Which countries are most susceptible to the spread of HIV? Russia is a leader among all countries in the world in terms of the rate of growth in the number of new cases of HIV infection. But in the Russian Federation they think and calculate differently

TASS DOSSIER. From May 15 to May 21, 2017, the All-Russian campaign “Stop HIV/AIDS” will be held in Russia for the third time. Its organizer is the Foundation for Social and Cultural Initiatives (the President of the Foundation is the wife of the Prime Minister of the Russian Federation, Svetlana Medvedeva). The action is carried out with the support of the Ministry of Health, the Ministry of Education and Science, the Ministry of Communications of Russia, Rosmolodezh, Rospotrebnadzor, as well as the Union of Rectors of Russia, leading state universities of the Russian Federation and the Russian Orthodox Church.

It is timed to coincide with World AIDS Day, which is held annually on the third Sunday of May. Its goal is to draw attention to this problem in Russia, to increase awareness of the population, especially young people, about the disease.

Campaign "Stop HIV/AIDS"

The all-Russian campaign “Stop HIV/AIDS” began to be held in Russia in 2016. The key event of the first campaign, held in May, was an open student forum. The second event was timed to coincide with World AIDS Day (December 1) and took place at the end of November. It started at the II All-Russian Forum for specialists in the prevention and treatment of the disease (November 28).

As part of the campaign, an open lesson “Knowledge - Responsibility - Health” was held in senior secondary schools, at which a film about current issues in combating HIV infection was shown.

HIV/AIDS disease

The human immunodeficiency virus (HIV) attacks the immune system and weakens the body's defenses against a wide range of infections and diseases, including some types of cancer. HIV-infected people gradually develop immunodeficiency.

The last stage of the disease that develops when infected with the human immunodeficiency virus is AIDS (acquired immunodeficiency syndrome), when the human body loses the ability to protect itself from infections and tumors. In different people, AIDS can develop 2-15 years after HIV infection.

There is no cure for HIV infection. However, through treatment with antiretroviral drugs, the virus can be controlled and transmission can be prevented. This facilitates and prolongs the life of those infected with the infection.

Statistics for Russia

The epidemiological situation regarding HIV infection in Russia (the first case was identified in 1987) is unfavorable; cases of the disease have been identified in all constituent entities of the Russian Federation.

According to Rospotrebnadzor, as of December 31, 2016, since 1987, a total of 1 million 114 thousand 815 cases of HIV infection have been registered among citizens of the Russian Federation, of which 243 thousand 863 people have died. Thus, at the beginning of 2017, 870 thousand 952 Russians lived in Russia with a diagnosis of HIV/AIDS, which is 0.59% of the total population of the country (146 million 804 thousand 372). The prevalence of HIV as of December 31, 2016 was an average of 594.3 people with an established diagnosis per 100 thousand of the country’s population.

The number of newly identified cases of HIV infection in the country continues to grow. According to Rospotrebnadzor, in 2011-2016. the annual increase averaged 10%. In 2016, territorial centers for the prevention and control of AIDS registered 103 thousand 438 new cases of HIV infection (excluding those identified anonymously and foreign citizens) - 5.3% more than in 2015 (95 thousand 475).

High HIV prevalence is observed in the 30 largest regions of the Russian Federation, where 45.3% of the country's population lives. The most unfavorable regions, where the number of people living with HIV exceeds 1 thousand people per 100 thousand population, are Sverdlovsk (1648 per 100 thousand population), Irkutsk (1636), Kemerovo (1583), Samara (1477), Orenburg (1217) region, Khanty-Mansiysk Autonomous Okrug (1202), Leningrad (1147), Tyumen (1085), Chelyabinsk (1079) and Novosibirsk (1022) regions.

A high level of HIV infection in the Russian Federation is observed in the age group from 30 to 39 years. Among young people (15-20 years old), more than 1.1 thousand people with HIV infection are registered annually. Cases of infection of children during breastfeeding continue to be identified: in 2014, 41 children were infected, in 2015 - 47 children, in 2016 - 59.

In 2016, 675 thousand 403 patients were registered with specialized medical organizations (77.5% of all those living with a diagnosis of HIV/AIDS). Of these, 285 thousand 920 patients (42.3% of those registered) received antiretroviral therapy.

HIV/AIDS in the world

Some scientists believe that HIV was transmitted from monkeys to humans as early as the 1920s. The first victim of this disease may have been a man who died in 1959 in the Congo. This conclusion was reached by doctors who later analyzed his medical history.

For the first time, symptoms of the disease characteristic of HIV/AIDS were described in 1981 during an examination of several men of non-traditional sexual orientation in clinics in Los Angeles and New York. In 1983, researchers from the USA and France described a virus that can cause HIV/AIDS. Since 1985, HIV blood testing has become available in clinical laboratories.

According to the World Health Organization, at the end of 2015, there were from 34 to 39.8 million (on average 36.7 million) people living with HIV in the world. The most affected region is sub-Saharan Africa, with about 25.6 million people living with HIV in 2015 (approximately two-thirds of all those infected). More than 35 million people have become victims of HIV/AIDS in the world. In 2015 alone, approximately 1.1 million people died. As of June 2016, 18.2 million patients had access to antiretroviral treatment, including 910 thousand children.

Many countries assess HIV infection as the main problem in the formation of a healthy nation throughout the world. Depending on the economic state of the state, the ability to quickly and accurately detect infected people, timely high-quality treatment of patients, as well as public awareness of the dangers of the disease and prevention methods, the indicator that determines in which country the incidence of HIV (AIDS) is highest.

The popularity of the state in the world community and economic growth in the 21st century depend on this indicator. Many highly developed countries do not allow entry into their territory without passing the appropriate test, which indicates that the government is interested in the health of its population. In the Russian Federation, every year every working person is required to take a test to determine the retrovirus in the blood. This allows you to control the disease and take appropriate measures to prevent immunodeficiency. For example, in Belarus, when crossing a border checkpoint, you must document your HIV-negativity. But in Europe this document is not always required. In any case, when traveling to another country, you must have such data with you, which is valid for 3 months.

Countries are divided into 3 levels based on the number of HIV-infected people:

1. States in which the AIDS pathogen is transmitted among men - homo- and bisexuals, drug addicts who use intravenous potent substances. These include the USA, Brazil, Bangladesh, Pakistan, Mexico, Great Britain, Turkey. These countries have a high rate of infected people per 100 thousand population, which ranges from 53 to 246 patients, depending on the region.
2. The disease occurs among heterosexuals when the pathogen is transmitted sexually through contact with a prostitute. At the same time, there is a high degree of possibility of infection in people who have many sexual partners. Often such patients are also exposed to sexually transmitted diseases. Similar regions include countries in Asia and Eastern Europe. They have a relatively low rate of retrovirus infections, which ranges from 20 to 50 patients per 100 thousand population.
3. In China, Japan, Nigeria, and Egypt, the incidence of HIV infection is lower than in other countries of the world. Here the disease is considered imported and is observed most often in prostitutes and people who use their services. These countries have a low infection rate, which ranges from 6 to 16 patients per hundred thousand citizens.

Countries intensively infected with HIV pose a great danger to the world's population. Statistics from such countries show that the incidence of immunodeficiency is growing every year. This suggests that the country is either not fighting AIDS, or the actions taken are not effective. There is a list that includes the most dangerous countries for HIV transmission. The rating below shows the level of danger in them:

1. SOUTH AFRICA. It has the highest degree of infection of the population with a retrovirus. It is believed that approximately a quarter of the population is affected by immunodeficiency. There are 5.6 million AIDS patients here. The state has a mortality rate from HIV of about 1 million people per year, 15% of the total number of citizens are infected.
2. India. AIDS has affected 2.4 million people here. In the country, the mortality index from immunodeficiency varies from 1% to 2% per year, the number of HIV-infected people is 10-12% of the population.
3. Kenya has the lowest rate of HIV (AIDS) in Africa. Statistics indicate 1.5 million patients. The country has a mortality index from a retrovirus of 0.75 million people, 7.5% of the population is infected with this pathogen.
4. Tanzania, Mozambique. There are 0.99-0.34 million people with AIDS here, depending on the region. These countries have a mortality rate from immunodeficiency of 0.2-0.5 million citizens per year, 8-12% of the population is infected.
5. USA, Uganda, Nigeria, Zambia, Zimbabwe. There are 1.2 million people with AIDS. These countries have a total HIV mortality rate of 0.3-0.4 million people per year, 5% of the population is infected.
6. Russia. There are 0.98 million people living with HIV in Russia. The mortality rate from AIDS reaches a level of slightly less than 3-4% of all cases. The most HIV-infected city in Russia is Yekaterinburg. It is believed that one in 50 city residents is infected with the retrovirus.
7. Uzbekistan. 32,743 people are affected by the infection in Uzbekistan. Of these, 57% are men.
8. Azerbaijan. The number of HIV (AIDS) patients in Azerbaijan is 131 people. Of these, 36 are women and 95 are men.
9. United Arab Emirates. Recently, the detection of HIV infection among Arabs has increased. According to the latest data, the incidence index is 350-370 thousand per 367 million population.

HIV (AIDS) in Kazakhstan

According to the latest report, HIV infections in Kazakhstan are 0.01%. At the end of 2016, 22,474 cases of infection were registered. 16,530 people with AIDS have been identified. Among the total number, infected men make up 69%, women - 31%. Although females make up a smaller share among those infected, their number is gradually growing. The government is actively involved in HIV (AIDS) treatment in Kazakhstan. The effectiveness of the program is evidenced by:

increasing the number of early detection of patients;

an increase in the number of patients who received antiretroviral therapy;

reduction in the birth rate of infected children.

HIV in the USA

The number of people living with HIV in the United States is growing every year. The country has a high level of economy, which contributes to the early detection of infected people and the appointment of adequate treatment in the initial stages of the disease. This helps reduce the aggressiveness of the virus, prolong life and improve its quality.

How many people are infected with HIV in the USA? In America, immunodeficiency is more common among homosexuals. It is believed that there are about 2.6 million carriers of the infection living in the United States. But the high level of medical care allows such patients to be well taken care of, making their lives the same as those of healthy people.

How common is HIV in Russia?

AIDS in Russia has not yet achieved epidemic status, but growing rates indicate the possibility of rapid progression of infection among people in the country. HIV infection in Russia is considered one of the most dangerous pathologies, because there is no vaccine to prevent it, and only self-awareness of citizens can lead to a decrease in the incidence rate.

Where did AIDS come to Russia? The first confirmed case of immunodeficiency was discovered in Moscow in the family of a long-distance sailor. After a 9-month business trip to hot countries, he was already in his hometown hospitalized in a hospital with Pneumocystis pneumonia, which very often affects infected people due to a decrease in the barrier function of the immune system. The examination revealed human immunodeficiency virus. The man died a few months later, and his family had to move to the other end of the country and change their last names so that ill-wishers would not find them.

Since this period, the level of HIV incidence in Russia has been gradually increasing, violating standard indicators of public health and reducing its working capacity.

How many HIV-infected people are there in Russia? At the end of 2016, the quantitative index among those infected with the retrovirus was 0.98 million. This number is considered one of the lowest in the world, while AIDS mortality in the Russian Federation remains stable at an average level. In the regions of Russia, the situation with HIV incidence is different. This is due to several factors:

1. Religiosity.
2. Population of the region.
3. Economic significance.
4. Quality of medical equipment and service.

How many people have HIV (AIDS) in Russia? The largest figure is in the Ural Federal District. The incidence rate is the highest numerically among other regions of the country. It is 757.2 infected per 100 thousand population.

The Siberian Federal District has an incidence index of 532 infected people per 100 thousand citizens. Volga Federal District - 424 patients for the same number of population.

Among all federal districts of the country, the North Caucasus Federal District has the lowest indicator, here the level is 58 people per 100 thousand population.

The number of AIDS patients in Russia in the Far Eastern Federal District is 172 infected. How many people suffer from HIV (AIDS) in Russia in the Northwestern region? The incidence index in this district is 407 patients per 100 thousand population.

The number of HIV and AIDS-infected people in Russia is progressing upward every year, so only prevention measures can reduce the incidence among citizens of the Russian Federation.

Thanks to standards for the treatment of immunodeficiency, the state program for detection and therapeutic assistance, the number of patients with HIV infection (AIDS) in Russia has decreased slightly. The rate of births of infected children has decreased, which indicates the early detection of the retrovirus in pregnant women and the provision of correct and effective treatment to them.

Thanks to the simplification of testing for retroviruses and constant screening of the population, the dynamics of HIV disease in Russia tends to reduce mortality rates. Some facts indicate that the number of carriers of the pathogen is increasing. But upon closer examination, it turns out that the number of citizens examined is growing every year, and this leads to an overestimation of the absolute incidence rate.

There is no need to be afraid that there are a million HIV-infected people in Russia. If you adhere to basic personal hygiene and prevention methods, the risk of infection approaches zero. You need to know that the best means of protection against infection with a retrovirus are barrier contraceptives and sterile instruments.

Basic indicators

At the beginning of 2017, the total number of cases of HIV infection among Russian citizens reached 1,114,815 people ( in the world - 36.7 million HIV-infected people, incl. 2.1 million CHILDREN). Of these, 243,863 HIV-infected people died for various reasons (not only from AIDS, but from all causes) (according to the Rospotrebnadzor monitoring form “Information on measures for the prevention of HIV infection, hepatitis B and C, identification and treatment of HIV patients”) . In December 2016, 870,952 Russians were living with a diagnosis of HIV infection.

As of July 1, 2017, the number of HIV-infected people in Russia amounted to 1,167,581 people, of which 259,156 people died for various reasons (in the first half of 2017, 14,631 HIV-infected people had already died, which is 13.6% more, than in 6 months of 2016). The rate of HIV infection among the population of the Russian Federation in 2017 was 795.3 people infected with HIV per 100 thousand of the population of Russia.

In 2016, 103,438 new cases of HIV infection were identified among Russian citizens ( 1.8 million in the world), which is 5.3% more than in 2015. Since 2005, the country has registered an increase in the number of newly identified cases of HIV infection; in 2011-2016, the annual increase averaged 10%.

The incidence rate of HIV infection in 2016 was 70.6 per 100 thousand population.

In terms of the growth rate of HIV infection, Russia has taken 3rd place after the Republic of South Africa and Nigeria.* (V.V. Pokrovsky).

*/approx. the statement is ambiguous, because not all countries estimate equally well the number of HIV-infected people, who also need to be identified for money (for example, in Ukraine, Moldova, Uzbekistan, Tajikistan, where there is hardly enough money to screen the population for HIV.

In addition, judging by the identification of a huge number of HIV-infected guest workers, the prevalence of HIV in these countries is several times higher than in the Russian Federation)/.

During the first half of 2017, 52,766 HIV-infected Russian citizens were identified in Russia. The incidence rate of HIV infection in the first half of 2017 was 35.9 cases of HIV infection per 100 thousand population.

The most new cases in 2017 were detected in the Kemerovo, Irkutsk, Sverdlovsk, Chelyabinsk, Tomsk, Tyumen regions, as well as in the Khanty-Mansiysk Autonomous Okrug.

Video. Incidence in Russia, March - May 2017.

An increase in the growth rate of new cases of HIV infection in 2017 (but the overall incidence of HIV infection is low) is observed in the Vologda region, Tyva, Mordovia, Karachay-Cherkessia, North Ossetia, Moscow, Vladimir, Tambov, Yaroslavl, Sakhalin and Kirov regions.

Growth in the total (cumulative) number of registered cases of HIV infection among Russian citizens from 1987 to 2016.

The growing number of HIV-infected Russians from 1987 to 2016.

HIV in regions and cities

In 2016, the following regions and cities were leaders in terms of morbidity rates in the Russian Federation:

1. Kemerovo region(228.8 new cases of HIV infection were registered per 100 thousand population - a total of 6,217 HIV-infected people), incl. in the city of Kemerovo there are 1,876 HIV-infected people.

2. Irkutsk region(163.6%000 - 3,951 HIV-infected). In 2017, 1,784 new HIV-infected people were identified in the Irkutsk region over 5 months. In 2016, 2,450 new HIV infections were registered in the city of Irkutsk, and 1,107 in 2017. Almost 2% of the population of the Irkutsk region are infected with HIV.

3. Samara Region(161.5%000 - 5,189 HIV-infected, including 1,201 HIV-infected in the city of Samara), for 7 months of 2017 - 1,184 people. (59.8%000).

4. Sverdlovsk region(156.9%000 - 6,790 HIV-infected), incl. in the city of Yekaterinburg there are 5,874 HIV-infected people (the most HIV-infected city in Russia / or are they well identified? ed./).

5. Chelyabinsk region(154.0%000 - 5,394 HIV-infected),

Tyumen region(150.5% 000 - 2,224 people - 1.1% of the population), in the first half of 2017, 1,019 new cases of HIV infection were identified in the Tyumen region (an increase of 14.4% compared to the same period last year year, then 891 HIV-infected people were registered), incl. 3 teenagers. The Tyumen region is one of the regions where HIV infection is recognized as an epidemic.

6. Tomsk region(138.0%000 - 1,489 people),

7. Novosibirsk region(137.1% 000) region (3,786 people), incl. in the city of Novosibirsk there are 3,213 HIV-infected people.

8. Krasnoyarsk region(129.5%000 - 3,716 people),

9. Perm region(125.1%000 - 3,294 people),

10. Altai region(114.1% 000 - 2,721 people) region,

11. Khanty-Mansiysk Autonomous Okrug- Yugra (124.7% 000 - 2,010 people, every 92nd resident is infected),

12. Orenburg region(117.6%000 - 2,340 people), in 1 quarter. 2017 - 650 people. (32.7%000).

13. Omsk region(110.3% 000 - 2,176 people), over 8 months of 2017, 1,360 cases were identified, the incidence rate was 68.8% 000.

14. Kurgan region(110.1%000 - 958 people),

15. Ulyanovsk region(97.2% 000 - 1,218 people), in 1 quarter. 2017 - 325 people. (25.9%000).

16. Tver region(74.0%000 - 973 people),

17. Nizhny Novgorod Region(71.1% 000 - 2,309 people) region, in 1 sq. 2017 - 613 people. (18.9%000).

18. Republic of Crimea(83.0%000 - 1,943 people),

19. Khakassia(82.7%000 - 445 people),

20. Udmurtia(75.1%000 - 1,139 people),

21. Bashkortostan(68.3%000 - 2,778 people), in 1 quarter. 2017 - 688 people. (16.9%000).

22. Moscow(62.2%000 - 7,672 people)

%000 is the number of HIV-infected people per 100 thousand population.

Table No. 1.

The number of HIV-infected people and the incidence of HIV infection by regions and regions of Russia (TOP). Interactive table with sorting capabilities.

How many HIV-infected people have been identified in the regions of the Russian Federation?

What is the incidence rate in the regions per 100 thousand population.

Table No. 2.

The number of HIV-infected people and the incidence of HIV infection in Russian cities (TOP). How many HIV-infected people have been identified in Russian cities?

HIV incidence rates in Russian cities.

Leading cities in terms of the number of identified HIV-infected people and the incidence of HIV infection: Yekaterinburg, Irkutsk, Kemerovo, Novosibirsk and Samara.

The subjects of the Russian Federation most affected by HIV infection.

The most significant growth (rate, growth rate of new HIV cases per unit time) of incidence in 2016 was observed in the Republic of Crimea, Karachay-Cherkess Republic, Chukotka Autonomous Okrug, Kamchatka Territory, Belgorod, Yaroslavl, Arkhangelsk regions, Sevastopol, Chuvash, Kabardino-Balkarian Republics, Stavropol Territory, Astrakhan Region, Nenets Autonomous Okrug, Samara Region and Jewish Autonomous Okrug.

Number of newly identified cases of HIV infection among Russian citizens in 1987-2016

Distribution of the number of new HIV cases by year (1987-2016).

The prevalence of HIV infection in the Russian population as of December 31, 2016 was 594.3 per 100 thousand people.

Cases of HIV infection have been registered in all regions of the Russian Federation. In 2017, the incidence rate was 795.3 per 100 thousand.

A high incidence of HIV infection (more than 0.5% of the entire population) was registered in the 30 largest and predominantly economically successful regions, where 45.3% of the country’s population lived.

Dynamics of HIV prevalence and incidence rates in the population of the Russian Federation in 1987-2016.

Incidence and prevalence of HIV in the Russian Federation.

The most affected constituent entities of the Russian Federation include:

Sverdlovsk region(1,647.9% of 000 people living with HIV are registered per 100 thousand population - 71,354 people. In 2017, there are already about 86 thousand people infected with HIV), including in the city of Yekaterinburg more than 27,131 HIV-infected people are registered, i.e. . Every 50th city resident is infected with HIV - this is a real epidemic. Serov (1454.2% 000 - 1556 people). 1.5 percent of the population of the city of Serov is infected with HIV.

1. Irkutsk region (1636.0%000 - 39473 people). In total, 49,494 people were identified as HIV-infected at the beginning of 2017; at the beginning of June (almost six months) of 2017, 51,278 people were registered with a diagnosis of HIV infection. Over the entire period, more than 31,818 people were identified in the city of Irkutsk.

2. Kemerovo region(1582.5%000 - 43000 people), including in the city of Kemerovo more than 10,125 patients with HIV infection are registered.

3. Samara Region(1476.9%000 - 47350 people),

4. Orenburg region(1217.0%000 - 24276 people) regions,

5. (1201.7%000 - 19550 people),

6. Leningrad region(1147.3%000 - 20410 people),

7. Tyumen region(1085.4% 000 - 19,768 people), as of July 1, 2017 - 20,787 people.

8. Chelyabinsk region(1079.6%000 - 37794 people),

9. Novosibirsk region(1021.9%000 - 28227 people) region. As of May 19, 2017, more than 34 thousand HIV-infected people were registered in the city of Novosibirsk - every 47 residents of Novosibirsk have HIV (!). As of August 1, 2017, 34,879 people infected with HIV were registered in the Novosibirsk region.

10. Perm region(950.1%000 - 25030 people) - Berezniki, Krasnokamsk and Perm are mostly severely affected by HIV,

11. Saint Petersburg(978.6%000 - 51140 people),

12. Ulyanovsk region(932.5%000 - 11728 people),

13. Republic of Crimea(891.4%000 - 17000 people),

14. Altai region(852.8%000 - 20268 people),

15. Krasnoyarsk region(836.4%000 - 23970 people),

16. Kurgan region(744.8%000 - 6419 people),

17. Tver region(737.5%000 - 9622 people),

18. Tomsk region(727.4%000 - 7832 people),

19. Ivanovo region(722.5%000 - 7440 people),

20. Omsk region(644.0%000 - 12741 people), as of September 1, 2017, 16,275 cases of HIV infection were registered, the incidence rate was 823.0%000.

21. Murmansk region(638.2%000 - 4864 people),

22. Moscow region(629.3%000 - 46056 people),

23. Kaliningrad region(608.4%000 - 5941 people).

24. Moscow(413.0%000 - 50909 people)

Table No. 3.

Rating of Russian regions according to the prevalence of HIV infection in the population. The number of HIV-infected people identified in different territories of the Russian Federation in absolute numbers and calculated per 100 thousand population of the represented region.

Age structure

The highest level of HIV infection in the population is observed in the group of 30-39 years old; 2.8% of Russian men aged 35-39 years lived with an established diagnosis of HIV infection.

Women become infected with HIV at a younger age; already in the age group of 25-29 years, about 1% were infected with HIV; the proportion of infected women in the age group of 30-34 is even higher - 1.6%.

Over the past 15 years, the age structure among newly diagnosed patients has radically changed.

In 2000, 87% of patients received a diagnosis of HIV infection before age 30.

Adolescents and young people aged 15-20 years accounted for 24.7% of newly diagnosed cases of HIV infection in 2000; as a result of the annual decrease in 2016, this group amounted to only 1.2%.

Diagram. Age and gender of HIV-infected people.

In 2016, HIV infection was predominantly detected in Russians aged 30-40 years (46.9%) and 40-50 years old (19.9%), the proportion of young people aged 20-30 years decreased to 23.2%.

An increase in the proportion of newly identified cases was also observed in older age groups, and cases of sexually transmitted HIV infection in old age have become more frequent.

It should be noted that with a low level of testing coverage among adolescents and young people, more than 1,100 cases of HIV infection are registered annually among persons aged 15-20 years.

According to preliminary data, the largest number of HIV-infected adolescents (15-17 years old) were registered in 2016 in the Kemerovo, Nizhny Novgorod, Irkutsk, Novosibirsk, Chelyabinsk, Sverdlovsk, Orenburg, Samara regions, Altai, Perm, Krasnoyarsk territories and the Republic of Bashkortostan. The main reason for HIV infection among adolescents is unprotected sexual contact with an HIV-infected partner (77% of cases among girls, 61% among boys).

Structure of the dead

In 2016, 30,550 (3.4%) patients with HIV infection died in the Russian Federation (10.8% more than in 2015) according to the Rospotrebnadzor monitoring form “Information on measures to prevent HIV infection, hepatitis B and C, identification and treatment of HIV patients.”

The highest annual mortality rate was recorded in the Jewish Autonomous Region, the Republic of Mordovia, the Kemerovo Region, the Republic of Bashkortostan, the Ulyanovsk Region, the Republic of Adygea, the Tambov Region, the Chukotka Autonomous Okrug, the Chuvash Republic, the Samara Region, the Primorsky Territory, the Tula Region, the Krasnodar, Perm Territories, Kurgan region.

Treatment coverage

In 2016, 675,403 patients infected with HIV were registered at dispensaries in specialized medical organizations, which amounted to 77.5% of the number of 870,952 Russians living with a diagnosis of HIV infection in December 2016, according to the Rospotrebnadzor monitoring form.

In 2016, 285,920 patients received antiretroviral therapy in Russia, including patients in prison.

In the first half of 2017, 298,888 patients received antiretroviral therapy; approximately 100,000 new patients were added to therapy in 2017 (most likely there will not be enough drugs for everyone, since the purchase was based on 2016 figures).

Treatment coverage in 2016 in the Russian Federation was 32.8% of the number of registered persons diagnosed with HIV infection; among those undergoing dispensary observation, 42.3% of patients were covered by antiretroviral therapy.

The achieved treatment coverage does not serve as a preventive measure and does not allow to radically reduce the rate of spread of the disease. The number of patients with active tuberculosis in combination with HIV infection is growing; the largest number of such patients is registered in the regions of the Urals and Siberia.

HIV testing coverage

In 2016, 30,752,828 blood samples of Russian citizens and 2,102,769 blood samples of foreign citizens were tested for HIV in Russia.

The total number of tested serum samples from Russian citizens increased by 8.5% compared to 2015, and among foreign citizens decreased by 12.9%.

In 2016, the maximum number of positive immunoblot results in Russians was detected in the entire history of observation - 125,416 (in 2014 - 121,200 positive results).

The number of positive results in the immunoblot includes those identified anonymously, not included in the statistical data, and children with an undifferentiated diagnosis of HIV infection, and therefore differs significantly from the number of new registered cases of HIV infection.

For the first time, 103,438 patients tested positive for HIV.

Representatives of vulnerable groups of the population in 2016 made up a small part of those screened for HIV in Russia - 4.7%, but 23% of all new cases of HIV infection were identified among these groups.

When testing even a small number of representatives of these groups, it is possible to identify many patients: in 2016, among the examined drug users, 4.3% were diagnosed as HIV-positive for the first time, among MSM - 13.2%, among contact persons during an epidemiological investigation - 6.4%, prisoners - 2.9%, patients with STIs - 0.7%.

Transmission Path Structure

In 2016, the role of sexual transmission of HIV infection increased significantly.

According to preliminary data, among HIV-positive people newly identified in 2016 with established risk factors for infection, 48.8% became infected through drug use with non-sterile equipment, 48.7% through heterosexual contact, 1.5% through homosexual contact, 0.45 % were children infected from mothers during pregnancy, childbirth and breastfeeding.

The number of children infected through breastfeeding is growing: 59 such children were registered in 2016, 47 in 2015, and 41 in 2014.

In 2016, 16 cases of suspected infection were registered in medical organizations due to the use of non-sterile medical instruments and 3 cases of transfusion of blood components from donors to recipients.

Another 4 new cases of HIV infection in children were likely associated with the provision of medical care in the CIS countries.

Diagram. Distribution of HIV-infected people by mode of infection.

conclusions

• In the Russian Federation in 2016, the HIV epidemic situation continued to deteriorate and this unfavorable trend continues in 2017, which may even affect the resumption of the global HIV epidemic, which, according to the UN report in July 2016, has declined.

• The incidence of HIV infection remains high, the total number of HIV carriers and the number of deaths of HIV-infected people is increasing, and the spread of the epidemic from vulnerable groups to the general population has intensified.

• If the current rate of spread of HIV infection continues and there are no adequate systemic measures to prevent its spread, the prognosis for the development of the situation remains unfavorable.

Radical actions by the Russian Government are required to stop trafficking, the spread of drugs and, most difficult, changes in the sexual behavior of the inhabitants of the Russian Federation (scraps are wonderful, but the number of people practicing abstinence and practicing with one heterosexual sexual partner throughout their lives is a small number and it is impossible to change, p .e. the development of drug methods of pre-exposure prophylaxis with minimal side effects is required (take a pill and do what you want)).

V.V. Pokrovsky about the situation in Russia regarding the incidence of HIV/AIDS

https://www.youtube.com/watch?time_continue=74&v=kUmU8m31dqw

The only regions in the world where the HIV epidemic continues to spread rapidly are Eastern Europe and Central Asia, according to a new UNAIDS report. Russia in these regions accounted for 80% of new HIV cases in 2015, the international organization notes. Another 15% of new diseases occur collectively in Belarus, Kazakhstan, Moldova, Tajikistan and Ukraine.

In terms of the rate of spread of the epidemic, Russia has overtaken even the countries of South Africa, as follows from the latest morbidity statistics. Meanwhile, the Russian authorities not only do not increase funding for the purchase of drugs for patients, but, if you believe reports from the regions, they are even increasing savings on this item.

Having compared the published UNAIDS statistics on new cases of HIV in different countries with the number of patients already existing in these countries, Gazeta.Ru was convinced that our country is the leader in the rate of spread of HIV not only in its region.

The share of new cases of HIV in Russia in 2015 was more than 11% of the total number of people living with HIV (95.5 thousand and 824 thousand, respectively, according to the Federal AIDS Center). In the vast majority of African countries, the number of new cases does not exceed 8%; in the largest countries of South America, this share in 2015 was about 5% of the total number of patients.

For example, in terms of the rate of growth of new cases in 2015, Russia is ahead of such African countries as Zimbabwe, Mozambique, Tanzania, Kenya, Uganda, each of them has almost twice as many patients as in our country (1.4-1.5 million people ).

More new cases than in Russia now occur annually only in Nigeria - 250 thousand infections, but the total number of carriers there is many times higher - 3.5 million people, so in proportion the incidence is lower - about 7.1%.

HIV epidemic in the world

In 2015, there were 36.7 million people living with HIV worldwide. Of these, 17 million were receiving antiretroviral therapy. The number of new infections reached 2.1 million. Last year, 1.1 million people died from AIDS worldwide.

The number of new HIV infections in Eastern Europe and Central Asia has increased by 57% since 2010. Over the same period, the Caribbean saw a 9% increase in new cases, a 4% increase in the Middle East and North Africa and a 2% increase in Latin America.

Declines were observed in Eastern and Southern Africa (by 4%) and in Asia and the Pacific (by 3%). Europe, North America and West and Central Africa saw slight declines.

In the largest countries of Latin America - Venezuela, Brazil, Mexico - the share of new cases of HIV infection remained at 5% of the number of carriers. For example, in Brazil, where the number of people living with HIV is approximately the same as in Russia (830 thousand), 44 thousand people became infected in 2015.

In the United States, where there are one and a half times more HIV patients than in Russia, half as many people become infected with HIV annually - about 50 thousand people, according to the AVERT charity organization, which funds the fight against AIDS.

Russia can't cope on its own

UNAIDS experts see the main reason for the deterioration of the situation in the fact that Russia has lost international support for HIV programs and has not been able to replace it with adequate prevention at the expense of the budget.

In 2004-2013, the Global Fund remained the largest donor for HIV prevention in the region (Eastern Europe and Central Asia), but as a result of the World Bank's classification of Russia as a high-income country, international support withdrew, and domestic funding for the fight against HIV did not provide adequate coverage of antiretroviral therapy (prevents the transition of HIV to AIDS and ensures prevention of infection).

The amount of grants from the Global Fund for HIV amounted to more than $200 million, head of the Federal AIDS Center Vadim Pokrovsky told Gazeta.Ru. “Many preventive and treatment programs were implemented in the country with this money. After the government returned this money to the Global Fund, it focused mainly on financing treatment, and there was no one to finance prevention programs; they died out,” he complains.

According to the Ministry of Health, today only 37% of patients who are constantly monitored receive the necessary medications. Of the total number of patients, this is only 28%, according to data from the Federal AIDS Center. There is not enough money allocated, so in Russia there is a standard according to which medications are prescribed only in the event of a critical decrease in the immunity of an HIV-infected person. This does not correspond to the WHO recommendation to treat all patients immediately after detection of the virus.

Another reason is that Russia is the leader in the use of injecting drugs by the population - 1.5 million people in our country already take them, according to the UNAIDS report.

It is the use of drugs with unsterile instruments that remains the cause of the largest number of infections - 54% of patients became infected in this way.

There is almost no prevention among drug addicts and other high-risk groups, Pokrovsky previously told Gazeta.Ru. According to UNAIDS, after the end of Global Fund grants in 2014, 30 projects serving 27 thousand people were left without support in Russia. And while the remaining projects in 2015 continued to support HIV prevention services among drug users in 16 cities, their scale was not sufficient, the report notes.

Russia also does not support the UN-recommended methadone substitution therapy, which involves drug addicts taking methadone instead of the drug they use. In this therapy programs, as a rule, methadone is used in the form of a liquid substance mixed with syrup or water, and is taken orally, without the use of injection needles and syringes, which reduces the risk of transmission not only of HIV, but also of other dangerous infectious diseases, including hepatitis A.

Secret underfunding

The release of the UNAIDS report coincided with the appearance of the first signals from Russian regions that funding for the purchase of HIV drugs may be reduced, despite recent statements by the head of the Ministry of Health, Veronika Skvortsova, about her intention to increase the proportion of patients receiving therapy.

The Republic of Karelia has been allocated 25% less funds compared to 2015 - 29.7 million instead of 37 million rubles, TASS reported on July 13, citing the regional Ministry of Health. At the same time, less funds were also allocated from the regional budget than last year - the reduction was 10%. The Krasnoyarsk Territory also received less money in 2016 (326 million instead of 400 million rubles in 2015), reports State Television and Radio Broadcasting Company Krasnoyarsk.

Similar reports are coming from St. Petersburg, the Perm Territory and other regions. At the same time, the total amount of funds provided in the 2015 and 2016 federal budgets for the purchase of antiretroviral drugs is approximately the same - the amount remains at about 21 billion rubles, part of the funds is allocated for purchases for federal medical institutions.

In the 2015 budget, 17.485 billion rubles were allocated directly to the regions; in 2016, the amount decreased slightly and amounted to 17.441 billion rubles. Information about whether the funds were delivered to the regions in full or somehow redistributed or frozen is kept secret by federal ministries. The Ministry of Finance and the Ministry of Health did not respond to relevant requests from Gazeta.Ru.

According to the government report on the implementation of the anti-crisis plan, which Gazeta.Ru was able to review, the money was transferred to regional budgets in full, but the Ministry of Finance refused to confirm this information.

How the world is fighting HIV

Measures to combat HIV in general are the same all over the world: prevention includes informing the population, identifying the most vulnerable groups of citizens, distributing contraceptives and syringes, active measures are antiretroviral therapy, which maintains the standard of living of those already ill and prevents the patient from infecting others. However, each country has its own regional characteristics.

Governments in the United States primarily fund social campaigns to combat the taboo topic of AIDS. Also, with the help of social actions, Americans are encouraged to undergo regular testing, especially if the person belongs to one of the most vulnerable groups - black citizens, men who have had homosexual contacts, and others.

Another way to combat the spread of HIV and AIDS is sex education. In 2013, the immunodeficiency virus was taught in 85% of American schools. In 1997, these programs were taught in 92% of American schools, but due to resistance from citizen religious groups, enrollment rates have declined.

From 1996 to 2009, more than $1.5 billion was spent promoting abstinence as the only way to combat HIV in the United States. But since 2009, funding for “orthodox” methods began to decline, and more funds began to be allocated to providing comprehensive information.

However, according to the Kaiser Family Foundation, so far only 15 states require that students talk about contraception when talking to schoolchildren about HIV prevention, despite the fact that, according to statistics, 47% of high school students have had sexual experience. Information about HIV remains optional in 15 states, as does sex education; in two more, only sex education is included in the program.

In China, according to 2013 data, 780 thousand people live with the immunodeficiency virus, more than a quarter of whom receive antiretroviral therapy. The most vulnerable groups of the population are gays and bisexuals, young Chinese under 24 years of age, drug addicts who inject themselves, and a high proportion of infections from mother to child. In China, infection most often occurs through unprotected sex, so preventing sexual transmission of the virus accounts for the bulk of efforts. Measures include treatment for couples in which one of the partners is infected with HIV, distributing free condoms, popularizing testing for the virus, and informing children and adults about the disease.

A separate category of efforts is the fight against the illegal blood market, which flourished after the ban on imported blood products in the 1980s. Enterprising Chinese, according to Avert, were looking for plasma donors in rural areas, without any concern for the safety of the procedure. Only in 2010 did China begin to test all donated blood for HIV.

In India, the world's second largest country, 2.1 million people were living with HIV in 2015, one of the highest numbers in the world. Of those sick, 36% received treatment.

Hindus identify four risk groups. These are sex workers, illegal immigrants, men who have had homosexual contacts, drug addicts and the hijra caste (one of the untouchable castes, which includes transgender people, bisexuals, hermaphrodites, castrati).

As in many other countries, the fight against HIV in India is carried out through outreach to the most vulnerable segments of the population, information, distribution of condoms, syringes and needles, as well as methadone substitution therapy. The epidemic in the country is declining: in 2015, according to UNAIDS, fewer people were infected here than in Russia - 86 thousand people.

In Latin and Central America in 2014, there were 1.6 million people living with the immunodeficiency virus, 44% of whom received the necessary treatment. Among the measures that countries in the region have taken to combat the epidemic are social campaigns explaining what HIV is and why people with the disease cannot be discriminated against. Such actions took place, in particular, in Peru, Colombia, Brazil, and Mexico. Needle and syringe programs were held in five countries—Argentina, Brazil, Mexico, Paraguay and Uruguay—and substitution therapy was used in select cities in Colombia and Mexico. In some countries in the region, sick people receive cash benefits.

Australia, which has one of the lowest incidence rates in the world, achieved these results by introducing comprehensive prevention programs and by never stopping them. She also began the fight against HIV earlier than others, notes Pokrovsky from the AIDS Center. “For example, back in 1989, I became acquainted with the work of the organization “Collective of Prostitutes of Australia,” which was involved in HIV prevention among sex workers. This and dozens of similar projects were constantly funded by the government,” he emphasizes.

Ten regions of Russia are in critical condition in terms of HIV prevalence. This was stated by the Minister of Health of the Russian Federation Veronika Skvortsova. The sad list is headed by the Sverdlovsk and Kemerovo regions.

“HIV is spread very unevenly throughout the country,” noted the head of the Ministry of Health. “The prevalence is significantly higher, several times, in those regions through which drug trafficking routes pass. Therefore, there are 10 critical regions out of 85. In first place is the Sverdlovsk region, Yekaterinburg, which got into the press (in connection with this),” Skvortsova said.

According to the minister, “57% of all sources of HIV infection are through injection, usually from heroin addicts.” As for such a traditional risk group as homosexuals, this trend is less pronounced in Russia.

“40% of cases of sexually transmitted infections relate to heterosexual couples,” Skvortsova pointed out, emphasizing that the increase in the number of infected people is due to healthy women who picked up the virus from their own husband.

According to the Federal Center for Prevention and Control of AIDS, at the end of last year the list of the most HIV-affected regions was as follows: Irkutsk region, Sverdlovsk, Kemerovo, Samara, Orenburg, Leningrad regions, Khanty-Mansi Autonomous Okrug, Tyumen, Chelyabinsk, Tyumen areas.

During the year, anonymous testing was carried out in problem regions, which was completed by 23.5 thousand young people under 30 years of age. Among them, 2.3% were identified as HIV-infected.

In early November, the Ministry of Health of Yekaterinburg announced that every 50th resident in the city has AIDS.

“We have an infection rate of 1,826 people per hundred thousand, this is 1.8% of the city’s population, 26,693 thousand infected,” said Tatyana Savinova, deputy head of the city health department of Yekaterinburg. “And these are just known cases, the real incidence is even higher,” she emphasized.

But this situation in Yekaterinburg has been developing for decades, so doctors do not make announcements about the beginning of the epidemic, the city health department emphasized.

According to the criteria of the WHO and the Joint United Nations Program on HIV, more than 1% of those infected means that the infection is firmly rooted in the population and its spread is practically independent of risk groups.

Meanwhile, the Federal Center for Prevention and Control of AIDS believes that Russia is today on the verge of moving to the third and final stage of the HIV epidemic.

“An epidemic is a relative concept. HIV has three stages. Initial - the first cases are imported from abroad. The second is concentrated, risk groups are affected. In our country, 10% of men who have sex with men and 20% of drug addicts are now infected. And when more than 1% of pregnant women are infected, then it is generalized. We are now at the stage of transition from the second to the third," the head of the center, Academician of the Russian Academy of Medical Sciences Vadim Pokrovsky, told the L!fe portal.