HIV and AIDS in Russia

• HIV and AIDS
• HIV vaccines

2024: A 1.5-fold reduction in the number of new infections over 10 years

The number of new cases of HIV infection in Russia has decreased by 50% over the past ten years thanks to the implementation of the state strategy to counter the spread of the disease. This was announced on October 25, 2024 by the Minister of Health of Russia Mikhail Murashko at a meeting of the board of the department.

According to TASS, the results achieved are associated with an increase in preventive measures and a significant expansion of the population testing program. HIV screening coverage increased by a third in the same period.

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Russian Health Minister Mikhail Murashko stressed that a hundred updated strategy, calculated until 2030, is being implemented ahead of targets in the Russian Federation as a whole. Significant progress has been made in the field of medical monitoring of patients.

The dispensary control system covers 97.2% of patients with HIV infection, and 89.5% of patients receive modern antiretroviral therapy. The number of citizens undergoing testing continues to increase every year.

According to the agency, Russia has achieved technological independence in the production of diagnostic equipment and test systems. Mikhail Murashko also said that the production of equipment and test systems necessary for the diagnosis of HIV has been established in Russia. According to him, complete import substitution of test systems for molecular genetic methods for diagnosing and monitoring HIV infection, including sequencing and drug provision of adult patients, has been achieved.

The HIV control strategy is implemented in conjunction with programs to counter other socially significant diseases, including tuberculosis, chronic viral hepatitis and sexually transmitted infections. All activities are coordinated within the framework of the unified state policy of prevention and treatment.^[1]

2023

Half of new HIV cases were detected in the regions where a third of the population of the Russian Federation lives

As of the end of 2023, HIV infection in Russia was 817.6 per 100 thousand population. More than half (approximately 51.9%) of new HIV infections were detected in 24 regions of the country, where more than a third (35.8%) of the country's population live. In the same regions, there is an excess of indicators of HIV infection, as stated in the report of Rospotrebnadzor, published on June 1, 2024.

The incidence rate of HIV infection in 2023 amounted to 40.04 per 100 thousand population, which is 7.5% lower than in 2022. The highest values ​ ​ were recorded in the regions of Siberia, the Urals and the Volga region. Most HIV patients are on, in To Chukotka,, and in Krasnoyarsk Territory Kemerovo region Irkutsk region. Altai Territory

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It is said that in Russia HIV infection is increasingly detected among the population of the most active working age. In particular, in 2023, the disease was diagnosed in 35.3% of Russians aged 30-39 years, 33.6% - in the group of 40-49 years, 13.4% - at the age of 50-59 years, 10.7% - in the group of 20-29 years. At the same time, the proportion of patients newly diagnosed over the age of 60 years was 6%, and young people aged 15-20 years - about 0.7%. Men made up the majority of all patients.

According to the published data, the total amount of direct medical expenses of the federal budget and the budgets of the constituent entities of the Russian Federation for the implementation of measures to counter

the spread of HIV infection amounted to 66.4 billion in 2023. rubles The cost of purchasing antiretroviral drugs is estimated at 31.5 billion rubles. Indirect economic costs, defined as losses GDP from premature mortality and disability of the population due to HIV infection, amounted to 176.2 billion rubles, and direct non-medical costs (payments of disability benefits) - 12.9 billion rubles. In total, the economic burden of HIV infection in 2023 in Russia is estimated at 255.4 billion rubles.^[2]

0.5% reduction in HIV-related deaths

In 2023, 34,254 people infected with HIV died in Russia, which is 0.5% less than in 2022. Such figures are presented in an article by employees of the FBUN "Central Research Institute of Epidemiology" of Rospotrebnadzor "Preventive effect of treating patients with HIV infection in Russia." Excerpts from this material were published in early May 2024.

According to Vedomosti, citing these statistics, in 2023, 855,142 patients infected with HIV were under the supervision of specialists, and 42,663 people were interrupted.

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At the same time, as indicated in the publication of the publication, more than a quarter (28.3%) of those identified in 2023 when testing people living with HIV did not register as a dispensary or were lost from observation. Vadim Pokrovsky, epidemiologist and head of the specialized research department for the prevention and control of AIDS at the Central Research Institute of Epidemiology of Rospotrebnadzor, divided such citizens into three categories - drug users; people unaware of their HIV-positive diagnosis; as well as those who are afraid to get up for dispensary registration, fearing that their illness will become known to others.

For example, a person was in the hospital for two days, where he was tested for HIV. And a positive result was found there, as reported to Rospotrebnadzor. The hospital had to inform the person, and he had to come to the AIDS Center and register there. But it also happens that the hospital could not inform the person or, when he was informed, he did not go to the AIDS center, - explained the epidemiologist.

According to the authors of the article, the decrease in the incidence of HIV in Russia may be associated with the preventive effect of antiretroviral therapy (ART). At the same time, the effect of this, according to them, is not yet sufficiently expressed due to the incomplete coverage of patients with medical care and the failure to achieve the goal of treatment in a significant part of patients.^[3]

HIV incidence in 6 years fell by 35% to 37.3 cases per 100 thousand people

In 2023, the incidence of HIV infection in Russia amounted to 37.3 cases per 100 thousand people, which is 36% less than in 2017 (58.4 cases per 100 thousand population). This is stated in the report of the Ministry of Health of the Russian Federation, which was published in April 2024.

According to Interfax, citing materials from the department, the number of new cases of HIV infection in Russia in 2023 amounted to 56.4 thousand people, which is 30% less than in 2017 (85.8 thousand people).

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In 2023, a historical minimum of morbidity and mortality rates will be achieved, [the] leading positions in the world in terms of the rate of decline [morbidity and mortality] are recorded, [an] increase in the coverage of preventive examinations is recorded, the report says in the HIV section.

According to Vadim Pokrovsky, head of the specialized research department of epidemiology and AIDS prevention at the Central Research Institute of Epidemiology of Rospotrebnadzor, by mid-2023 about 1.2 million people with HIV infection lived in Russia. By this date since 1987, "1 million 664 thousand people were registered who were diagnosed with antibodies to HIV with confirmation in the immune block, which is considered an internationally recognized criterion for diagnosis, and these are not studies (the number of tests carried out), but specific people who managed to identify," Pokrovsky said.

According to him, over the entire period of HIV monitoring in Russia, 475 thousand infected people died by mid-2023. The head of the specialized research department of epidemiology and AIDS prevention of the Central Research Institute of Epidemiology of Rospotrebnadzor also cited statistics according to which the average age of those who died from HIV in Russia is 37-43 years.^[4]

2022

The rating of regions of the Russian Federation in terms of HIV prevalence has been released

On December 5, 2023, it became known in which regions of the Russian Federation HIV is most common. The rating of the regions was compiled by the organization "To be precise."

According to the results of the study, it became known that the E rating (the most difficult situation) was assigned to the regions of Siberia and the Urals. They have been in this position for many years. An unexpected trend for experts was the increase in morbidity among representatives of the village. In addition, the number of regions is growing in which more than 1% of pregnant women are infected with HIV. This, according to experts, shows the "blurring" of traditional risk groups.

It became known in which regions of the Russian Federation the most common HIV

There are five indicators in the "To be precise" rating:

• the number of new cases of the disease per 10 thousand examined;
• the number of deaths from HIV-related causes per 100,000 population;
• the proportion of pregnant women with HIV;
• the proportion of those receiving antiretroviral therapy (from all people with HIV);
• proportion of patients with undetectable viral load (from those receiving treatment).

Rating E in 2022 was assigned to Kemerovo, Sverdlovsk, Chelyabinsk, Irkutsk and Tomsk regions, as well as Altai, Krasnoyarsk and Perm Territories. Of these, Kemerovo and Irkutsk regions have received an E rating for nine years in a row. In addition, the Kemerovo region is the leader in the number of people with HIV in terms of per capita (2039 people per 100 thousand population), followed by Irkutsk (1978 people per 100 thousand) and Sverdlovsk (1910 people per 100 thousand) regions. The average figure for Russia is 797 infected per 100 thousand population.

The head of the committee of the Eurasian Association for Harm Reduction Alexei Lahov connects such indicators with the high level of drug use in these regions.

The data of the State Narcological Service for 2021 show that the total incidence of narcological disorders, in particular drug dependence syndrome, is the highest in the Siberian Federal District (196.8 per 100 thousand population), the Far Eastern Federal District (189.2) and in the UFO (167.2) - noted Lahov.

The most prosperous regions were the Kirov, Lipetsk, Belgorod and Tambov regions, Kalmykia, Ingushetia and Mordovia. They received an A rating.

At the same time, the Ministry of Health noted that the number of new HIV infections in 2022 amounted to just over 55 thousand.^[5]

The incidence of HIV in Russia over 4 years decreased by 35%

In 2022, more than 55 thousand new cases of HIV infection in Russia were detected in Russia, which is 35% less than four years earlier. The Minister of Health RFMikhail Murashko cited such data within the framework of the All-Russian Forum for Specialists in the Prevention and Treatment of HIV/AIDS.

According to the head of the Russian Ministry of Health, the country remains in the leader in HIV testing coverage - in 2022 it amounted to 32% of the population. This allows us to reliably talk about maintaining a confident trend towards an annual decrease in the number of new patients, Murashko emphasized.

More than 55 thousand new cases of HIV infection in Russia have been detected in Russia

The minister added that, according to the Federal Register of Persons for 2022, therapy coverage of those infected with HIV infection is almost 87%. He noted that these are high numbers.

According to the FBUN of the Central Research Institute of Epidemiology of Rospotrebnadzor, by the end of 2022, the total number of Russians with a laboratory-confirmed diagnosis of HIV infection amounted to 1,168,076 people, excluding 461,879 patients who died over the entire observation period. For comparison, in 2021 this figure was 1,137,596 people, excluding 424,974 patients who died over the entire observation period.

Purchases of HIV drugs in Russia per year covered the need of only 52% of patients

In 2022, the Ministry of Health of the Russian Federation and the authorities of the regions of the country purchased approximately 593 thousand annual courses of HIV therapy. However, this covers the need for only 52% of patients with the immunodeficiency virus in Russia (or 74% of the number of people registered at the dispensary). Such data are provided in a study by the International Coalition for Preparedness for Treatment (ITPC), the results of which were published on May 12, 2023.

According to the Vedomosti newspaper, we are talking about the purchase of antiretroviral drugs (ARV). In 2022, the ARV therapy coverage rate in the Russian Federation turned out to be higher than the previous year. But this was achieved only by allocating an additional 8.6 billion rubles. budget funds planned for 2023. In general, as noted, about 95% of funds come from the federal budget for the purchase of drugs for HIV, while the regions allocate about 4-5% of the total expenses in the country for the corresponding drugs.

Purchases of the Ministry of Health and regions cover only 52% of HIV patients

In 2023, 31.7 billion rubles were allocated for the centralized purchase of drugs for the treatment of HIV, including in combination with hepatitis B and C. However, as Vedomosti clarifies, approximately 13 billion rubles. will go towards paying for drugs under previously concluded three-year contracts with manufacturers. Taking into account the 8.6 billion rubles spent in 2022, about 10.1 billion rubles remain. This can lead to an acute shortage of drugs to treat HIV. The ITPC report notes that almost the entire annual budget has already been spent, and the volume of drugs is designed for only 36% of patients in total need of ARV therapy.

In such a situation, according to Coalition experts, it is necessary to attract at least another 20 billion rubles. Moreover, the use of borrowed funds of 2024 and subsequent years will not solve the problem of a long-term deficit, since with such a scheme there may come a time when there will be no money left at all when moving to the new year.^[6]

The number of new HIV cases in Russia decreased by 2% over the year

In 2022, the number of new cases of HIV infection in Russia decreased by 2%. This was reported by the Ministry of Health of the Russian Federation at the end of March 203.

As noted in the department, the number of new patients with HIV in the Russian Federation is becoming less and less annually. The Ministry of Health also noted an annual increase in the coverage of the population with HIV tests. Coverage of patients with antiretroviral therapy in 2022 also increased and amounted to 84.9% of those under medical supervision or 82.1% of all people living with HIV.

The first stage of the HIV epidemic is observed in nine regions of Russia, the third stage, in which more than 1% of pregnant women are infected, in 27 regions of the country

According to the Ministry of Health, a number of regions in the Urals, Siberia and the Volga region "should pay special attention to the problems of HIV prevention." At the same time, the regions of the North Caucasus Federal District remain one of the least affected by HIV infection in Europe, the department said.

Academician of the Russian Academy of Sciences, Deputy President of the Russian Academy of Education, Doctor of Medical Sciences Gennady Onishchenko, in a conversation with RIA Novosti, noted that the number of HIV-infected people is usually higher in those regions through which drug trafficking passes, as well as in "rich" subjects, including gas producers, since there is a higher level of drug use and, accordingly, more HIV-infected.

At the end of March 2023, Vadim Pokrovsky, head of the specialized research department of epidemiology and AIDS prevention at the Central Research Institute of Epidemiology of Rospotrebnadzor, said that the first stage of the HIV epidemic is observed in nine regions of Russia, the third stage, in which more than 1% of pregnant women are infected, is in 27 regions of the country.

To say that we have an epidemic, for this we need to have 1.5 million HIV-infected (1% of the country's population), we do not have such a number, "Onishchenko said on March 29, 2023.[7]

2021

The number of deaths of HIV-infected Russians increased by 2.4%

In 2021, 32,160 people with the human immunodeficiency virus (HIV) died in Russia, which is 2.4% more than a year earlier, when the number of deaths was measured at 31,408. This is evidenced by the data of Rospotrebnadzor, disclosed in December 2022.

According to Vedomosti, citing statistics from the department, more than a third (36.2%) of people with HIV who died in 2021 were injecting drug users. 33.3% of the total are women, 0.3% of deaths were men who have sex with their gender.

At the same time, the number of deaths directly from the human immunodeficiency virus for 2017-2021. in the Russian Federation reached the lowest values ​ ​ - 16,914 people died, follows from the data of Rospotrebnadzor. The mortality rate reached its maximum value in 2018 (it was 14.0), by 2021 it decreased to 11.6.

The most common cause of death for HIV patients was mycobacterial infection - almost 40 percent of those who died suffered it, most of them were also diagnosed with tuberculosis.

In the certificate, Rospotrebnadzor took into account 973,037 Russians who live in 83 regions of the country, among them there were 58,749 cases for the first time.

Vadim Pokrovsky, head of the research department of epidemiology and AIDS prevention at the Central Research Institute of Epidemiology of Rospotrebnadzor, says that HIV has already been detected in one percent of the Russian population. According to the academician, "despite the fact that many die, the increase in the number of infected people is obvious." According to his forecasts, from 2020 to 2030, another 660 thousand new cases are expected - among those patients who will need the help of doctors. He added that, according to experts, in the future, an increase in the number of new cases is expected in the world by 15-20%.

On December 12, 2022, the chief freelance HIV specialist of the Russian Ministry of Health and the capital's health department, Alexei Mazus, announced that the number of young people aged 15 to 17 infected with HIV had decreased in Moscow compared to 1999 by 50 times.^[8]

The Ministry of Health named the exact number of people with HIV in Russia

By the end of 2021, 851,754 infected with the human immunodeficiency virus (HIV) were registered in Russia. This figure at the end of November 2022 was named by the chief freelance specialist of the Ministry of Health on HIV infection Alexei Mazus.

According to him, the number of new cases of HIV infection in 2021 amounted to less than 59 thousand people, which is almost 20% lower than planned.

The exact number of people with HIV in Russia is named

We were able to keep the same pace in the most difficult covid 2020 - a little more than 60 thousand new patients. And in 2019, this figure was at the level of 80 thousand people, - said Mazus.

Coverage by testing for infection in Russia in 2021 amounted to 28.2% - in Europe, according to the specialist, this figure ranges from one to eight percent. According to Mazus, more than 90% of HIV-infected people in Russia know about their disease.

He noted that Russia has taken a decisive, initiative position in the framework of international cooperation and continues to systematically develop it on a multilateral and bilateral basis.

Highly professional work of AIDS specialists... allows us to say that the epidemic process of HIV infection in our country is stably controlled. I would like to especially note that Russia retains a leading position in the world in terms of HIV testing coverage, in 2021 this figure was more than 28%. Today we have reached dock-like numbers, and during the pandemic we passed with a minimal decrease. Even in 2020 (coronavirus), the screening level was slightly less than 25%, - said the Minister of Health of the Russian Federation Mikhail Murashko.

According to him, a confident trend towards an annual decrease in the number of new infected is recorded in the Russian Federation, which indicates a responsible approach to the implementation of the regional plans envisaged by the state and regional strategies.^[9]

More than 71 thousand new HIV infections identified

In 2021, more than 71 thousand new cases of HIV infection were detected in Russia, which is 1.4% less than a year earlier. The data released by the Central Research Institute of Epidemiology do not include cases of anonymous testing and infection of foreign citizens.

Nearly 68% of new cases are heterosexual contacts, according to the center's report. At the same time, only 3% of those infected with HIV in 2021 reported homosexual relations. Cases of infection with intravenous drugs decreased. If at the beginning of the epidemic drug users accounted for almost 57%, in 2021 the figure decreased to 27.8%.

From the time of the discovery in 1987 of the first Russian infected with HIV, to December 31, 2021, the total number of detected cases of HIV infection among citizens of the Russian Federation reached 1,562,570 according to preliminary data. As of December 31, 2021, 1,137,596 Russians with a laboratory-confirmed diagnosis of HIV infection lived in the country, excluding 424,974 patients who died over the entire observation period (27.2%).

In 2021, the death of 34,093 Russians infected with HIV was reported, which is 5.9% more than in 2020 (32,208). Since HIV infection is an incurable disease, and the number of new cases of HIV infection exceeds the number of deaths, the total number of Russians living with HIV continues to grow, the researchers note.

The Central Research Institute of Epidemiology identifies disadvantaged regions where there is a very high incidence among children and residents of rural areas, which is not typical for HIV infection. According to the report, these are Kemerovo, Tyumen, Novosibirsk regions and the Chukotka Autonomous Okrug.

The Central Research Institute of Epidemiology reports on 22 regions of Russia, where the indicators of HIV infection exceed the average Russian values. Among them are Kemerovo, Irkutsk, Sverdlovsk, Orenburg and Samara regions, where the rate of HIV infection varies from 2069 to 1515 people per 100 thousand population.

HIV infection in the Russian Federation as of December 31, 2021

Infectious diseases that cause the most people to die or lose health, for 2021

• lower respiratory tract infections;
• HIV/AIDS;
• tuberculosis;
• diarrhoeal diseases;
• malaria;
• measles.

Ministry of Health: In Russia, the number of births from mothers with HIV is growing by 13-14 thousand per year

On December 20, 2021, it became known about the annual increase in the number of children born from HIV-infected mothers in the Russian Federation by 13-14 thousand people. With such dynamics, in 5-6 years, the total number may exceed 300 thousand, said Ministry of Health Russia Yevgeny Voronin, chief freelance children's specialist in HIV infection.

According to him, by the end of 2021, 10,379 HIV-infected children were registered in Russia. 50% of them live in 10 regions of the country, in particular, in the Moscow region and St. Petersburg.

For the entire existence of HIV in Russia, by September 30, 2021, 229,097 children were born from HIV-positive mothers

Voronin also said that the number of premature babies with delayed physical development among contacts with HIV-infected is three times more than in the general population.

It is not always from mothers with HIV that infected babies are born. So, in 2020, more than 600 healthy children were born in the Moscow region from a mother infected with the human immunodeficiency virus.

According to the head physician of the Moscow Regional Center for the Prevention and Control of AIDS Alexander Pronin, every woman with HIV-positive status can give birth to a healthy baby. If an HIV-infected woman is planning a pregnancy, her priority task is to register with the Moscow Regional AIDS Center as early as possible. Modern antiviral drugs are able to suppress the virus in a woman's blood and completely protect the child from HIV infection, he stressed.

Pronin also says that if the mother does not act, the virus can be transmitted to the baby during pregnancy, during childbirth, as well as breastfeeding.

For the entire existence of HIV in Russia, by September 30, 2021, 229,097 children were born from HIV-positive mothers. In 2021, people learned about the positive status mainly at the age of 30-50 years (71.3% of new cases).^[10]

FSIN: 10% of prisoners are infected with HIV

According to the Federal Penitentiary Service (FSIN), by the end of November 2021, about 50 thousand prisoners in Russia are infected with HIV infection. In total, about 459 thousand people are held in pre-trial detention centers, colonies and prisons of the country. Thus, almost 10% of those serving sentences have human immunodeficiency virus.

Such figures were presented by the representative of the FSIN Tatyana Barankina at the VII All-Russian Forum for specialists in the prevention and treatment of HIV/AIDS in Moscow. She said that by the end of November 2021, 623 medical units and 135 hospitals for convicts were functioning within the penitentiary system. According to Barankina, mortality from HIV infection in FSIN institutions has more than halved. She did not specify for what reporting period, reports TASS.

FSIN: 10% of prisoners are infected with HIV

In September 2021, analysts of the "To be precise" project of the "Need Help" fund analyzed the official statistics of the FSIN and reported that in four Russian regions the share of prisoners with HIV ranged from 20 to 25% of the total population of places of imprisonment. These are Kemerovo (25%), Samara (23%) and Tomsk (20%) regions, as well as the Khanty-Mansiysk Autonomous Okrug (21%). In the Murmansk and Sverdlovsk regions, the indicators are 18% and 17%, respectively. In another 19 regions, the number of HIV-infected people exceeds the average 10%.

The head of the monitoring department of the Coalition for Preparedness for Treatment (ITPCru) Natalya Egorova suggested that a large percentage of registered HIV-infected people in places of imprisonment is due to the fact that 100% of people entering the penitentiary system are necessarily tested for HIV.

According to Egorova, there are cases when people are infected with HIV, already in the FSIN system, as a rule, this is due to the use of injection drugs.^[11]

Mishustin approved an action plan in the strategy to counter HIV until 2030

In October 2021, Prime Minister Mikhail Mishustin signed a government order approving an action plan to implement a state strategy to counter the spread of HIV infection in the Russian Federation for the period until 2030.

According to the document, by 2023, the Ministry of Health, FMBA, Rospotrebnadzor, along with other ministries, should develop and approve methodological recommendations for the prevention of HIV for schoolchildren and students. Also, until 2023, departments must develop and implement a "roadmap" to expand the coverage of HIV medical examination, including using field forms of work.

Russian Prime Minister Mikhail Mishustin approved the state strategy for combating HIV infection in the country until 2030

According to the plan, the authorities will develop an information and communication campaign on HIV prevention, including in key groups, which will help reduce the level of stigma and discrimination. For example, it is planned to develop recommendations for HIV prevention for students with a focus on "efforts to promote family and traditional values, prevent risky behavior, socio-economic support for youth and women." In addition, Russian employers and workers are going to educate.

The Ministry of Health, the Ministry of Industry and Trade, the Ministry of Finance and the FMBA were instructed to organize a full cycle of production of innovative combined drugs and their prolonged forms in Russia. It is also planned to take measures to reduce the price of antiretroviral therapy and improve the maintenance of the Federal Register of HIV-positive people.

In addition, the country is going to conduct studies on the prevalence of HIV in key groups in regions with a high incidence rate. 

The document also says about plans to cooperate on HIV response with UN organizations and international partners.Order of the Government of the Russian Federation No. 2933-r dated 19.10.2021

Russians with HIV are denied vaccinations against COVID-19

In early July 2021, the SPEED.center Foundation sent a letter to the Minister of Health of the Russian Federation Mikhail Murashko, in which he complained about the refusal of Russians with HIV to vaccinate against the coronavirus COVID-19.

In the context of a pandemic of a new coronavirus infection, the AIDS Center Fund for Assistance to People Living with HIV registers cases of discrimination against people with HIV during vaccination. The fund regularly receives reports of "medical diversions" from the vaccine based on HIV infection... The practice of refusing to vaccinate people with HIV directly contradicts medical recommendations, and primarily the interests of patients, the appeal says.

Russians with HIV are denied vaccinations against coronavirus COVID-19

According to Sergei Abdurakhmanov, director of the SPEED.Tcenter Foundation, out of 700 patients admitted in June by one of the doctors of the Moscow Regional Center for AIDS Prevention and Control, 30 people reported refusing to vaccinate them. The fund does not keep general statistics, but Abdurakhmanov noted that the number of recorded requests is only a "small layer."

HIV infection is not a contraindication to vaccination against COVID-19, Alexey Mazus, chief freelance HIV specialist of the Ministry of Health, told RBC. Moreover, vaccination is indicated for HIV-positive people, he noted.

There was a case when a person was not vaccinated, but asked to bring permission from an infectious disease doctor. The patient had to leave, you need to go to an infectious disease specialist, and this is a loss of time, "said Yulia Vereshchagina, an activist of the Patient Control movement.

The Foundation asked the Ministry of Health to send clarifications to hospitals, clinics and vaccination points that it is unacceptable to refuse vaccination to people with HIV.

The chief freelance specialist in HIV infection of the Ministry of Health, Alexei Mazus, said that vaccination with HIV-positive people, on the contrary, is indicated, since they belong to a vulnerable group.^[12]

2020

Russia accounts for 4% of all new HIV infections in the world

9 countries that account for half of all new HIV infections worldwide, 2020

HIV incidence in Russia has halved in 5 years

The incidence of HIV in Russia in 5 years has halved - from 68.5 per 100 thousand population in 2015 to 35.8 in 2020. This was reported by RIA Novosti with reference to the statistics of the Ministry of Health of the Russian Federation.

According to the ministry, in 2020, 56.5 thousand new cases of HIV were registered against 80 thousand a year earlier. Most of all new patients per 100 thousand people were recorded in the Kemerovo region, Perm Territory and Tyumen region, the smallest - in the republics of Kalmykia, Chechnya and Smolensk region.

The incidence of HIV in Russia in 5 years has fallen 2 times

Despite the decrease in the incidence of HIV, this infection remains a great threat, and there are several reasons:

• unsanitary conditions in medical institutions, piercing and tattoo workshops, manicure rooms;
• prevalence of injection drug addiction;
• prevalence of HIV dissidence;
• insufficient awareness of the population about the disease;
• lack of access to medicines.

In 2020, the HIV strategy ended (it was approved by the government in 2016), a new strategy is needed that will take into account the mistakes of the previous one, says Vadim Pokrovsky, head of the AIDS prevention and control department at the Central Research Institute of Epidemiology of Rospotrebnadzor. In his opinion, first of all, it is necessary to strengthen preventive measures in order to reduce the emergence of new cases of infection. The strategy will be effective if the number of new cases drops to several thousand, the expert said.

HIV-related mortality could have decreased due to the fact that the number of people on treatment has significantly increased, said Alexei Mikhailov, head of the monitoring department of the Coalition for Preparedness for Treatment movement, which deals with the problems of access of HIV-infected people to medicines. However, the supply system of HIV-infected drugs remains imperfect, he complains.^[13]

Reduction in HIV-related deaths by 19%

Mortality from HIV infection at the end of 2020 decreased by 19% compared to 2019. Such data in early June 2021 were cited by the chief freelance specialist in HIV infection of the Ministry of Health of the Russian Federation, the head of the Moscow City Center for AIDS Prevention and Control Alexei Mazus.

This is very important. And so it should be when it comes to the fact that almost all patients are provided with antiretroviral therapy, "he said.

Mortality from HIV in Russia fell by 19% at the end of 2020

The specialist noted that Russia was one of the first to reach the indicator when 90% of patients know their HIV status. At the same time, in Moscow, the level of infection is lower than the average in Russia. The same picture has been observed in recent years in Kuzbass.

On February 8, 2021, Deputy Prime Minister Tatyana Golikova reported that, according to preliminary data, mortality from HIV infection in 2020 in Russia decreased by 9.1% compared to 2019. However, already at the end of March, the Federal Scientific and Methodological Center for the Prevention and Control of AIDS of the Central Research Institute of Epidemiology of Rospotrebnadzor cited other information: 32,208 infected with HIV died in 12 months of 2020, which is 4.1% less than in the same period of 2019. Mostly the sick died at the age of 41. Experts call tuberculosis the leading cause of deaths.

According to the centre, HIV has been diagnosed in older age groups in recent years. If in 2001 87% HIV-infected people were diagnosed at the age of 15 - 29, in 2020 almost the same number of patients (86.1%) were first identified at the age of 30 years. Among patients with HIV infection in 2020, men dominate the country - 62.6% among all reported cases and 61.5% among newly diagnosed. The highest rate of HIV infection in the population is observed in the age group of 30-44 years.^[14]

799,706 patients with HIV infection are registered in Russia

In 2020 Russia , 799,706 patients with HIV infection were registered at the dispensary. Over the year, 60,124 new cases of infection were registered, which is 20 thousand less than in 2019. Such data on May 20, 2021 was provided by the chief freelance specialist in HIV infection Ministry of Health of Russia Alexei Mazus.

According to him, in 2020, among all Russians registered with HIV, 610,762 received antiretroviral therapy, that is, treatment coverage amounted to 76.4% of the total number of patients. This is above the target for this period (72%), Mazus noted.

The number of registered patients with HIV infection in 2020 amounted to 799,706 patients

At the same time, according to the report of the Coalition for Readiness for Treatment (ITPCru), in which it analyzed government purchases of drugs necessary for immunodeficiency, in Russia only half of registered patients with HIV (45.7%) in 2020 were able to receive antiretroviral therapy - this is 505 thousand annual courses. Almost 600 thousand more people were left without the medicines they were entitled to.

In 2020, the Ministry of Health spent 30.9 billion rubles on the purchase of antiretroviral drugs, which is two billion more than in 2019. This money paid 85 percent of all purchased courses. Another ten percent were bought by the FSIN institutions. Only four percent of medicines were purchased from regional budgets.

In some cases, patients complained of drug shortages by the end of the year, but there was no massive disruption. In total, 358 appeals of infected citizens were recorded, 266 of them concerned problems in the supply of medicines and diagnostics. A year earlier, there were 455 such complaints. Most of the messages were from St. Petersburg, Novosibirsk and Sverdlovsk regions.

Alexey Mazus noted that planning of the need for medicines for HIV-infected citizens in the regions is carried out "on a personalized basis, taking into account the data of the Federal Register of Persons Infected with HIV."^[15]

Mishustin approved a strategy for combating HIV

At the end of December 2020, Prime Minister Mikhail Mishustin signed an order approving the state strategy to counter the spread of HIV infection in Russia for the period until 2030. The corresponding document is published on the official Internet portal of legal information.

The strategy involves providing population coverage with effective HIV screening to maximize detection of those infected, as well as increasing coverage of antiretroviral therapy and reducing the risk of mother-to-child transmission of HIV.

Mikhail Mishustin approved a strategy for combating HIV

The goal of the initiative is to prevent the spread of HIV in the country. Within the framework of the state strategy in Russia, among other goals, the awareness of the population about the disease should increase. In addition, discrimination and stigmatization of people with HIV should be discouraged. It is planned to provide social support to HIV-infected and their family members, as well as to ensure a high quality of life for children with HIV infection.

According to the document, the share of citizens in the Federal Register of persons with HIV infection and receiving antiretroviral therapy should be 95%. In addition, by 2030 it is planned to reduce the number of new cases of HIV infection to 45.6 thousand, and the share of those tested for HIV to increase to 39% of the country's population.

Mishustin instructed the Ministry of Health of the Russian Federation to submit to the government a plan of measures for the implementation of the state strategy in six months. Also, the authorities of Russian subjects are recommended to approve regional programs to counter the spread of HIV, taking into account the coronavirus pandemic (COVID-19) infection.

As part of the strategy, it is also planned to continue cooperation with the Eurasian Economic Union, BRICS, CIS, SCO and UN on HIV.^[16]

Ministry of Health: Russia has reached a plateau on HIV

At the end of October 2020, the Ministry of Health of the Russian Federation announced that Russia had reached a plateau for HIV infection. In recent years, "fewer and fewer patients" have been identified, and here Russia is in the same trend with the United States and other developed countries, said Alexei Mazus, chief freelance specialist in the diagnosis and treatment of HIV in the Ministry of Health.

The Ministry of Health said that the Russian Federation has reached a plateau on HIV

According to him, it has not yet been possible to drop to a level below the plateau, since this requires the creation of a vaccine against HIV. By the end of October 2020, all the forces of the world scientific community are aimed at developing drugs and vaccines against the coronavirus COVID-19, after the pandemic they need to be repurposed to create drugs against HIV, he said.

A set of scientific efforts will create a vaccine against HIV infection, and this will end the epidemic, - Alexey Mazus is sure.

The Ministry of Health says that the HIV situation in Russia remains tense, but there has been a trend towards a decrease in the growth rate of newly diagnosed HIV-infected people.^[17]

11,494 children with HIV. How They and Their Parents Live

As of April 30, 2020, 11,494 children with HIV were registered in Russia.

On July 29, 2020, the non-profit charitable foundation Svetlana Izambaeva, with the support of the international research company Ipsos and the biopharmaceutical company Gilead Sciences, published the results of the study "HIV-positive adolescents and their parents: problems of life with a diagnosis," dedicated to the problems of perception of diagnosis, treatment and finding ways to support families with HIV-positive children.

Children and adolescents are a vulnerable and unprotected category of patients. They need to be protected from abuse and discrimination, to ensure access to treatment. In Russia, children with HIV need modern preventive therapy, psychological support and acceptance by society. The study "HIV-infected adolescents and their parents: problems of life with a diagnosis" was conducted in order to determine in families with HIV + children difficulties with social adaptation and therapy, as well as to identify psychological difficulties associated with the diagnosis. The study was conducted by a series of in-depth interviews with HIV + adolescents 16-18 years old and parents of children diagnosed from 5 cities of Russia : Moscow, St. Petersburg, Kazan, Togliatti, Novosibirsk and Irkutsk.

The difficulties of parents of children with HIV associated with the perception of the diagnosis are primarily expressed in the form of fear, shame and misunderstanding. A study conducted by the Foundation showed that adoptive parents perceive HIV more calmly and rationally, which is associated with their moral training and level of knowledge about the disease. After the diagnosis, native parents are in a state of shock and are not fully aware of the specifics of the disease. It is shameful to talk about HIV due to strong stereotypes in society. In the family, the topic is often taboo and even relatives may not know about the child's diagnosis. Adolescents, in turn, do not feel fear about the disease, realizing that, thanks to therapy, HIV does not harm their bodies. Respondents believe that negative attitudes towards HIV are associated with a low level of public awareness and the presence of a large number of myths about the disease.

"The toughest group in terms of adherence to therapy is teenagers. This category of patients must be constantly provided with help: effective therapy, psychological and information support. It is difficult for HIV-positive children to socialize and live ordinary lives due to a number of difficulties, including social discrimination. Today, public awareness of HIV transmission is higher than, for example, 20 years ago, but stereotypes have remained and continue to make life difficult for families with HIV-positive children and adolescents. Informing society about the problem of HIV will help not only reduce the number of infections in the future, but also prevent discrimination against children and adolescents with this infection, "said Evgeny Evgenievich Voronin, MD, professor, chief freelance specialist in the diagnosis and treatment of HIV infection in children of the Russian Ministry of Health, head of the Scientific and Practical Center for the Prevention and Treatment of HIV Infection in Pregnant Women and Children.

Indeed, the range of drugs prescribed by HIV + to children, especially under the age of 12, is limited, and often only regimens are prescribed that imply the use of drugs several times a day. Despite the free drug provision for HIV patients, continuous therapy creates difficulties for children and their parents. Taking drugs several times a day, at the same time, does not make it possible to relax and live an ordinary life. Even more difficult are the reception schemes associated with food - when you need to wait a certain time before eating. Families in which children with HIV often cannot go on vacation, since they need to carry drugs that require storage in a refrigerator that is not always accessible or hidden from prying eyes. Teenagers claim to be aware of the need to take drugs, but dream of an "ideal drug" - a medicine in the form of a tablet, which can be taken as rarely as possible. Respondents who started the drug once a day are quite satisfied with this therapy.

Helping psychologists and visiting support groups are vital for parents and caregivers of HIV + children. Parents deprived of such support note that they experience symptoms of depression and burnout, negatively affecting children. Support groups and psychological training are essential for adolescents as well. Children with ongoing support can discuss any experiences associated with the disease and resolve all problems, while children without support are lonely and shrouded in fears and myths about the disease.

2019

In 13 regions of Russia, the share of people infected with HIV infection exceeded 1% of the population

According to Rospotrebnadzor data for 2019, in 13 regions Russia the share of people infected with HIV infection exceeded 1% of the population. The most difficult situation was observed in the Irkutsk, Sverdlovsk and Kemerovo regions. Central scientific research institute of epidemiology of Rospotrebnadzor Vadim Pokrovsky, head of the AIDS prevention and control department, then pointed out that the situation in these regions could be considered a generalized epidemic.

In 13 regions of the Russian Federation, the share of people infected with HIV infection exceeded 1% of the population

By the end of 2019, the number of people infected with the human immunodeficiency virus (HIV) in Russia was 1.06 million, of which less than half were treated, said Vadim Pokrovsky, head of the Federal Scientific and Methodological Center for the Fight and Prevention of HIV Infection.

According to the Ministry of Health, 80,118 new cases of HIV were detected in 2019, which is 7.5% less than in 2016, when 86,519 new cases were recorded.

In Russia, for the first time, the number of new cases of HIV infection has decreased

The number of new cases of HIV infection in Russia in the first ten months of 2019 decreased by 8% compared to the same period in 2018 and amounted to 65,755 cases. This is the first decline, Health Minister Veronika Skvortsova said during the V All-Russian Forum for HIV/AIDS Prevention and Treatment Specialists at the end of November 2019.

According to her, there are about 900,000 HIV-positive people in Russia. She classified young people as a high-risk group.

Skvortsova said that the implementation of a set of preventive measures at the federal and regional levels made it possible to increase population testing coverage to 25.8% in 2018, which is about 38 million people, almost one and a half times more than it was 10 years ago, and one of the highest rates in the world.

 The head of the Ministry of Health called the spiritual and moral education of young people, their education and raising awareness about HIV ― the necessary measures to combat the spread of HIV infection. 

 According to Skvortsova, in the zero years, the incidence of infection increased by 8-12% every year,  and in 2015 there was a turning point when measures were taken to combat infection.^[18]

2018

Mortality increase by 2.2% to 20.6 thousand people

In 2018, 20.6 thousand Russians died from HIV, which is 2.2% more than a year earlier. This was reported in the report of the Central Research Institute for the Organization of Population Informatization, published at the end of July 2019 Ministry of Health Russia.

There is an overestimation of the indicator "Mortality from HIV infection," since almost all those who died in the presence of a combination of tuberculosis and HIV infection are registered as dead from HIV infection, the document explains.

People aged 25 to 44 make up more than 76% of all deaths from HIV in Russia in 2018. Almost 16% of all deaths of HIV-infected citizens fall on the age category from 45 to 54 years old, about 5% - 55-64 years old. However, most often it is young people who die - men and women from 25 to 34 years old. They account for 22.3 deaths per 100 thousand population.

Another 5.4% die as a result of respiratory diseases, digestive problems destroy 14.9%, and with the nervous system - 3.6%. Due to coronary heart disease, death occurs in 8.4%. Cerebrovascular diseases kill 5.1%, tuberculosis - 3.3%.

In 2018, almost 86 thousand people were diagnosed with HIV, while a total of 896 thousand HIV-positive were registered in Russia. Most of them (712.5 thousand) are under dispensary supervision.

The highest incidence of HIV in 2018 was recorded in the Ural, Siberian and Volga federal districts.

In early July 2019, the Ministry of Health explained that the increase in the number of people with HIV in Russia indicates a decrease in mortality among infected people. According to the ministry, high rates of lesion "cannot be unambiguously interpreted as a deterioration in the epidemiological situation in the region." For example, these numbers can grow as a result of successful treatment and "accumulation" of patients.^[19]

1,007,369 Russians diagnosed with HIV infection

According to Rospotrebnadzor, the incidence rate of HIV infection at the end of 2018 amounted to 59.74 per 100 thousand population (in 2017 - 61.16), the rate of HIV infection - 686.2 per 100 thousand population of Russia.

As of December 2018, 1,007,369 Russians with a diagnosis of HIV infection lived in the country. At the same time, according to data from MEDIA, the real number of HIV-infected people in Russia, it may be higher than this figure. Thus, Vadim Pokrovsky, head of the AIDS control center at Rospotrebnadzor, calls the figure, which is enough to declare an epidemic.

"It can be assumed that about 1.5 million carriers of the human immunodeficiency virus live in Russia, of which a third have not yet come to the attention of medical workers," Pokrovsky told Izvestia, recalling that HIV infection may not appear until 20 years old.

2017: For 100 thousand people - 71.1 patients with HIV

According to Rospotrebnadzor, the incidence rate of HIV infection in 2017 amounted to 61.16 per 100 thousand population.

Data for 2017

2014: More than 900,000 HIV patients, men 60%

In Russia, according to the Federal Scientific and Methodological Center for the Prevention and Control of AIDS, in 2014 there are over 900 thousand people with HIV, among them men prevail - there are just over 60% of them.

1987: AIDS detected in the USSR

The fact of the presence of infection doctors first established in the summer of 1987. By the end of the year, there were already 25 HIV-infected people from among those with whom he contacted.

1988. The first people infected with HIV in the USSR with a list of professions.

Notes