Date Published: November 28, 2017
Publisher: Public Library of Science
Author(s): Chris Beyrer, Andrea L. Wirtz, George O’Hara, Nolwenn Léon, Michel Kazatchkine
Abstract: In a Perspective, Chris Beyrer and coauthors discuss the threat of HIV to health in the Russian Federation.
Partial Text: In 2017, the Russian Federation (RF) is estimated to have the largest number of HIV-1 infected citizens of any country in Europe . Cumulative reported diagnoses reached over 1.16 million infections by mid-2017, and actual infections, including those that remain undiagnosed and/or unreported, are doubtless substantially higher . In contrast to the global epidemic pattern, the HIV epidemic in the RF and in most countries of Eastern Europe and Central Asia continues to expand significantly. Over 103,000 new HIV diagnoses were reported in the RF in 2016, a 5% increase in new infections over the previous year ; reported HIV diagnoses had been increasing at some 10% per year from 2011–2016 . Among Russian men aged 30–39 years of age, a group that has the highest male infection burden, some 2.8% were living with HIV infection in 2016 . AIDS deaths, too, are rising and now negatively impact life expectancy . From January to June 2017, some 14,631 AIDS deaths were recorded, a 13.5% increase over the previous 6-month period . HIV/AIDS has risen to feature in the top 10 causes of premature death in the RF—a 35% increase from 2005 . These realities should concern all who seek global control of the HIV pandemic.
The RF is undergoing a severe, widespread, and geographically dispersed HIV epidemic. There is a very large 6-region cluster in Eastern and Western Siberia that is now the most affected part of this vast country. HIV prevalence and incidence are difficult to directly deduce from the available reporting data, but there is enough evidence to suggest that Russia’s epidemic is uncontrolled and worsening in 2017. It is disturbing that deaths are rising rapidly in an upper middle-income country that could, and should, be doing much better in the provision of prevention, treatment, care, and support for its citizens, especially those at high risk of HIV infection .