Fear and Cajoling in Kabul: Bringing HIV Services to High Risk Groups

Edris receives his methadone and anti-retroviral medicine from a UNDP/Global Fund-supported centre in Kabul. Photo: UNDP Afghanistan / Ahmad A.Fakhri / 2016

1 December 2016, Kabul – Edris is a young man living in Kabul. Last year, he broke his nose trying to break up a fight, but when he went to hospital, doctors found out he had HIV and refused to treat him.

“It really disappointed me,” he says. “Not just the bad treatment, but because I know that other people with HIV also run into the same kind of discrimination.”

Edris knows this because he’s seen it. Just four months before, one of his friends died of appendicitis because doctors weren’t willing to operate.

Highlights

  • Edris is HIV-positive and a tireless advocate against HIV discrimination
  • He also works at Bridge, a small NGO that refers drug users to UNDP/Global Fund-supported drop-in centres
  • These centres provide HIV counselling, testing and treatment across Afghanistan
  • There are just over 2,000 people confirmed to be living with HIV in Afghanistan, but the actual number is likely to be far higher because most people don’t get tested

“Worse than that,” adds Edris, “His body was thrown into the garbage. If even doctors have this kind of attitude, how can we complain about the behavior of less educated people?”

There are just over 2,000 people confirmed to be living with HIV in Afghanistan, but the actual number is likely to be far higher because most people don’t get tested. In an online survey conducted by UNDP last month, over 20% of 260 respondents said they had been involved in activity that might lead to the spread of HIV, but only one-third got tested afterwards.

This is hardly surprising in a climate where even doctors discriminate against their patients.

To try to extend the reach of testing services, particularly among injecting drug users and other high-risk groups, UNDP and the Global Fund support 36 drop-in centres across Afghanistan that provide voluntary HIV counselling and testing. They also offer advice on methadone replacement therapy and supply anti-retroviral medicine.

They have the capacity to serve nearly 60,000 people over the next 18 months, but the question is how to get people to use them.

That’s where Edris comes in.

He works at a small NGO called Bridge that employs nine youth volunteers to reach out on the streets of Kabul to injecting drug users.

It’s a shoe-string operation, but the volunteers manage to reach about 15-20 people a day. They provide first aid and encourage people to visit testing and treatment services such as the ones supported by UNDP and the Global Fund.

The volunteers find it easier to win the trust of Kabul’s drug users because they are all ex-drug users themselves.

So is Edris. “I was on drugs and on the verge of death,” he recalls. “But now I’m really hopeful for my future and not worried at all about my HIV.”

Edris has known he is HIV-positive for seven years. But he is on a successful treatment regimen. In the coming years, he wants to continue to raise awareness about HIV prevention and treatment, fight stigma and help people living with HIV to live a normal life.

“My greatest hope,” he adds, “is that I will be able to raise the voice of my community and see a day when hospitals treat HIV patients with respect and dignity.”

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