LocationsEven as it battles the COVID-19 pandemic, Ukraine faces one of the largest HIV epidemics in Eastern Europe and Central Asia
Fighting HIV stigma and discrimination in Ukraine: Some progress, but still a long way to go
December 1, 2020
Photo: Shutterstock
Today, when the world is up against unprecedented challenges caused by the COVID-19 pandemic, it is of the utmost importance to pay attention and show support to those who feel particularly vulnerable due to their health conditions. On 1 December the world marks World AIDS Day to raise awareness and demonstrate global solidarity with people living with HIV. This is also a day to address the social and structural barriers they still encounter.
Even though new HIV infections are decreasing globally, in Ukraine the epidemic continues to be a major factor threatening society’s wellbeing. According to UNAIDS, in 2019, 16,405 newly diagnosed HIV cases (4 percent more than in 2018) were reported. This year, in January-October 2020, 13,277 cases of HIV infection were officially registered in Ukraine, which represents a slight increase (0.5 percent) compared with the same period last year.
No less striking, though perhaps less noticeable to the general public, are the obstacles and issues related to human rights, stigma and discrimination that are still faced by people living with HIV in Ukraine. Despite the active involvement and support of international organizations, in particular UNDP, which has been actively working with expert NGOs and representatives of judiciary system to ensure that the rights of people living with HIV are observed, the refusal to provide healthcare, the disclosure of HIV status by medical personnel and other human rights violations still remain a stark reality for thousands of them.
HIV Stigma and Discrimination Persist
Serhiy Dmitriev, Director for Policy and Advocacy of the "100% Life" Charitable Organization, Ukraine. He has worked in the healthcare field for more than 12 years, specializing in the human immunodeficiency virus (HIV), tuberculosis (TB) and viral hepatitis.
Photo by Andriy Kriepkih / UNDP Ukraine
“There have been some positive developments in terms of the legal framework. For instance, this year the Ministry of Health cancelled an order that prohibited people living with HIV from adopting children (MOH order № 479, dated 20.08.2008). However, we should understand that despite the law protecting people living with HIV (PLHIV) in general, people do not always, and not fully, obey the law,” says the expert.
Since 2010 CO "100% Life" has been conducting a survey to measure stigma against PLHIV in healthcare – the Stigma Index.
“We conducted such surveys in 2010, 2013 and 2016, and currently plan to present the 2020 Index,” says Dmitriev. “The study is quite representative, as 2,200 PLHIV participated in this year’s survey. One of the main conclusions is that stigma and discrimination has decreased by almost two times compared to 2010 and 2013. At the same time, the level of discrimination is still quite high. Thus, about 20 percent of respondents mentioned that they had faced discrimination and stigmatization by healthcare workers, which means that almost 25,000 PLHIV experienced this challenge. And about 7,000 PLHIV were denied healthcare services. And that is a lot.”
Olena Volkova, Judge of the Yuzhnoukrainsk city court of Mykolaiv Oblast, and a trainer of the National School of Judges of Ukraine. She has over 26 years of legal experience, 17 of them as a judge of general jurisdiction.
Photo: Stella Shabliovska / UNDP Ukraine
“Not every hospital can provide primary or secondary specialized medical care, not to mention medical care for HIV-infected people. Most hospitals do not have the necessary facilities to provide such services. Therefore a person living with HIV will either be redirected to a specialized institution that will be at a greater distance (and during the quarantine restrictions it also decreases his or her chances of getting there) or will be denied treatment,” explains Volkova.
“It is prohibited to deny employment to a job applicant based on his or her HIV status. However, such discrimination and stigmatization still persists, especially in small towns,” she adds.
Securing access to justice
With the support of international organizations, civil society representatives form partnerships and networks, and are helping people living with HIV to access legal aid. In addition, judges across Ukraine are familiarising themselves with the challenges and developments regarding HIV-related jurisprudence in order to better protect and serve key populations. Consequently, more PLVIH are able to defend their rights in court.
“We provide legal assistance to vulnerable groups and people living with HIV,” says Dmitriev. “Some of the cases were brought to court and resolved in favour of these claimants. One of the cases was even won in the European Court of Human Rights.”
The expert is confident that if there were more successful precedents of HIV-positive people protecting their rights, discrimination against them would decrease. “The issue of self-stigmatization among PLHIV poses a serious problem,” he says. “Often they refuse to defend their rights, and only a few are ready to take a case to court.”
“I considered a case when the company management learned about the HIV status of an employee and forced him to resign,” says Volkova. “And then during the court hearing they claimed that this person resigned voluntarily. Everyone should be well aware of Article 2 of the Constitution of Ukraine and their rights and, of course, apply for legal assistance. It is also important to be informed about the legislation on the protection of personal data and responsibility for the disclosure of such information.”
More work ahead
Both experts agree that a lot of effort still needs to be put into raising awareness among people living with HIV about their rights, as well as overcoming the existing legal barriers and strengthening the legal, policy and regulatory frameworks that govern national efforts in HIV prevention, treatment, patient care and support.
“We use many court cases to advocate changes to Article 130 of the Criminal Code of Ukraine ‘Infection by human immunodeficiency virus or other incurable infectious diseases,’ which criminalizes the transmission of HIV,” Dmitriev points out. “As far as I know, five criminal cases were initiated under this article from 2016 to 2018. In some cases, PLHIV were even sentenced to probation. UN agencies have also stated that this article of the Criminal Code is discriminatory.”
“In addition, when HIV-positive people are registered at the AIDS Centre, they sign a certificate stating that they are aware of criminal responsibility for "deliberately putting another person at risk of contracting the immunodeficiency virus." As a result, only 70 percent of PLHIV go for a medical examination after their first testing. “Some 30-32 percent of PLHIV do not register and do not take medication.”
“It is important to create platforms with permanent support for HIV/AIDS patients, with a developed system of legal and social assistance, keep transparent records for patients receiving therapy, and strengthen responsibility for corruption among pharmaceutical and medical workers,” says Volkova.
“It is also important for PLHIV to be informed about the legal aid they can access,” she adds. “Please remember the hotline numbers of the Ministry of Health and the office of the Commissioner for Human Rights. Always demand explanations from health professionals (in case your rights are violated) and record them on your camera or phone.”
Ministry of Health Hotline - 0 800 505 201
Commissioner for Human Rights Hotline - 044-253-75-89; 0800-50-17-20 (a toll-free number)
Supporting human-rights-based changes in the institutional relations between patients and governmental officials is one of the key goals of the United Nations Development Programme. Since 2018, UNDP has been supporting judicial and law enforcement system representatives through day-to-day operational advice, educational and training programmes, workshops, and other capacity-building activities. In particular, UNDP organized the National Judges’ Platform on HIV, TB and Health Rights, with the intention of supporting a new generation of legal experts on human rights, and resolving the systemic challenges faced by HIV and tuberculosis (TB) patients.
The article is prepared by Nadiia Kaidanovych, UNDP Ukraine
Translated by Kostiantyn Prymak, edited by Yuliia Samus and Euan MacDonald
