The spread of the deadly disease in Kazakhstan is widely acknowledged by authorities in national and local levels. Perhaps, the most alarming sign of the trend is the rising toll of the AIDS epidemic. In 2002, according to official sources, 2972 residents of Kazakhstan were reported to have contracted HIV. By March 1, 2004, according to the bulletin of the National AIDS Prevention Center, the number of the HIV-infected people rose to 4107. Since the beginning of the year, four people have died of AIDS.

Surprisingly enough, the coal-mining Karagandy region in Central Kazakhstan with a total population of 1,410,200 residents and 1330 HIV cases registers on the top of the list of the most infected areas, whereas the most densely populated South Kazakhstan (1,978,300 residents) has only 473 cases to report. Second on the list is Pavlodar region in the North, where the population barely totals 807,000. Nevertheless, 815 cases of HIV-infections were detected in that region. This indicates that the assumption that HIV-infection occurs almost exclusively in densely populated areas may be wrong.

As of March 1, according to the National AIDS Prevention Center report, 163 people were diagnosed with AIDS. More than half of the HIV-infected people, 2995 persons, are unemployed residents of Kazakhstan, and only 450 people with fixed or seasonal employment are listed among the infected with HIV. But the analysis of the National AIDS Prevention Center is incomplete in many ways. For one thing, it does not include the socially marginalized high-risk groups such as prostitutes, homosexuals and drug addicts. The monthly bulletin of the National AIDS Prevention Center simply categorizes them rather vaguely as “unidentified groups’.

Inconceivable as it may appear, official health centers and authorities in the regions are reluctant to even recognize the fact of the existence of homosexuals and lesbians in Kazakh society. In traditional Kazakh community governed for centuries by Islamic laws, pre-marital sex, abortion and even divorce, whatever may be the reason, are considered the most shameful acts.

For centuries, this puritan mindset served as deterrent against sexual promiscuity, which, in the eyes of the Muslim population of Kazakhstan, emanates solely from Western culture. Hence the widespread fear of being stigmatized as outcasts among the Kazakhs infected with HIV, particularly women, who in cases of contracting AIDS or extra-marital childbirth are often ostracized from their families.

For reasons of Islamic ethics, anti-AIDS campaigners and volunteers cannot simply go to Kazakh villages to teach safe sex or distribute condoms. This old-age morality clashes with realities of today. Market economy has caused a host of social problems, impoverished rural areas, and also broken up traditional family units. Ongoing unemployment and migration of villagers to cities are apparently among the reasons of changing sexual behavior and loosening morals among young people. According to statistics, migrants under the age of 29 make up 28% of the population of the capital city Astana. This stratum of the population is the most vulnerable to HIV and AIDS risks. Employers refuse to hire people with AIDS. “The infected people are doomed to slow death. There is nothing we can do about it. We distribute single-use syringes, condoms, educate people. But these measures are inadequate” says Sergey Simukhin, the head of the AIDS Prevention Center in the North Kazakhstan region where the first infection of a child through blood transfusion, transported to a Moscow clinic for operation, occurred in 1984.

It is believed that most of the prostitutes who gather every night along the Sain Street in Almaty are girls from the countryside disillusioned in their search for a decent job. Many of them are willing to share a bed with anyone who offers 10 dollars. They are rarely tested for HIV. Analysis shows that women account for some cases of sexually contracted HIV cases recorded. But 79.8% of HIV infections are transmitted by intravenous drug users. It is also alarming that 54.4% of all the HIV-positive are in the age group between 20 and 29.

“The main carriers of AIDS are women. Our estimations indicate that 30% of the roughly 200 prostitutes in Astana are Kazakh women. They come to our office only on conditions that we observe confidentiality” says Balsia Kuatbayeva, the deputy director of the “Saktanu” (“Protection”) public foundation in Astana. Another similar public organization “Vmestye” (“Together”) was established this year in Almaty to provide moral support for people suffering from AIDS.

In general terms, most of the AIDS and HIV-related problems of Kazakhstan can be attributed to the ignorance of the threat of the epidemic in the past. The Law on Prevention of AIDS adopted in 1994 was limited to information campaigns on national level. This law does not respond to existing problems of creating a wide network of counseling and treatment centers, training highly qualified specialist doctors and joining international research organizations in working out efficient methods of medication. The HIV/AIDS pandemic will not abate unless a new law is adopted to activate economic leverages to solve the problem.