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Tatyana Em: Equality as a Fact, not a Theory

Violation of women’s gender rights is not always and not in all countries considered as a crime, especially in Asia, and in rural areas. Most often, women and young girls are forced to endure discrimination in the family, which can escalate into a form of violence. For example, the right to “safe sex”, which is one of the reasons for the spread of HIV in Kazakhstan.

Little attention is paid to the issues related to violations of the rights of women with HIV in Kazakh society. Of course, it should be noted that Kazakhstan is the only country in Central Asia where HIV/AIDS treatment is organized at the state level. Measures are taken in relation to the issue of prevention and treatment of HIV/AIDS. In this regard, Kazakhstan is a country with a low prevalence of HIV infection among the population in comparison with the countries of Eastern Europe and Central Asia.

However, the issue of violation of HIV-positive women’s rights in Kazakhstan remains unresolved. To date, according to the Ministry of Health, HIV prevalence in the population is 0.168%, of which 40% are women. Women and girls are more vulnerable to rejection due to their HIV status by their families and loved ones, which leads to incidents of domestic violence, violation of property and moral rights. Gender-based discrimination is the main reason women and girls in today’s society are socially vulnerable.

“When my husband was released from prison, where he stayed for 2 years for hooliganism, I did not think that he could be sick or infected. At that time, he already knew he was infected with HIV; he would go to the hospital for tests but would not tell me about it. When I was diagnosed with HIV, his family beat me and forced me out of the house. I was left alone, without my children, with no money and no roof over my head. There was only one thought in my head – suicide. But I talked myself out of it, knowing that it is a sin. Then I turned to religion. I was afraid of myself, that I would infect others, even though I knew that infecting is only possible through blood or sexual contact. As my husband had infected me,” says Amina (name changed).

Gender Inequality in Relation to HIV Status

Throughout the world, young women aged 15-24 years are the most vulnerable to HIV – their incidence is twice as high as that of young men, and women become infected faster.

According to experts, over sixty percent of all women in Kazakhstan have experienced physical or sexual violence at least once in their lives. Twenty-eight percent of married women are victims of violence by their husbands, in the regions and cities of Kazakhstan, and these acts are not considered as a crime. There are statements in the treatment of law-enforcement agencies on the fact of battering, marital rape is still completely unpunishable by law. According to the traditions and customs, the husband cannot rape his wife because she belongs to him.

Financial dependency also increases women’s vulnerability to HIV transmission through sexual contact. Sole control over the family budget by the husband leads to greater vulnerability of women. In rural areas, women show unconditional obedience to their husbands, whereby a woman does not refuse to have intercourse with her husband because he is the only breadwinner of the family, even if the woman suspects about the risks of unprotected sex, for example, when the husband comes back from prison or uses drugs.

Independent women can easily negotiate with their husbands about practicing safe sex. These studies suggest that the improvement of the social and economic status of women have an effect on the reduction of the risk of HIV infection, as it reduces the dependence on male partners and increases the possibility of independent decision-making.

“HIV affects the lives of women with a much higher negative force than it does to men. There is a close link between violence and HIV, fear and dependence on men. Existing stereotypes in rural areas strongly affect and increase the vulnerability of women in regards to HIV. A man has no right to beat his wife, or to throw her out of the house and take away the children just because she was diagnosed with HIV first; however, these precedents are a common practice in the regions. Despite the fact that most often the carrier of infection is man who has been incarcerated or uses drugs and afterwards infects his wife through intercourse. However, it is difficult for women to prove that, because after the HIV diagnosis, they are subjected to stigma and discrimination from their families and the people around them. A man can be a drug addict and infected with HIV and still be treated sympathetically by the society, whereas a woman with HIV status will be viewed based on formed stigma that she is a drug addict or a sex worker.
According to statistics, women make up 40% of HIV-infected people in Kazakhstan, but their position cannot be considered equal. Many do not receive the necessary medical and psychological care or do not know their status because they live in the countryside. Despite the Strategy for Gender Equality in the Republic of Kazakhstan for 2006-2016, which focuses on the gender equality in the economy, education, society, and family, women in remote regions still face severe inequality, which prevents the full realization of the potential countermeasures to HIV,” says Lilia Kurbatova, Director of the Community Representatives of People Living with HIV in Kazakhstan.

Fear Generates Cruelty

It is not uncommon for a woman with HIV to be subjected to brutal violation of her human rights. The list of violations of HIV-infected women’s rights is endless, the most common ones being: verbal abuse, physical harassment and violence (beating) by family members and relatives, breach of confidentiality, refusal to employ, to provide health care, and access to family planning services.

Women and girls living with HIV have the right to dignity and respect. They need to know their rights and be able to defend them, including the right to choose their sexual activity and childbearing. Human rights and gender equality are critical to effective measures in dealing with unfair treatment of people diagnosed with HIV.

“I work in the service sector, and I hide my HIV status as I have faced insults and physical abuse a number of times. My parents were not able to come to terms with my new life. They are decent people, and they were terrified of what people might say. My father hates me. He believes that this is God’s punishment, because I left my husband and dated other men. I had to move out of the house because my father told me that he could not look at my “diseased” face again. People immediately become crude and rude to me when they find out about my status. The idea of committing suicide crossed my mind, but I reconsidered after contacting the Support Center. The people there helped me to understand and accept a lot. But I’m still not ready to talk openly about my status, the fear of the people’s reaction is too strong,” shared Svetlana (name changed).

At the State Level

The problem of HIV and AIDS is recognized as one of the priorities in Kazakhstan. In 2013, the Republic of Kazakhstan made progress in achieving the objectives outlined in Declaration of Commitment on HIV and AIDS and national Goals of universal access to prevention, treatment, care and support for HIV-infected. A number of institutional and legal solutions were adopted, as well as measures to overcome problems identified during the preparation of the previous report on the implementation of the Declaration. Political support and increased funding, primarily at the expense of the state, have led to significant progress in providing access to services on prevention, treatment and care for HIV infection.

Prevention of HIV infection in populations key to HIV epidemic infection (PWID, MS, MSM, prisoners);
·         Prevention of HIV infection among young people and the general population;
·         Provision of treatment for HIV-infected and AIDS patients;
·         Support for non-governmental organizations working on the issues of HIV and AIDS, including in prisons;
·         Provision of AIDS service laboratory equipment and test systems;
·         Provision of replacement therapy to injecting drug users with opioid dependence;
·         Improved epidemiological surveillance of HIV.

“The most effective measure to counter HIV is the empowerment of women worldwide. The basis for this should be the Convention on the Elimination of All Forms of Discrimination Against Women (1979) – for example, the need to ensure equal opportunities for women in employment and full participation in economic and social life,” says Nicole Ameline, vice chair of the Committee on the Elimination of Discrimination against Women.
Excluding the Victim Status

Despite the measures taken by the government, public foundations, NGOs, and the people who are not indifferent, there is a large segment of the outstanding issues with respect to gender inequalities among women with HIV status.

“Today, with timely and proper treatment, people with HIV infection can return to their work, without having to lose their earning capacity. But the main achievement is that people living with HIV can have healthy children. Several dozen children born from HIV-positive mothers do not have even the slightest hint of HIV infection.

The government should put more effort to provide women and girls with access to a full range of services for sexual and reproductive health and HIV prevention. To increase outreach and advocacy at the local, national, regional and international levels to combat gender stereotypes and discriminatory attitudes towards HIV-infected women. And most importantly, to monitor trends in gender equality in the media and to encourage the participation of women in the accumulation of knowledge and the creation of a base for providing equal access to new media technologies and their use. More efforts should be put to increase access of rural people, particularly women, to the diagnosis and treatment of sexually transmitted infections,” highlighted Liliya Kurbatova, Director of the Council of Community Representatives of People Living with HIV in Kazakhstan.

Author: Tatyana Em, journalist (Almaty, Kazakhstan) 

The views of the author do not necessarily represent those of CABAR