AIDSfree appeal: Former boxer Vitali Klitschko on his fight against the stigma making young people too scared to get tested for HIV

In Kiev, the spread of HIV is fuelled by prejudice and ignorance. The city’s mayor, former boxer Vitali Klitschko, talks about his efforts to tackle a silent epidemic
Vitali Klitschko enjoyed an illustrious boxing career before his defeat by Antony Joshua in 2017.
Bongarts/Getty Images
Vitali Klitschko19 December 2018

When I was growing up in Kiev, HIV was talked about as a capitalist disease. It was the disease of capitalist countries and loose moral values. For most Ukrainians, HIV positive citizens were written off as people with no chance of survival — a danger to society.

The fear was everywhere, and we were all so ignorant. I remember being too scared to use a pop vending machine in school because it meant drinking out of communal glasses.

Three decades on, the ignorance is still with us. Only 23 per cent of our people aged between 15 and 25 know about HIV. The school curriculum covers sexual education only superficially.

Some teachers find these issues too difficult to talk about; for others religion gets in the way. Prejudice is still with us too. Not only is prejudice wrong on a moral level, but also it gets in the way of progress.

It hinders us from making the right policy calls, and achieving diagnostic success and successful treatment.

According to statistics in 2014, every fifth Ukrainian living with HIV is subjected to threats and verbal abuse. In another survey, 65 per cent said they would not buy vegetables from a market seller if they knew he or she had HIV.

We see it in Kiev. Casual stigma and discrimination mean people, especially young people, are scared to get tested and receive treatment. This fear leads to deaths from Aids, new infections, and to the spreading of the virus.

Ukraine’s epidemic remains serious, but most often, silent. Worryingly, one in two people do not know they are living with the disease. Diagnoses are usually made far too late.

Spreading the message: Vitali Klitschko is now the mayor of Kiev
AFP/Getty Images

The nature of our epidemic is changing. Before, HIV mainly affected people who injected drugs. Today, heterosexual sex is the main route of transmission.

The war in the east of the country has also had an impact, with the internal displacement of 1.7 million people leading to a redistribution of the virus. One in four Ukrainians with HIV lived in the Donbass, for example.

But there are positive trends too, and I’m cautiously optimistic about our efforts to fight the epidemic.

Young people, for a start, are beginning to demand better sexual education in schools. They understand it concerns their health.

Ukraine healthcare is also being reformed. The system has become more flexible and efficient. We are now able to give Ukrainians living with HIV the latest advances in medical care.

Slowly and surely, we are also beginning to reach those at the highest risk of infection. We’ve put a lot of efforts into distributing free condoms, and introducing rapid home HIV tests, as recommended by the World Health Organisation (WHO).

Over the last few years, we have benefited from breakthroughs in diagnosis and treatment regimens.

In 2016, my administration signed up to the WHO’s 90-90-90 goals — we want at least 90 per cent of people with HIV to know about their status, 90 per cent of those to be receiving effective therapy, and 90 per cent of those to have undetectable viral loads.

We’re making reasonable progress. This year we’ve managed to diagnose 61 per cent of all infections, treat 68 per cent, and suppress the virus in 83 per cent of cases.

But we still have three problems.

First, Ukrainian society remains fixed in the view that HIV is a problem for marginal groups. Ukrainians believe this problem will never affect them.

Many patients who start therapy find it difficult to keep the regimen, and stop taking the medicine

Second, many patients who start therapy find it difficult to keep the regimen, and stop taking the medicine. This creates the perfect conditions for the virus to mutate and become more resistant.

Third, there is a lack of social workers and medical staff with experience of HIV. They determine the future fate of these patients. So we’re doing our best to recruit and train more.

Ukrainians must take responsibility for their own health. People need to know that early detection and treatment can help to save lives.

That it can help to make lives longer and healthier. And it can significantly reduce the risk of further transmission.

I am sure that the Evening Standard Christmas Appeal will help to raise global attention and reduce the problem of discrimination of those living with the virus.

I hope that together we can take another step towards overcoming this epidemic.

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