My name is Irena Ermolaeva. I’m the director of Asteria, an organisation by and for women who use drugs in Kyrgyzstan. In my country, people who inject drugs are often living with HIV. It saddens me that HIV continues to spread in Kyrgyzstan. And I’m particularly concerned about the high HIV infection rates among women who use drugs, all the more so because they have limited access to HIV services. That’s why my organisation, Asteria, pushes for change.
Women experience more discrimination
In Kyrgyzstan, women who use drugs experience several barriers when they want to access HIV testing, treatment and care. A huge challenge is that women in general face more discrimination, including in medical settings. Some women fear that healthcare will be refused because of their HIV status or drug use. And so they don’t visit a doctor when they are pregnant or need HIV medicines. Also, women who use drugs are often poorly informed about HIV treatment opportunities, and some are frightened to go for testing. All this affects the spread of HIV in my country.
Some women are frightened to go for HIV testing
Four activist women
In 2006, I had come to the point where I wanted to stand up for the rights of women who use drugs. Together with three women, I created an activist group. The official registration of Asteria in 2007 was a fantastic milestone! Back then, Kyrgyzstan had no gender-sensitive programmes. Women who use drugs didn’t have access to social and medical services, and the laws and government programmes did not reflect their specific challenges. We saw that harm reduction programmes lacked a gendered approach. And we were worried about the discrimination against them by the government and society. It was high time for change.
Organisation by and for women who use drugs
Asteria is the only organisation in Kyrgyzstan that works for and with women from the community of women who use drugs. We are the only ones that provide services specifically for this group and advocate to the government for upholding their human rights. HIV is still spreading among Kyrgyz women, so this group needs our support most. If nobody works with women who use drugs, the HIV infection rates will rise.
We make women feel comfortable enough to go for an HIV test
Sometimes, they don’t use clean needles
I’m very proud that Asteria offers tailor-made solutions for the challenges faced by Kyrgyz women who use drugs. Women who inject drugs sometimes don’t use clean needles and think they might be HIV-infected. But they are too scared to have a test. At Asteria, we take them by the hand and make them feel comfortable enough to go for an HIV test. And, if necessary, we support them in continuing to take their HIV medications.
‘Asteria changed my life,’ Eugene said
We supported a woman named Eugene, who had been using heroin for five years. This is what she told me:
“Talking with the Asteria employee made me understand that my way of living was quite risky. I couldn’t remember ever using a clean needle. So I went for testing for HIV and other diseases. The image that loomed before my eyes kept me awake the night before the tests. I was very scared to hear the results. While I was waiting, a woman from Asteria spoke with me and calmed me down. In the end, I was diagnosed with tuberculosis and hospitalised. Now, I’m completely cured and in an opioid substitution therapy programme. It made me so happy that Asteria also took care of my little daughter while I was in hospital. They arranged for her to stay with my mother. Before that, my mother wouldn’t talk to me because of my drug use, but we’ve reconciled now. My plan is to get a job. I’m very grateful for the support that the women at Asteria gave me. They’ve changed my life!”
Advice on safe behaviour
It is really rewarding to see women like Eugene get their health back and feel happy with themselves. Besides supporting women to go for testing and adhere to treatment, we give them advice on safe behaviour and enrol them in harm reduction programmes. Our building is a shelter for women who use drugs, a safe place. In addition to women who use drugs, we work with sex workers and female prisoners living with HIV and their children. Asteria staff know from experience what works and what doesn’t when reaching out to women. Our peer-to-peer approach is very effective. We also fight self-stigmatisation. Women who use drugs can see that we, the women at Asteria, are the same as them and that we have a better life now. We are role models who inspire women to make changes in their lives.
We protect women’s rights
Advocacy for protecting women’s rights is another important activity of Asteria. I’m thrilled about what we’ve achieved. Until recently in Kyrgyzstan, undocumented women couldn’t get primary healthcare for themselves or their children. No less than 90 per cent of women who use drugs don’t have the ability to obtain a passport due to lack of residence permit. Thanks to Asteria’s advocacy, all people without a passport or birth certificate can now access healthcare, including HIV testing and treatment, just by showing an NGO certificate. To push our case, we filmed violations of human rights in medical institutions and talked with officials.
Asteria staff know from experience what works and what doesn’t when reaching out to women
The gender component is vital
In the past three years, HIV was only rarely detected in women who use drugs in Kyrgyzstan. Thanks to prevention programmes and services focusing on women, HIV hasn’t spread widely among them. A great result! The gender component is vital in HIV programmes and should not fall out of budgets and strategies. Asteria continues to advocate for this.
Fewer HIV infections in Kyrgyzstan
Women experience more discrimination, so it is very important to invest in programmes for them. We are lucky that Bridging the Gaps finances Asteria’s work intended for women who use drugs. Funding Asteria means fewer HIV infections in Kyrgyzstan. Yet, funds are cut while Kyrgyzstan desperately needs support for programmes focusing on groups at risk of HIV. My wish for the future is that governments and other donors will continue to fund programmes with the groups most affected, but often forgotten.
Text: Anna Maria Doppenberg
Photos: Denis Smirnov