Tajik Migrants to Russia: A Focus on HIV Infections and Transmissions
Across Central Asia, Tajikistan is considered to be the most impoverished country, owing to the poor state of its economy. Due to the poor economic conditions of their motherland, the people of Tajikistan, known as Tajiks, have been migrating to Russia in search of work (Kulaeva 6). In 2017, the population of Tajikistan reached 8 million. Of these, 1m worked in Russia and sent money back to their home country regularly, helping to maintain Tajikistan’s economy. Migrants working in Russia and other countries are estimated to remit back money equivalent to about 37% of Gross Domestic Product (GDP) (Ryazantsev et al. 175-177). Nevertheless, the high number of Tajik migrant workers in Russia has resulted in human rights abuses and other humanitarian problems.
Health represents the main area of problems for migrant workers in Russia. The purpose of this study is to assess HIV and AIDS infections and transmissions among these migrants. The Russian government has increasingly depended on the migrants’ labor to ensure the progress of its economy (Kulaeva 12). The huge influx of Tajik migrants to Russia has strained healthcare and other social services. Tajik immigrants have experienced significant problems accessing and using HIV and AIDS testing and drugs. Russians have also tended to exclude Tajik immigrants in business, taking advantage of them in businesses of drug use and sex (Cook 4). Such exploitation and exclusion have affected the Tajik population adversely, leading to adverse health outcomes at the population level (Laruelle 111-112). Among the major health problems in this context is the high rate of HIV infections among Tajik laborers in Russia.
Contexts of the Sending and Receiving Countries
The Asian Development Bank (para.2-3) reports that 32% of the Tajik population lived below the poverty line in 2013. The appeal of Russia for Tajik labor is evident when one compares the relative work environments on offer in the two countries. Russia’s average GDP per capita ($14,612) is nearly fifteen times higher than that in Tajikistan ($1,037) (Mukha 3-4). At the same time, the unemployment rate is twice as high in Russia (5.5%) relative to Tajikistan (2.4%), illustrating the huge demand for work in Russia with advancing economic development. In comparison, the stagnating economy in Tajikistan offers few vacancies and economic opportunities (Kulaeva 8). Tajikistan has ‘the lowest total health expenditure per capita in the WHO’s categorized European Region. It has undergone few socioeconomic reforms over the years, thereby maintaining the influence of its Soviet inheritance in politics and social structure (Khodjamurodov and Sodiquov 44-45). In contrast, the situation in Russia has improved significantly, with improvements in economic and infrastructural investment (Hays para.1-6). A key influence in migrants’ decisions is the availability of free emergency care for unregistered migrant workers in Russian hospitals (Cook 2-3). At the same time, Schottenfeld (para.7) note that as a former member of the Soviet Union, Tajikistan shares the languages and traditions of Russia, which makes the transition of migrants to Russia relatively easy.
Based on these economic, social, and cultural factors, Russia is a highly desirable working environment for Tajik migrants in search of work and opportunities. At the same time, economic weaknesses in Tajikistan push workers away, causing an outflow of human resources that is detrimental to its progress. This migration follows the neoclassical model, which provides that wage differentials and increased opportunities in the destination country are motivations for labor migration (Kurekova 5-7). Related to the neoclassical theory is the suggestion in a study by Borjas (535-538) that high-income inequalities between countries generate ‘negative self-selection’, such that migrants coming from poorer countries tend to be less skilled. This theory, which Chiswick (62-70) and Liebig and Sousa Pousa (130-133) examined deeply, is evident in the migration flow from Tajikistan to Russia. Differences in social, economic, and political conditions between the two countries influence the movement of low-skilled Tajik workers from their home country to Russia.
A particular feature of this migration is the higher proportion of men migrants, relative to women. These men leave their families behind and move to Russia independently. In 2012, the Tajik government estimated that 226,178 of its people (only 25,000 of which were women) had moved to Russia. This pattern aligns with the traditional, gendering model of migration (Piper 136). Men are more likely to find jobs in host societies and maintain their families through regular remittances. This selection, also defined as gendering, suggests a traditional form of migration. This gender imbalance in migration has health implications that this paper investigates further later.
The dual system theory is also relevant in this migration pattern. This theory considers traditional or prior links between two countries in migration patterns, holding that cultural and political ties between two societies influence migration patterns between them (Schottenfeld para.7-10). As discussed above, this is a key feature of migration between Tajikistan and Russia.
Migration and Health in Russia
There has been an increasing demand in the Russian economy for people who can provide affordable and constant labor for the country’s fast-growing economy (Kulaeva 9). Labor migrants from Tajikistan have flooded the Russian market, raising Russian government concerns about their health status. The International Organization for Migration (IOM) is the body responsible for the health assessment of migrants at the Russian border (Ivakhniouk 40; De Fazio 92-94). Medical controls for communicable diseases at the border are important to ensure a healthy coexistence between Tajik migrants and Russian natives.
Similar health controls are necessary for all migrants reentering Tajikistan and other countries in Central Asia, but this is not the case. Poor economic circumstances, especially in Tajikistan, have caused infrastructural inefficiencies, limited medical knowledge, and poor services, thus resulting in the uncontrolled movement of people into the country. These conditions have been key factors in causing an increased incidence of HIV and tuberculosis in Tajikistan. Huffman (867-868) and RFE (para.1-6) note that each year, about 188 Tajiks experience deportation back to their country due to health reasons.
HIV Infection among the Tajiks
In Tajikistan, HIV/AIDS has remained a taboo subject for many years (TjDHS, 2012). As a result, Tajiks have little awareness of the disease and remain highly vulnerable to its transmission. The main reason for the high rate of infection in Tajikistan has been the government’s inefficiency in the allocation of enough resources to facilitate training and prevention of the disease.
In 2001, Tajikistan affirmed its commitment to handling the HIV/AIDS crisis, signing the ‘Declaration of Commitment on HIV/AIDS at the UN General Assembly Special Session on HIV/AIDS’ (Ancker, 33-35). In 2015, it commenced a ‘National Development Strategy’ to stop and reverse the virus spread in the population, especially targeting young citizens and women. The Tajik government is therefore trying to deal with HIV/AIDS whilst fighting other diseases like malaria and tuberculosis, thereby stretching healthcare resources.
Winsky (2) notes that the estimated prevalence of HIV rose steadily between 1998 and 2009. By 2009, there were nearly 30 affected cases per 100,000.
Diagram illustrating a rising prevalence of HIV/AIDS in Tajikistan between 1998 and 2009
In 2016, 0.3% of the population was infected (nearly 300/100,000) (CIA/Tajikistan). UNAIDS observes an alarming increase of 23% between 2010 and 2015.
Health concerns among Tajiks working in Russia
The Ministry of Health in Tajikistan reports that under 5% of migrants are registered and work legally in Russia, such that few ‘have contracts and health insurance’ (Cook 4; Ivakhnyuk 5-7). This implies that the majority of migrants are covered with basic health care that only deals with accidents, excluding social and medical services that are essential in the prevention and treatment of HIV infections. This exposes Tajiks to a high risk of contracting and transmitting HIV/AIDS since they lack access to services that would be essential for the prevention of such infections.
A major influence of the high incidence of HIV/AIDS among Tajik migrants is risky sexual behavior. Men leave their wives behind and engage in risky sexual relationships while working in Russia. Male Tajik migrants in Russia report having more than three sexual partners with low use of condoms due to limited knowledge of contraceptives (Hernandez 2-4; TDHS 3-5). In most cases, these sexual relationships occur with sex workers, with a sense of loneliness in a harsh environment contributing to the need for amusement.
Diagram illustrating an HIV prevalence rate of 1% in Russia (AVERT para.1).
Another important contributing factor to the high prevalence of HIV/AIDS among Tajiks is the abuse of alcohol and drugs (Cook 4). This behavior applies as a means to alleviate stress relating to poor living conditions and suffering. A significant number of Tajik men return home HIV positive without knowing their status, thereby transmitting the disease to their spouses. Bennet (3-6) and Haarr (766-768) note that this has caused an increase in the rate of infections in Tajikistan, having a tremendously adverse effect on the family set up and on the economy of the country.
Mansfeld (19-22) and Hernandez (3-5) observe that migrants in Russia experience inadequate healthcare and social services. These factors contribute to the abject health experiences of Tajik immigrants.
The vulnerability of Tajik Migrants
The World Bank rates Tajikistan as one of the top recipients of remittances, rating it at 52% (WB para.10). Tajik migrants tend to be poor and with low education levels (Dietz 5-8). These factors influence their employment in humble jobs. The Russian government does not fully protect these workers, supplying them with limited services, healthcare, and legislation support to make their lives easier (Kulaeva 17-20). Without enough protection and support from the Russian government, these migrants face high exposure to violence and xenophobic attacks.
Diagram illustrating low rates of knowledge of HIV/AIDS and its transmissions in Tajikistan
As indicated in the diagram above, only 11% of the Tajik population has a comprehensive knowledge of HIV/AIDS. About 70% believe that this virus can be transmitted through kissing or mosquito bites. According to another study conducted by Habibov (30-31), around 85% of Tajik women, aged 15-49, have never been scanned for HIV infection.
Furthermore, both men and women in Russia are reluctant to use condoms in sexual activity, even with sex workers (Weine 704-706). They believe that condoms could cause infertility (Perlman and McKee 48). This risky behavior promotes the vulnerability of Tajiks to HIV/AIDS infections.
The Impact of Migration on Tajikistan
Tajikistan is a poor country whose population shows a high rate of dependence on remittances from foreign countries. The migration of its population to foreign, more advanced countries for jobs promotes the financial security and wellbeing of families left behind because of these remittances (Hegland 21-23; Marat 17-18). Nevertheless, heavy labor migration has undermined the sustainability of economic development in Tajikistan.
Owing to the emigration of labor, Tajikistan faces a major drain of its workforce, particularly young, able-bodied and productive males (Laruelle 117-118). At a macroeconomic level, this problem limits the Tajik economy’s performance, impedes the growth of local businesses, and reduces taxable income for the government, therefore limiting the adequacy and effectiveness of public services (Danzer 194). This scenario represents a vicious cycle that Tajikistan is hard-pressed to end. The critical solution involves the government’s creation and implementation of a vigorous plan to stem the emigration and grow local infrastructure to provide employment and business opportunities. The current socioeconomic scenario features and promotes over-dependence on Russia. As a result, recent economic challenges in Russia, owing to falls in the oil process, have rubbed off on Tajikistan (Awan 3-5). In order for Tajikistan to address this problem, a proactive, effective, and sustainable socioeconomic strategy is necessary to improve the Tajik economy and wean it from overdependence on Russia.
Disparities in the strength and performances of economies in Tajikistan and Russia, coupled with deep social and economic ties between the two countries, have fostered heavy immigration of Tajiks to Russia. Most of these migrants are young men who leave families behind in search of increased wages and opportunities. In Russia, these migrants live in poor socioeconomic conditions, including exploitation at work, poor living conditions, and lack of adequate healthcare and social support services. These conditions promote risky sexual behaviors that expose Tajik to HIV/AIDS infections. HIV/AIDS causes long-term social and economic problems for Tajiks both in Russia and back home, including an adverse effect on economic productivity. To solve the problem, a proactive, effective, and sustainable socioeconomic strategy is necessary to improve the Tajik economy and wean it from overdependence on Russia. In the short term, both countries have to demonstrate responsibility for the health of Tajik migrants through investment in civil education, healthcare services, and political cooperation to screen and control transmissions across the border.
“HIV and AIDS in Russia”. AVERT, 2016. https://www.avert.org/professionals/hiv-around-world/eastern-europe-central-asia/russia [Accessed 6 Jan. 2018].
“Incidence and Prevalence”. Advanced Renal Education Program (AREP), 2015. http://advancedrenaleducation.com/content/incidence-and-prevalence [Accessed 5 Jan. 2018].
“Poverty in Tajikistan”. Asian Development Bank, 2017. https://www.adb.org/countries/tajikistan/poverty [Accessed 5 Jan. 2018].
“Remittances to developing countries to stay robust this year, despite increased deportations of migrant workers, says WB”. World Bank (WB), 2014, April 11. https://www.worldbank.org/en/news/press-release/2014/04/11/remittances-developing-countries-deportations-migrant-workers-wb
“Russia may ban Tajik migrants’ ‘on health grounds’”. Radio Free Europe. 2011, Nov. 14. https://www.rferl.org/a/russia_may_ban_tajik_migrants_on_health_grounds/24390839.html [Accessed 5 Jan. 2018].
“Tajikistan Demographic and Health Survey 2012” (TDHS). 2013). Tajikistan Demographic and Health Survey 2012.
“Tajikistan” UNAIDS, 2018. http://www.unaids.org/en/regionscountries/countries/tajikistan [Accessed 5 Jan. 2018].
Ancker, Svetlana. “HIV/AIDS: Security Threat in Central Asia?” China & Eurasia Forum Quarterly. Vol. 5. No. 3, 2007, pp.33-60
Ataev, Dominic. Deputy Head of the Migration Service in the Sogd Region, Khujand, 17/6/2013, interview. 2017.
Awan, Aron. Analysis of the Impact of 2008 Financial Crisis on the Economic, Political and Health Systems and Societies of Advanced Countries. Global Journal of Management and Social Sciences vol.1, no.1, 2015, pp.1-16.
Bennett, Rachel. The Impact of Household Members’ Migration on the Education of Children ‘Left Behind’ in Tajikistan. Population, Space and Place vol. 19, 2013, pp.1–14
Borjas, George. Self-selection and the earnings of immigrants. American Economic Review vol.77, no.4, 1987, pp. 531-553.
Chiswick, Barry. Are Immigrants Favorably Self-Selected? An Economic Analysis. IZA Discussion Paper no.131, 2000
Cook, Linda. Tajik Labor Migrants to Russia: Their Access to Health and Welfare Services. IREX Scholar Research Brief, 2014.
Danzer, Alexander, and Oleksiy Ivaschenko. Migration Patterns in Remittances Dependent Economy: Evidence from Tajikistan during the Global Financial Crisis. Migration Letters vol.7, no.2, 2010, pp.190-202.
De Fazio, Matthew. Guarding International Borders against HIV: A Comparative Study in Futility. Pace International Law Review vol.25, no.1, 2013, pp.89-120.
Dietz, Barbara, Gatskova Kseniia, and Ivlevs Artjoms. Emigration, Remittances and the Education of Children Staying Behind: Evidence from Tajikistan. IZA, 2015.
Haarr, Rachel. Suicidality among Battered Women in Tajikistan. Violence against Women vol. 16, no.7, 2010, pp.764-788.
Habibov, Nazim, and Hakim, Zainiddinov. Do Family Planning Messages Improve Antenatal Care Utilization? Evidence from Tajikistan. Sexual and Reproductive Healthcare vol.13, 2017, pp.29-34.
Hays, Jeffrey. Health care in Russia. Facts and Details, 2016. http://factsanddetails.com/russia/Education_Health_Transportation_Energy/sub9_6b/entry-5145.html
Hegland, Mary. Tajik Male Labour Migration and Women Left Behind: Can They Resist Gender and Generational Hierarchies? Anthropology of the Middle East vol.5, no.2, 2010, pp.16-35.
Hernandez, Aaron et al. Tajikistan Demographic and Health Survey 2012. Global Health Action vol. 7. No.46, 2014, pp.1-9.
Huffman, Simon et al. Exploitation, Vulnerability to Tuberculosis and Access to Treatment among Uzbek Labor Migrants in Kazakhstan. Social science and medicine vol.74, no.6, 2012, pp.864-872.
Ivakhniouk, Irina. Illegal Migration: Russia. European Security vol.13, no.1-2, 2004, pp.35-53.
Ivakhnyuk, Irina. Russian Migration Policy and its Impact on Human Development. Human Development Reports, 2009.
Khodjamurodov, Gregory, and Sodiquova, Dennis. Tajikistan: Health System Review. US National Library of Medicine National Institutes of Health, 2016.
Kulaeva, Stephania. From Tajikistan to Russia: vulnerability and abuse of migrant workers and their families. FIDH, 2011.
Kurekova, Lucia. Theories of migration: Conceptual review and empirical testing in the context of the EU East-West flows. Central European University, 2010.
Laruelle, Marlene. Central Asian Labor Migrants in Russia: The” Diasporization” of the Central Asian States?” China and Eurasia Forum Quarterly Vol. 5. No. 3, 207, pp.101-119.
Liebig, Thomas, and Sousa-Poza, Alfonso. Migration, self-selection, and income inequality: An international analysis. KYKLOS vol.57, 2004, pp.125–146.
Mansfeld, Maiken. et al. HIV Programme Review in Tajikistan. WHO, 2015.
Marat, Erica. Labor Migration in Central Asia: Implications of the Global Economic Crisis. Silk Road Studies Program, Institute for Security and Development Policy, 2009.
Mukha, Alvin. Reyting srednikh zarplat rabotnikov v stranakh SNG i Pribaltiki (Rating of average wages of workers in the CIS area and Baltic countries in 2013). 2013.
Perlman, Francesca, and McKee, Martin. Trends in Family Planning in Russia, 1994-2003. Perspectives on Sexual and Reproductive Health vol.41, no.1, 2009, pp.40-50.
Piper, Nicola. Gendering the Politics of Migration. International Migration Review vol.40, no.1, 2006, pp.133-164.
Ryazantsev, Sergey et al. Transformation of Sexual and Matrimonial Behavior of Tajik Labour Migrants in Russia. Asian Social Science vol. 10, no. 20, pp.174-181.
Schottenfeld, Joseph. The Midnight Train to Moscow. Foreign Policy, 2017, August 10. http://foreignpolicy.com/2017/08/10/the-midnight-train-to-moscow-tajikistan-migration/
The World Factbook – Central Intelligence Agency/Tajikistan. (2016). https://www.cia.gov/library/publications/the-world-factbook/rankorder/2129rank.html [Accessed 5 Jan. 2018].
Weine, Simon et al. HIV Sexual Risk Behaviors and Multilevel Determinants among Male Labor Migrants from Tajikistan. Journal of immigrant and minority health vol.15, no.4, 2013, pp.700-710.
Winetsky, Daniel et al. Prevalence, Risk Factors and Social Context of Active Pulmonary Tuberculosis among Prison Inmates in Tajikistan. PLoS ONE vol.9, no.1, 2014, pp.1-10.
 Incidence: the rate of new (or newly diagnosed) cases of the disease (AREP para.1-6)
 Prevalence: number of cases alive, with the disease either during a period of time (AREP para.1-6)
 UNAIDS: United Nations Programme on HIV and AIDS