For Svyatoslav, founder and head of Community Friends, there are always reminders of the crucial nature of his work in HIV. He recalls one in particular, in 2018, at a time when, for many countries, deaths from AIDS-related illnesses were steadily declining: "I have a vivid memory of a client who had known his HIV status for many years, but he had fallen prey to a lot of misinformation and conspiracy theories and started to sincerely believe that HIV was fake. And so he disengaged from medical care and stopped taking antiretroviral therapy. He was adamant that he did not want to return to medical observation.
"Of course, by the time he came to us, the situation was critical. He went into surgery and had serious complications afterwards. We began working with him in his post-operative recovery. After we finally convinced him to go to therapy, he only lived for three more days. We still remember this loss and probably always will remember him.
"We had fought, believing we could succeed and save him. Although it was extremely sad, cases like this really motivate us to keep going with our work."
Svyatoslav lives in Almaty Kazakhstan and works directly with the city's MSM and transgender populations, for whom recent years have seen an exponential rise in HIV (HIV prevalence among MSM in Kazakhstan has risen by 442% since 2013).1,2 Although Svyatoslav remains dedicated to addressing HIV and HIV stigma in Kazakhstan, it sometimes feels like an uphill struggle: "It is sad to see that while on average the whole world is recording a downward curve in new cases, here we have an increase in infections."
When I see the light in people's eyes and hear testimonials of appreciation, this bright energy and gratitude is really what gives us strength to get up in the morning and do what we do
Community Friends, the organisation Svyatoslav founded, is Almaty's leading organisation serving the city's MSM and transgender communities with HIV-related services. Stigma is perhaps the greatest challenge Svyatoslav's community faces when it comes to HIV, causing people to avoid testing, and accessing necessary medical services. Combatting stigma is complicated, but Svyatoslav believes shining a light on it and its effects can help break the cycle: "The first step is to find and highlight the problem. There is a saying that as long as evil is not named, it cannot be defeated, so we need to start with this."
In the face of enduring challenges, Svyatoslav and his team remain tenaciously optimistic. He sees more people willing to talk openly about living with HIV, which decreases tension and fear. He believes starting the organisation is his main contribution and takes pride in his team, who have helped increase HIV testing among Almaty's MSM community, ensured access to prevention programmes, and founded peer support groups.
Svyatoslav has extraordinary faith in the strength of his team and their communities. He explains, "We are called Community Friends because it epitomises the spirit of the group. Every day is different, and it is always a special experience. Our clients each bring something new and their own spirit to the project.
"When I see the light in people's eyes and hear testimonials of appreciation, this bright energy and gratitude is really what gives us strength to get up in the morning and do what we do."
The impact of RADIAN on Svyatoslav’s work
In Almaty, Kazakhstan, RADIAN's first 'Model City', there are currently approximately 5,172 people living with HIV.3 The HIV prevalence rate in the city is almost double the national rate.4 Among MSM, HIV prevalence is even higher, and rising.5,6 Support from RADIAN has helped Community Friends implement strategies which have been needed for many years, but which the foundation have struggled to find adequate funding for.
Specifically, the priority for organisation is improving their case management. Svyatoslav explains that RADIAN's impact on this is enormous.
Community Friends is implementing optimised, network-based HIV testing and linkages to prevention and treatment among MSM and transgender people, including innovative social media-based approaches.
For those who test positive, they provide active case management for HIV, community-based adherence support, and linkage to PrEP for their partners.
Kazakh Scientific Center of Dermatology and Infectious Diseases – 2014 Report. Available at: http://kncdiz.kz/files/00001894.pdf [Accessed: October 2021]
Kazakh Scientific Center of Dermatology and Infectious Diseases – 2020 Report. Available at: http://kncdiz.kz/files/00007836.pdf [Accessed: October 2021]
Kazakh Scientific Center of Dermatology and Infectious Diseases – 2019 Report. Available at: http://www.kncdiz.kz/files/00005859.docx [Accessed October 2021]
Almaty City AIDS Centre. Available at: https://gcaids.kz/ru/ctatistika [Accessed October 2021]
UNAIDS – Country Factsheets Kazakhstan. Available at: https://www.unaids.org/en/regionscountries/countries/kazakhstan [Accessed October 2021]
Paine, EA., Lee, YG., et.al. (2021). HIV Stigma, Homophobia, Sexual and Gender Minority Community Connectedness and HIV Testing Among Gay, Bisexual, and Other Men and Transgender People Who Have Sex with Men in Kazakhstan. AIDS Behavior. 2021 Aug;25(8):2568-2577. Available at: doi: 10.1007/s10461-021-03217-9. [Accessed October 2021].