MOSCOW (Thomson Reuters Foundation) - Dilovar moved to Russia from Tajikistan a decade ago hoping for a better life but he contracted HIV and now lives with the threat of deportation and unable to access proper medical care.
Russia is among 19 states that deport HIV positive non-nationals, along with Egypt, Malaysia and Singapore, according to UNAIDS, the United Nations’ HIV/AIDS program, which describes such laws as stigmatizing and a violation of human rights.
“HIV treatment is not possible. I will get deported if I go to the doctor,” said 31-year-old Dilovar, who is gay and declined to give his full name. “I do not want to lose my job by telling my employer about my infection.”
Russia is one of the few countries in the world where HIV rates are increasing, with a record number of new cases in 2017 and a total of about 1.2 million infected, largely drug users, according to the World Health Organization.
Russia’s ministry of health, which supervises the ban on HIV positive migrants, and the interior ministry, which is responsible for deportations, did not respond to requests for comment.
Homosexuality was a criminal offence until 1993 in the socially conservative country and classed as a mental illness until 1999. There is scant data on HIV rates among gay and bisexual men, particularly migrants, in Russia.
“We can assume that homosexual men make up for a rather large part among the HIV positive men in general,” said Tatiana Kazantseva, a sociologist with LaSky, a charity providing HIV services to Russia’s LGBT+ community.
“But many are silent about their orientation.”
Globally, the risk of HIV acquisition among men who have sex with men is about 22 times higher than among all adult men, according to UNAIDS.
Testing and treatment are a priority in the fight against HIV/AIDS because medication reduces levels of the virus in the blood so that people with HIV cannot transmit it to others.
But many gay men fear getting tested due to homophobia and stigma about the disease in Russia, HIV charities say.
Dilovar is one of hundreds of HIV positive migrants who have gone underground for fear of deportation, said Daniil Kashnitskyi, a program adviser with the Moscow-based East Europe and Central Asia Union of People Living with HIV.
While Russia gives free healthcare and antiretroviral drugs to its HIV positive citizens, it does not offer testing or treatment to migrants, he said.
“Being a high-risk group, HIV+ migrants need to be included in such a program,” said Kashnitskyi, calling for gay HIV positive migrants to be allowed to stay in Russia so that they can come out of the shadows and get the medication they need.
“Migrants stay in Russia without treatment while their immune system gradually deteriorates ... To leave migrants untreated puts them and society at risk.”
LaSky tested some 900 men who had sex with men in 2017 and found that 8% of Russians were HIV positive while the rate for migrants - who by law should be deported in 10 days if found positive - was twice as high, at 16%.
WAITING TO DIE
In addition to the prejudice against LGBT+ people and those with HIV, there is also widespread hostility in Russia towards migrants from Tajikistan, Kyrgyzstan and Uzbekistan who work in factories, on construction sites, drive taxis and shovel snow.
Timur, 31, is an HIV positive gay man from Uzbekistan. He was diagnosed when he applied for a work permit in 2017.
The doctor told Timur that he had one year to live and gave him a letter saying that he had to leave Russia within 10 days.
“I was waiting to die ... I had no treatment and I was in shock,” said Timur, adding that he was determined not to return to Uzbekistan where gay sex is illegal and he had been harassed for “looking like a girl”.
That same year, Timur was abducted and beaten by a gang near Moscow. He decided that it was safer to leave Russia.
“They made me admit that I’m gay and dishonor Islam,” said Timur, who received help from the United Nations refugee agency to move to an undisclosed European country three months ago and received HIV-treatment almost upon arrival.
“My immunity has improved, I feel much better,” said Timur, who declined to publish his full name.
Back in Moscow, Dilovar is afraid to use the metro or walk the streets in case he is stopped by the police and asked for identity documents.
But he prefers to remain in Russia illegally rather than return home to Tajikistan, where he was blackmailed after telling a man he met online - who turned out to be part of a criminal gang - that he was gay.
Steps is one of the few charities that is brave enough to help migrants like Dilovar get HIV tests and treatment.
It often send its clients, many of whom are gay or sex workers, to private clinics in small towns outside Moscow where doctors are willing to bend the rules.
“We find doctors who treat them in secret,” said Kirill Barsky, a program manager for Steps, told the Thomson Reuters Foundation.
“We work anonymously and cannot reveal anything about them.”
Dilovar, who works as a waiter, receives some financial support from Steps towards the 4,000 roubles ($61) it costs each month to buy the cheapest antiretroviral drugs on the market.
He has not seen a doctor for more than a year and ekes out his medication. Meanwhile, the government provides his Russian boyfriend with monthly medical check ups and free drugs.
“I do not have the same opportunity as my boyfriend,” said Dilovar. “Nobody monitors my situation ... I fear it is getting worse.”
($1 = 65.3110 roubles)