The pursuit of status: How fear, the law and social stigma are hindering the fight against HIV in Central Asia

 

26.05.2026

 

Article published on the anhor.uz website

 

At the end of last year, around 52,000 HIV sufferers were officially registered in Uzbekistan and over 13,000 in Tajikistan. These figures highlight a systematic problem in which the fear of a positive diagnosis often outweighs that of the disease itself.

 

Modern treatments enable those living with HIV to lead normal lives, start families and have healthy children. However, in Central Asian countries, medical progress often faces issues that date back to the late 20^th century: social stigma, criminal prosecution and discrimination within State institutions.

 

The following investigation explores why many residents of the region still avoid being tested, how the medical and legal systems reinforce the fear of a positive diagnosis, and why human rights activists believe the current model for combating HIV is ineffective.

 

The legacy of the 1980s: A fear that has outlived scientific progress

 

Despite decades of research, attitudes towards HIV in the region remain largely stuck at the level of the 1980s, a time when the virus was widely perceived as a death sentence and associated exclusively with “at risk groups”.

 

Today, the WHO and other international medical bodies say otherwise:

 

• HIV is not transmittable through everyday contact – handshakes, shared crockery, hugs or in swimming pools;

 

• With timely treatment, a person can live just as long as those who don’t have the disease;

 

• The epidemic has long since spread beyond closed communities and now affects a wide range of social groups.

 

One of the key scientific principles in recent years has been the concept of U=U (Undetectable=Untransmittable), i.e. a person undergoing antiretroviral therapy and having an undetectable viral load does not transmit HIV sexually. However, human rights activists and CSOs note that in Central Asian countries this principle remains little known among the general public and even by medical workers themselves.

 

According to experts interviewed by Anhor.uz, it is precisely the fear of public condemnation and the possible consequences of a positive diagnosis that deters people from getting tested.

 

Hospitals as a source of discrimination

 

Human rights organisations have documented numerous cases of discrimination against people with HIV in the healthcare system. The Ishonch va Hayot CSO recorded 130 complaints in 2022-2023 alone relating to the denial of medical care, or violations of the rights of HIV patients. However, there are no centralised Government statistics on these cases.

 

Among the most common problems are: being refused treatment, humiliating treatment and breaches of patient confidentiality.

 

One of the cases reported by human rights activists in Dushanbe involved a woman named Nasiba, who said that during a medical appointment, a doctor demanded that a chair she had been using be disinfected after the examination, which Nasiba saw as a blatant display of fear and social stigma.

 

Another case concerns 61-year-old Farukh from Tashkent who, say activists, was refused access to a social care facility for a long time due to his HIV status.

 

Experts say that such examples undermine trust in the healthcare system and deter people from seeking help.

 

Madina’s story

 

Problems are particularly acute in the area of reproductive health. According to Ishonch va Hayot, an Uzbek woman named Madina, who found herself in a difficult social situation, was unable to receive proper care during her pregnancy. CSOs claim that a lack of coordination between medical and social services meant that the woman didn’t receive the help she needed. As a result, according to activists, Madina was forced to give up her child after giving birth. Human rights activists say that this case highlights major systemic gaps in inter-agency cooperation.

 

Criminal liability and the fear of testing

 

Another factor influencing attitudes to testing is HIV-related legislation. The Criminal Codes of Uzbekistan and Tajikistan still include provisions that assign liability for “knowingly exposing a person to the risk of HIV infection”. This applies specifically to Article 113 and 125 of the Uzbekistan and Tajikistan Criminal Codes respectively.

 

According to the International HIV Justice Network, 86 such criminal prosecution cases have been recorded in Uzbekistan since 2008, a quarter of which occurred in 2023.

 

Human rights activists believe that such legislation creates an additional fear of testing in that a person who knows their HIV status could potentially face criminal liability.

 

 

 

Aziza’s story

 

One high-profile case involved a Tashkent resident named Aziza, who worked in a beauty salon.

 

Criminal proceedings were brought against her under Article 113 of Uzbekistan’s Criminal Code. During the investigation, details of her diagnosis became public, which led to her losing her job and suffering public opprobrium as a result.

 

Lawyers who handle such cases highlight the problem of how the concept of “knowingly” is interpreted, saying that the courts don’t always consider factors such as the use of contraceptives, or an undetectable viral load which eliminates the risk of virus transmission.

 

At the end of 2023, the Plenum of Tajikistan’s Supreme Court recommended that the courts take international norms and medical data into account when considering such cases. However, human rights activists believe that this is insufficient without changes to the law.

 

Restrictions on the rights to be a parent

 

Family and adoption issues are another sensitive topic for those living with HIV. The Tajikistan Government’s Decree No.406, adopted in 2000, which prohibits HIV sufferers from adopting children, remains in force. International organisations and UN bodies have repeatedly asked for this directive to be reviewed but with no success.

 

There is no legal ban in Uzbekistan but human rights activists speak of informal obstacles. According to monitoring carried out by Ishonch va Hayot, one in three HIV-positive applicants faces rejection at the medical examination stage. Experts attribute this to the lack of standard and transparent assessment criteria, as well as personal prejudice.

 

Even when treatment is available,  it is becoming increasingly difficult to access it

 

Although antiretroviral therapy is still technically available, the HIV care system in Central Asia is facing a new crisis, namely a reduction in international funding, and the weakening of a network of CSOs that has kept people in the treatment system for years.

 

This became particularly noticeable in Tajikistan after the freezing of some US foreign aid in early 2025. For many years, it was civil society organisations that carried out the work which the State system was often unable to do on its own: identifying people from vulnerable groups, going with them to AIDS centres, helping them to continue with their treatment, organising support groups and creating safe, stigma-free spaces.

 

A number of programmes were put on hold following the suspension of some USAID and PEPFAR (President’s Emergency Plan for AIDS Relief) related projects. According to USAID conservative estimates, in the first few months after the halt of funding, around 1,700 people dropped out of social programmes, more than 2,000 were not tested for HIV, and approximately 100 cases of infection went undetected.

Although medicines and core treatment have remained in place, the blow has fallen on another part of the system: outreach work, counselling and patient support. CSOs are warning that without this “invisible infrastructure” people will be more inclined to discontinue their treatment, less likely to be tested and left to face social stigma alone. Former prisoners, those who use drugs, migrant workers and HIV sufferers are particularly vulnerable, many of whom work as peer counsellors in community organisations.

 

According to researchers and international organisations, this situation is not unique to Tajikistan. In many countries, cuts to donor programmes mainly impact on prevention and community work, the very part of the system that bridges the gap between people and healthcare.

 

What human rights and medical professionals are proposing

 

CSOs, lawyers and doctors are proposing a range of measures which, they believe, could reduce the level of social stigma and improve HIV prevention. The key ones are:

 

• A review of all HIV-related criminal legislation;
• Tougher penalties for the disclosure of a diagnosis;
• Lifting restrictions on the adoption of children by people living with HIV.

 

Changes to the healthcare system

 

• Training medical staff in modern approaches to treating HIV;
• Introduction of uniform patient care standards;
• Improving coordination between HIV centres and social and medical services.

 

Information campaigns

 

• Disseminating information about the “U=U” principle;
• Government programmes to reduce social stigma;
• Support for CSOs that provide legal and psychological assistance to HIV sufferers.

 

Postscript

 

Today, HIV in Central Asia remains not only a medical but also a social issue. Modern medical treatment makes it possible to control the virus, yet social stigma, fear and the threat of criminal prosecution continue to affect the lives of thousands of people.

 

Human rights activists warn that as long as people are afraid of the very idea of being diagnosed, a significant part of the epidemic will stay hidden, which means that prevention and treatment will be less effective.

 

Source: https://anhor.uz/society/hiv-stigma-central-asia-uzbekistan-tajikistan/