Two Decades of HIV/AIDS in Tajikistan: Reversing The Tide or The Coming of Age Paradigm?

Central Asian region has witnessed a dramatic ‘rise of the HIV tide’ over the last decade. This article provides a historical overview, describes the process of domestication, and examines legal, social and political dimensions of the HIV epidemic in Tajikistan in order to highlight existing contradictions and barriers in HIV policy-making and program implementation in that country. The response to HIV/AIDS in Tajikistan has been seriously influenced by pre-existing Soviet policies, crackdown on illegal substance use, and stigmatization of at risk groups and people living with HIV/AIDS. Contradictions between law enforcement and public health approaches in dealing with vulnerable populations are among the most significant factors impeding effective HIV prevention programs in Tajikistan. Without resolving fundamental problems, such as prevention of punitive actions of the police against drug users and commercial sex workers, abolishment of control-oriented registration