“We must strive to remove barriers and stop judging people as ‘good’ or ‘bad’. Medicine should be for everyone,” says Lena, women’s mentor from Pavlodar
“This is a complex group,” says Lena from Pavlodar, Kazakhstan. She works with 17 women in a mentoring programme. Many of the women use drugs, have experienced domestic violence or have been in prison. Lena, aged 55, used drugs for over 20 years, but she has been drug-free for seven years, crediting opioid agonist maintenance therapy for helping her quit.
“I went through all this myself. I remember how it was using drugs: I fell asleep—it’s winter. Woke up—summer,” she says. “If a person comes to therapy out of desperation, does not want to steal or torment their parents and loved ones, this programme can help them.”
The therapy helps mitigate the need for drugs, but Lena emphasizes “it is important that peers and psychologists work with people and prepare them to leave the programme and have access to essential HIV prevention services and treatment”.
After being released from prison nearly a year ago, Lena became a peer consultant in the women’s mentoring programme.
“The problem for many people who use drugs is that they live with HIV and TB but cannot access available services or receive therapy,” Lena explains. Without a home or family, they are invisible to the social protection system and are often driven into desperate situations. “They need a helping hand. They are humans and live next to us. We must strive to remove barriers and stop judging people as ‘good’ or ‘bad’. Medicine should be for everyone.”
Lena helps some people register for medical or social support facilities, and others to get treatment. The mentoring programme covers 13 regions of the country. Dozens of women have received help. Some have learnt a new skill and found a job, and others have managed to accept their diagnosis and restore family ties. With help from the programme, many women who use drugs have managed to quit active drug use, improve adherence to life-saving HIV and TB treatment, and reconnect with the community.
For Aliya Bokazhanova, UNAIDS Country Director a.i. in Kazakhstan, these are incremental steps to empowering women from key populations. “Women living with HIV have the opportunity to develop and receive the necessary support and inspiration from experienced mentors, which contributes to their self-realization and integration into society,” she says.
Lena is dedicated to the programme. “I am reborn from this work. My eyes light up, and I feel strong and ready to help,” she says.
She plans to meet with the akim (mayor) to propose a project to create a support system for people who are left behind. Lena believes there should be no situations where a person is alone and cannot be admitted to a home for disabled or elderly people because they are living with HIV. It is crucial to revise the laws so that everyone is allowed access to social institutions.
As of 2024, there are 40 000 [35 000–46 000] people living with HIV in Kazakhstan. New HIV infections are mostly among people from key populations (people who use drugs, gay men and other men who have sex with men, sex workers, and people in prisons and other closed settings). HIV prevalence among people who inject drugs is almost 7%, compared with 0.3% in the general population.
* Myanmar: Intensification of Clashes Flash Update #10 (as of 15 December 2023) [EN/MY] | OCHA (unocha.org)