key populations and about living with HIV in a crisis.

Erkin Ryskulbekov, a UNAIDS Goodwill Ambassador for Kyrgyzstan and television presenter, invited a human rights activist, Gulgaaki Mamasalieva, and Kyrgyzstan’s triathlon champion, Aivaz Omorkanov, to his Instagram Live feed.

Ms Mamasalieva shared her experience in creating an online forum that brings together most of the country’s volunteer organizations and makes it possible to make a direct request for assistance and receive an immediate response. The forum is based on the Telegram platform and facilitates volunteers communicating with each other during an emergency. “We have 10 years of experience in civil monitoring. We know all the standards and requirements for providing such assistance, including how these processes should be organized during emergencies,” said Ms Mamasalieva.

Mr Omorkanov spoke about how he managed to complete his triathlon training programme while staying at home under lockdown as well as starting an online fundraising initiative, inviting world sports starts to join him and raise funds to provide personal protective equipment for doctors at the infectious diseases hospital. In total, US$ 6500 was raised. “My message was that we can help our country even while staying at home,” said Mr Omorkanov. In addition to raising funds, the action had another goal—to encourage people to do sports and maintain a healthy lifestyle, even while under lockdown.

Mr Ryskulbekov ended the discussion by saying, “When I do charity work and help people, I understand that although my actions are needed by others, I’m actually the one who needs it the most; it’s me who becomes happier by doing good things.”

The lockdowns and self-isolations imposed to fight the COVID-19 pandemic have affected everyone, key populations and people living with HIV included. Prolonged isolation and limited contact with family and friends have increased anxiety and depression and impacted quality of life, increasing the need for mental health services.

To respond to this need, an online platform that offers psychological services and support for people from key populations has been launched in Kazakhstan. On it, people can get answers to questions related to different aspects of mental health, request professional consultations with psychologists or psychotherapists and receive broader information about health and well-being. 

“Anxiety, uncertainty, worries—these feelings are consequences of the quarantine and self-isolation during the coronavirus pandemic. For many people, the time spent in quarantine was difficult. Today, we see a greater need for psychological help and support. It was for this purpose that this platform was created for key populations,” said Nikolay Negay, Director-General of the Republican Scientific and Practical Center for Mental Health of the Kazakhstan Ministry of Health.

The platform was developed with the participation of people from community organizations, representatives of key populations and activists.

“During isolation, we supported each other as best we could through social networks, communication by phone, Skype, but there was a need for qualified professional help. We are glad that such assistance has become available, and for free. The resource is informative and answers many questions,” said Oksana Ibragimova, the acting President of the ALE Kazakhstan Union of People Living with HIV.

“An anonymous rapid needs assessment conducted by UNAIDS in Kazakhstan among people living with HIV and key populations found that around 60% of respondents needed psychosocial support during the COVID-19 lockdown. It was therefore decided to find a way to provide reliable information, advice and professional assistance to those who may need it,” said Gabriela Ionascu, UNAIDS Strategic Information Adviser for Central Asia.

The platform was created as an initiate of the Republican Scientific and Practical Center for Mental Health of the Kazakhstan Ministry of Health, with financial support from UNAIDS and technical assistance from the Kazakh Scientific Institute of Dermatology and Infectious Diseases of the Kazakhstan Ministry of Health.

Countries reaffirmed the fundamental right of every human being to the enjoyment of the highest attainable standard of health and committed to strengthen primary health-care services at the Global Conference on Primary Health Care. The Declaration of Astana, unanimously endorsed at the conference by all World Health Organization Member States, makes pledges in four key areas: making bold political choices for health across all sectors; building sustainable primary health care; empowering individuals and communities; and aligning stakeholder support to national policies, strategies and plans.

HIV disproportionately affects populations that are in many countries marginalized, stigmatized, discriminated against and criminalized. The new commitment to primary health care presents a timely and unique opportunity to step up efforts to address the many barriers that those populations face in accessing HIV and primary health-care services. Addressing such barriers requires having the courage to respond to issues that are often considered sensitive or taboo—around gender, sexuality, identity, exclusion and power.

“UNAIDS is proud to be leading on community and civil society engagement, as part of our contribution to the Global Action Plan for Healthy Lives and Well-Being for All. Only by taking AIDS out of isolation can we can save lives holistically, not disease by disease, issue by issue,” said Vinay P. Saldanha, Director of the UNAIDS Regional Support Team for Eastern Europe and Central Asia.

UNAIDS’ contribution to the event, The AIDS response and primary health care: linkages and opportunities, sets out examples of how to integrate HIV services into primary health care and, conversely, how to use the AIDS response to further leverage primary health care. It calls for urgent attention to be given to the structural and root causes of ill health and for sexual and reproductive health and rights to be central to primary health care.

The Global Conference on Primary Health Care took place in Astana, Kazakhstan, on 25 and 26 October.

To defend her access to life-saving opioid substitution therapy, Marzhan Zhunusova overcame her fear of flying and, for the first time, took a flight to Astana, the capital of Kazakhstan. She was visiting the city to take part in a country-wide mobilization of people accessing the country’s harm reduction pilot programme, with people from all over Kazakhstan publicly showing the importance of opioid substitution therapy.

After injecting drugs for more than 25 years, Ms Zhunusova had lost hope for a better life. “When I first heard about opioid substitution therapy, I thought that it may be the way out and that it could help me. Drugs, my HIV-positive status, I thought my life was over. I’m 45 years old and only now thanks to methadone have I started to live life fully.”

The campaigners marched in Astana on 27 June and were joined by activists from other groups, including people living with HIV and gay men and other men who have sex with men.

The people who mobilized for the event share similar backgrounds. Their use of drugs may have deprived them of their health and their dreams. Some do not have jobs or have served time in prison. Many are isolated from society and the majority are living with HIV.

Ibrahim Dolgiev tried drugs for the first time in the 1970s, when he was 22 years old. “After many years of trying to stop using drugs, for the past year I’ve been in the opioid substitution therapy programme. It has been a salvation for me. My life has changed dramatically for the better, and for the first time in many years I can get through the day without heroin,” he said.

The people taking part in the mobilization came together to express their hope that the opioid substitution therapy programme will remain and that it will be further expanded.

In partnership with international and national partners, UNAIDS provided the Government of Kazakhstan with evidence-informed arguments on the effectiveness of opioid substitution therapy in controlling the HIV epidemic among people who use drugs.

“Access to opioid substitution therapy is one of the main factors enhancing adherence to antiretroviral therapy among people who use drugs,” said Alexander Goliusov, the UNAIDS Country Coordinator in Kazakhstan.  

“Over the past three years, people who use drugs in the opioid substitution therapy pilot project in Pavlodar demonstrated 100% adherence to antiretroviral therapy,” said Zhannat Musaevich Tentekpayev, Chief Doctor of the Pavlodar AIDS Centre.

Unfortunately, however, the future of the programme in Kazakhstan remains uncertain, and no one has been enrolled in the programme since December 2017.

At the end of June 2018, a government commission announced that the pilot programme would continue, but that it would not be expanded to other regions of the country. An investigation into the cost-effectiveness of the programme is under way and the results will be presented by November. The Kazakhstan Union of People Living with HIV has appealed to the President of Kazakhstan not to close down the programme, noting that support for effective national responses to HIV is critical to making progress towards the 90–90–90 targets.

"While the law enforcement agencies are deciding whether the opioid substitution therapy programme is appropriate or not, the number of people accessing the programme remains very limited. The programme has to be not only maintained, it must exit its pilot status and be available and accessible everywhere in Kazakhstan for people who inject drugs,” said Oksana Ibrahimova, the coordinator of the Kazakhstan Union of People Living with HIV.

Today, there are 13 opioid substitution therapy centres in Kazakhstan, in nine of the 16 regions of the country. Since the beginning of the programme in 2008, more than 1000 people have been enrolled. Currently, 322 people are enrolled in the programme, the majority of whom have stopped using drugs, become employed and are enjoying a family life.

At a conference entitled HIV: Yesterday, Today, Tomorrow, experts discussed the urgent measures that Kazakhstan should take to Fast-Track the AIDS response in the country. More than 170 governmental officials, activists, scientists, experts, health-care professionals and representatives of the AIDS community from all 16 regions of Kazakhstan gathered in Almaty, Kazakhstan, from 12 to 13 October for the conference.

Access to HIV testing for key populations, the cost of the diagnosis and treatment of people living with HIV, scaling up harm reduction programmes, such as opioid substitution therapy, and optimizing investments in Kazakhstan’s AIDS response were some of the issues discussed in the context of developing a new national strategy on HIV.

The issue of HIV prevention among young people was also highlighted during a ceremony to appoint Asya Ospanova as an envoy for the UNAIDS Regional Youth Red Ribbon Team, a group of young personalities from 10 countries of eastern Europe and central Asia. In her new role, Ms Ospanova, an actress, singer and television presenter, will raise awareness about HIV and promote tolerance towards people living with HIV among adolescents and young people in Kazakhstan.

The HIV epidemic in Kazakhstan is concentrated among populations at higher risk, such as people who inject drugs, sex workers, men who have sex with men and prisoners. The government estimates that more than 18 000 people were living with HIV in the country as of June 2016.