Kyrgyzstan Fights AIDS with Taxi Drivers, Condoms
A program jointly funded by the United Nations and the Kyrgyz government is taking an unusually strong stance on HIV prevention, the Christian Science Monitor reports. Kyrgyzstan, one of the poorest former Soviet Republics, is waging an aggressive information campaign, aimed primarily at the nation's prostitutes, their customers and the country's growing number of intravenous drug users. Steadily rising numbers of prostitutes since the dissolution of the Soviet Union in 1991, coupled with a recent "surge" in IV drug use among such high-risk groups as prostitutes and homosexual men, has made HIV infection a leading health problem in Kyrgyzstan. Thirty percent of prostitutes, who average one to four clients a day, are estimated to be drug users, and 10% of those are suspected IV drug users, making the prostitution community and its clients extremely vulnerable to HIV. Government Intervention Slows Spread Kyrgyzstan began focusing on HIV prevention in 1995, well ahead of its neighboring republics. Officially there has been only one death attributed to AIDS and 11 cases of HIV recorded in the nation, but a May test of hundreds of needles returned by heroin users reported a possible HIV-infection rate of 18% to 50% among IV drug users. The U.N.-government program, which began in 1997, runs an organization called Tais-Plus in the nation's capital, Bishkek, which enlists taxi drivers and prostitutes in education and condom-distribution programs. The program also supports a free clinic and a needle exchange program. Drug use in the nation has risen dramatically as Central Asia has become a major drug trafficking route, making heroin cheap and plentiful. Many addicts have turned to prostitution to feed their habit, driving up the risk for HIV transmission. The frontline efforts seem to be paying off. "The impact has been big: Two years ago, some girls didn't even know what a condom was," said Irina Rybkina, a prostitute volunteer with Tais-Plus. "These days, if a client doesn't want to use a condom, we lecture him for 15 minutes about all the problems. Then he wants one," she said. Kyrgyzstan is the only Central Asian country to earmark money for AIDS prevention. Neighboring Kazakhstan has only just begun to address the issue and has a reported 1,500 HIV cases. Realizing that an "ounce of prevention is worth a pound of cure," the government wants to extend the U.N. program, which expires this year, and plans to set aside $1.2 million over the next two years for HIV-related projects (Peterson, Christian Science Monitor, 11/21).This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.