AIDS spread statistics in the world. Official statistics of HIV, AIDS in Russia

Statistics on HIV incidence and AIDS mortality vary widely across countries and continents. The indicators are affected by the standard of living of the population, economic development, health and welfare, youth policy and promotion of healthy lifestyles. It would seem that backward third world countries are among the leaders in immunodeficiency. However, HIV in the Russian Federation is spreading at a rate that brings Russia to third place in the world ranking in terms of the rate of increase in incidence, behind only South Africa and Nigeria.

HIV statistics in Russia change from year to year for the worse. Since 1987, when they first started talking about a terrible diagnosis, and to the present, the number of cases has been increasing, and mortality has been increasing. The percentage of new cases of immunodeficiency and the population bring the Russian Federation to a leading position in the lists of countries former USSR and the whole planet. Moreover, the main increase in deplorable statistics does not occur in the 90s, neither the change of power, nor the change in the way of thinking, nor the improvement in the quality of life affect - an increase in the rate of HIV spread is recorded every year. The mortality index (number of deaths per 1,000 people) has increased 10 times over the past ten years.

According to official data, there are about a million HIV patients in Russia, that is, approximately 0.7% of the country's inhabitants are infected with HIV. According to unofficial information from foreign agencies, the percentage in reality is exactly 2 times higher, and this indicates an epidemic of immunodeficiency in the Russian Federation.

In order not to cause panic and not take away the first place in AIDS from South Africa and Nigeria, in Russia the statistics are slightly corrected in the right direction. For example, a person with AIDS dies, but the cause of death is a secondary disease - heart failure or a malignant neoplasm, and the patient was not registered for immunodeficiency. This death is not reflected in HIV mortality. Also, the data on the total number of cases are not accurate enough - there is no mandatory procedure for testing for HIV. Thousands of people do not go to medical institutions for years and do not donate blood. Naturally, if they are infected, Rosstat and Rospotrebnadzor do not know about it. If a person is diagnosed with HIV, but does not undergo an examination and is not registered with an infectious disease specialist, then such a case is also not taken into account - the patients actually registered are taken into account. In Russia, most citizens need to be forced and persuaded to go to the hospital and get treated. Based on the above cases, the actual incidence of AIDS in the Russian Federation is clearly much higher.

Regions and cities are leaders in the number of HIV infections

Russia is a large country in terms of territory and, accordingly, statistical data varies by region. most disadvantaged for HIV last years steel Sverdlovsk, Irkutsk, Kemerovo, Novosibirsk, Samara, Orenburg regions, Perm Territory, Khanty-Mansiysk autonomous region. In these regions, the highest rate of increase in the incidence and highest percentage HIV-infected - more than 2% of the inhabitants are infected with a retrovirus, with a huge number of infected children and pregnant women (every 50th woman in labor is immunodeficient). Of the leading cities for HIV, the geography remains identical to the regional one - Kemerovo, Yekaterinburg, Irkutsk, Novosibirsk.

HIV statistics by age

HIV statistics by age in Russia has not changed for many years - the majority of those infected are young people from 20 to 39 years old, accounting for approximately 80% of registered patients. Another 10% are from 40 to 60 years old, 9% are from newborns to 19 years old. The latter category of patients is more vulnerable in terms of diagnosing immunodeficiency. An HIV diagnosis is accurately established in children from 0 years of age, infected in utero, during childbirth from a sick mother. The rest of the children, among whom the peak of injection drug addiction is recorded at the age of 13-17, are not tested for retrovirus and remain unaccounted for.

Reasons for Russia's leadership in HIV infection

The UN has called Russia the epicenter of the global epidemic of secondary immunodeficiency. Inaccurate and underestimated statistics of immunodeficiency in the Russian Federation exceeds the scale of the disaster in other countries. For example, in Germany, the increase in the incidence is three times less than in Russia. And there HIV is national problem, with which they fight and allocate funds from the state budget. The HIV epidemic in Russia is not considered something global and serious, given the lack of state program to fight AIDS. By the way, in the United States, the state wrestling program appeared in the late 1980s.

There are two main reasons for Russia's leadership in infection with immunodeficiency:

• lack of fight against the disease at the state level - correction of statistics, lack of mandatory HIV testing of citizens without exception, lack of funding - propaganda and youth policy aimed at healthy lifestyle life;
• HIV and drug addiction epidemics coincide geographically, that is, the main route of infection in Russia is injection drugs.

African countries, where at some time every second citizen was infected with HIV, were able to suppress the epidemic and began to fight the spread of infection. Economically and socially developed state the more one must recognize and accept the problem. Otherwise, according to experts, in the next 5 years Russia will come out on top in the world in terms of HIV, and the death rate from AIDS in the country will increase exponentially.

TASS-DOSIER. From 15 to 21 May 2017 in Russia for the third time will be held All-Russian action"Stop HIV/AIDS". It is organized by 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 supported by 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.

She is dedicated to world day in memory of the victims of AIDS, which is held annually on the third Sunday of May. Its goal is to draw attention to this problem in Russia, to raise awareness of the population, especially young people, about the disease.

Campaign "Stop HIV/AIDS"

The all-Russian action "Stop HIV/AIDS" began to be held in Russia in 2016. The key event of the first action, which took place in May, was an open student forum. The second action was timed to the 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).

Within the framework of the action in the senior classes of secondary schools was held public lesson"Knowledge - Responsibility - Health", which showed a film about topical issues counteracting HIV infection.

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 defend itself against infections and tumors. At different people AIDS can develop 2-15 years after HIV infection.

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

Statistics for Russia

The epidemiological situation of HIV infection in Russia (the first case was detected in 1987) is unfavorable, cases of the disease have been identified in all regions of the Russian Federation.

According to Rospotrebnadzor, as of December 31, 2016, since 1987, 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, 870,952 Russians were living with HIV/AIDS in Russia, which is 0.59% of the total population of the country (146,804,372). As of December 31, 2016, the prevalence of HIV was 594.3 people with an established diagnosis per 100,000 of the country's population.

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

High prevalence of HIV is observed in the 30 largest subjects 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) regions, Khanty-Mansi 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 detected: in 2014, 41 children were infected, in 2015 - 47 children, in 2016 - 59.

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

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, the symptoms of the disease, characteristic of HIV/AIDS, were described in 1981 during a survey in clinics in Los Angeles and New York of several men of non-traditional sexual orientation. In 1983, researchers from the US and France described a virus capable of causing HIV/AIDS. Since 1985, blood tests for HIV have been available in clinical laboratories.

According to World Organization health care, at the end of 2015 there were from 34 to 39.8 million (on average - 36.7 million) HIV-infected people in the world. Sub-Saharan Africa is the most affected region, with an estimated 25.6 million people living with HIV in 2015 (about two-thirds of those infected). More than 35 million people have become victims of HIV/AIDS worldwide. In 2015 alone, approximately 1.1 million people died. As of June 2016, 18.2 million patients had access to antiretroviral treatment, including 910,000 children.

HIV statistics in the worldhelps to keep track of how many suffer from this disease and look for more effective ways fight him.

HIV

HIV infection is a disease caused by the immunodeficiency virus. The disease belongs to the category of slowly progressive. It affects the immune system, as a result of which it develops. The body loses its defenses and ability to resist disease.

How many live with the immunodeficiency virus? StatisticsHIV shows that on average no more than 11 years. In the AIDS stage - 9 months. If the patient turns to doctors in a timely manner and undergoes antiviral therapy, then it can be 70–80 years old.

The health status of the patient is also important. A healthy person is more likely to long life and successful therapy.

The virus is transmitted by a single contact of the damaged skin or mucous membrane with the patient's biofluids: blood, semen, vaginal secretions. Infection is transmitted:

• during unprotected
• with manicure (through non-disinfected instruments);
• during the period and at (from mother to child);
• when (if the medical staff violates the rules of blood testing);
• while taking a dose of injecting drugs (through syringes and needles);
• while breastfeeding.

The virus is not able to be transmitted through tears, saliva, insect bites, household and airborne droplets.

Data for different countries

Most at risk are people who inject drugs.

Cases of sickness among health workers were also recorded. HIV statistics show that the risk of infection in this category of the population is also high. In the United States alone, more than a hundred cases have been reported over the past few years, 57 of which have been proven.

Indicators for Russia

According to the Ministry of Health, the HIV statistics in our country are shocking. There is a real epidemic in Russia. In terms of the growth rate of the number of sick people, the Russian Federation will soon approach those of Africa. Statistics HIV infection in Russia allows us to conclude that 57% of infections occur among heroin addicts through dirty syringes.

FROM HIV statistics by yearsreflects the number of people who have died from AIDS and are still living with the immunodeficiency virus:

HIV incidence statistics by region go off scale where the largest drug distribution channels pass. Most of the sick citizens in 2016 were in the Irkutsk, Kemerovo, Sverdlovsk and Samara regions. Here, for every 100,000 population, there are at least 1.5 thousand patients.

The chart shows HIV statistics by region, showing the 10 regions with the highest a large number sick.

HIV statistics in Russia suggests that the most infected people are in the Irkutsk region. In addition to those listed on the diagram, the most affected include Moscow, Tomsk, Ivanovo, Omsk, Murmansk regions, Altai region. The same applies to SPB.

From HIV shows growth. In 2015, 212,578 patients died. This figure is 12.9% higher than the previous year.

The number of HIV patients in Tatarstan also increased. Statistics say that in 2015, about 18,000 patients diagnosed with HIV were identified here. Every year the number of infected people increases by 1 thousand people. Mortality among those infected with the immunodeficiency virus has also increased. Also, more infected children were born.

Most carriers of the virus are people between the ages of 20 and 39. The main cause of infection is the injection of narcotic substances with dirty syringes.

Russian HIV suggests that the most a large number of The patient is between the ages of 30 and 39. The vast majority are men. Women are most often infected before the age of 35. At the same time, the number of sick teenagers and from 15 to 20 years old has decreased. The data is shown in detail as a percentage in the chart:

Ways of transmission of the disease in Russia

AT Soviet time in the first place were unprotected sex with students from Africa. Today, the statistics of those infected with HIV indicate that the largest number sick people among drug addicts - 48.8% of total number infected. They become infected when using non-sterile syringes. According to the results of studies in cities, the largest number of cases among drug addicts was registered in Moscow (12-14%), St. Petersburg (30%), Biysk (more than 70%).

The diagram shows the statistics of HIV patients, showing the main causes of infection in the USSR and modern Russia for the period from 1987 to 2016:

Indicators in the countries of the former USSR

HIV statistics in Ukraine also not comforting. In six months of 2016, 7,612 people were diagnosed. Of these, 1,365 are HIV-infected children. Statistics show that the main reason is the reduction in funding for AIDS programs.

In total, there are 287,970 patients in Ukraine today. Between 1987 and 2016, nearly 40,000 citizens died of AIDS. Ukraine is among the leaders in the spread of the disease in the world.The diagram shows which areas are most affected by HIV:

HIV statistics in Belarusrecorded 17,605 patients as of 2017. The prevalence rate is 185.2 per 100 thousand people. population. In just 2 months of 2017, 431 citizens with the immunodeficiency virus were identified. Most of the HIV-infected people are in the Gomel, Minsk and Brest regions. For the period from 1987 to 2017. 5044 people died from AIDS in Belarus.

In 2016, HIV statistics in Kazakhstan show an increase in the number of infected people. During this year, about 3 thousand carriers of the virus were identified, of which 33 patients are children under 14 years of age.

conclusions

As the HIV statistics in Russia and the CIS countries show, the epidemiological situation continues to deteriorate. Morbidity and mortality rates are very high. It is necessary to strengthen measures to counter the disease in the country, otherwise the rate of spread will continue to grow.

At the beginning of 2017 The total number of HIV infections among Russian citizens has reached 1,114,815 people (in the world - 36.7 million HIV-infected, incl. 2.1 million CHILDREN ). And according to calculations international organization UNAIDS (UNAIDS) in Russia there are already more than 1,500,700 HIV-infected (!), moreover, according to the calculations of American and Swiss scientists in Russia now (December 2017) resides over 2 million patients with HIV infection ( published in PLOS Medicine).

Of them died on different reasons(not only from AIDS, but from all causes) 243,863 HIV-infected(according to the Rospotrebnadzor monitoring form “Information on measures to prevent HIV infection, hepatitis B and C, identify and treat HIV patients”) ( 1 million people died in the world in 2016 ). In December 2016, 870,952 Russians were living with a diagnosis of HIV infection.

As of 01 July 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 1st half of 2017 already died 14 631 HIV-infected that 13.6% more than for 6 months of 2016.). Attack rate population of the Russian Federation with HIV infection in 2017 made up 795,3 infected with HIV per 100 thousand of the population of Russia.

In 2016 It revealed 103 438 new cases of HIV infection 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 diagnosed cases of HIV infection; in 2011-2016, the annual increase averaged 10%. HIV incidence rate in 2016 made up 70.6 per 100 thousand population.

afflicted HIV countries world in terms of the number of HIV-infected people living in them.

64% of all new HIV diagnoses in Europe are in Russia. Every hour 10 new HIV-infected people appear in Russia.

The number of HIV in the CIS countries, the Baltics

*/approx. the statement is ambiguous, because not all countries calculate equally well the number of HIV-infected people, who also need to be identified for some money (for example, in Ukraine, Moldova, Uzbekistan, Tajikistan, where there is hardly any enough money to screen the population for HIV. In addition, judging by the identification of a huge number of HIV-infected gastro workers, the prevalence of HIV in these countries is several times higher than in the Russian Federation) /.

HIV growth rates in Russia (according to UNAIDS, the international organization to fight AIDS).

Rapid growth of HIV infection in Eastern Europe and Central Asia.

The dynamics of the spread of HIV in the world.

Comparison of the growth of HIV-infected people in the European Region with and without the Russian Federation.

Russia's contribution to the HIV and AIDS epidemic in the European region.

Per 1st half of 2017 in Russia revealed 52 766 HIV-infected citizens of the Russian Federation. HIV incidence rate in 1st half of 2017 made up 35,9 cases of HIV infection per 100,000 population. Most new cases in 2017 were detected in the Kemerovo, Irkutsk, Sverdlovsk, Chelyabinsk, Tomsk, Tyumen regions, as well as in the Khanty-Mansiysk autonomous region.

Per 9 months 2017 in Russia revealed 65 200 HIV-infected citizens of the Russian Federation, for 11 months 2017- registered 85 thousand new cases of HIV infection, observed exceeding the long-term average for HIV by 43.4%(49,7%000 vs 34.6%000 ).

Video. Incidence in Russia, March - May 2017.

Increasing the rate of growth of new cases HIV infections in 2017 year (but general level the 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

Growing number of HIV-infected Russians from 1987 to 2016

HIV in regions and cities

In 2016 and including 2017 in terms of morbidity in Russian Federation the following regions and cities were in the lead:

1. Kemerovo region (228.8 new cases of HIV infection were registered per 100,000 population — total 6,217 HIV-infected), including in the town Kemerovo 1 876 HIV-infected. For 10 months of 2017 in Kemerovo region revealed 4,727 new HIV-infected (indicator morbidity - 174.5 per 100 thousand population) ( honorary 1st place)
2. Irkutsk region (163,6%000 — 3,951 HIV-infected). In 2016 in the city Irkutsk registered 2 450 1,107 new HIV-infected people in 2017. In 2017, 1,784 new HIV-infected people were detected in the Irkutsk region over 5 months. for 10 months 2017 - 134.0 per 100 tons ( 3 228 newly diagnosed HIV-infected) Nearly 2% of the population of the Irkutsk region are infected with HIV. (honorary 2nd place )
3. Samara Region (161,5%000 — 5,189 HIV-infected, incl. in the city of Samara 1,201 HIV-infected), for 10 months of 2017 - 2,698 people (84,2% 000) . Every hundredth inhabitant Samara region infected with HIV!
4. Sverdlovsk region (156,9%000 — 6,790 HIV-infected), morbidity for 10 months 2017 - 128.1 per 100 tons, i.e. 5 546 new HIV=-infected. In the town Yekaterinburg, in 2016, 1,372 HIV-infected (94.2% 000 ), for 10 months 2017 years - in the "capital of AIDS" have already identified 1 347 "pluses" (the incidence of HIV infection in 2017 in the city - 92,5% 000 ).
5. Chelyabinsk region (154,0%000 — 5 394 HIV-infected),
6. Tyumen region (150,5%000 — 2 224 people), for the first half of 2017, 1,019 new cases of HIV infection were detected in the Tyumen region (an increase of 14.4% compared to the same period last 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, 1.1% of the population is infected with HIV. Incidence for 9 months 2017 - 110.2 people per 100 thousand population. ( honorary 3rd place). Z and 10 months of 2017 revealed 1 614 HIV-infected, incl. 5 teenagers.
7. Tomsk region (138.0% 000 - 1 489 people),
8. Novosibirsk region(137.1%000 ) areas ( 3 786 pers.), incl. in the town Novosibirsk 3 213 HIV-infected. Incidence for 9 months 2017 - 108.3 per 100 tons — 3 010 people infected with HIV (for 10 months of 2017 - 3,345 people) (on the 4th place came out).
9. Krasnoyarsk Territory (129.5% 000 - 3 716 people),
10. Perm Territory (125.1% 000 — 3 294 people). Incidence for 10 months 2017 - 126.2 per 100 tons — 3 322 HIV+, up 13.1% compared to the previous year. ( on the 5th place rose)
11. Altai Territory (114.1% 000 - 2 721 people) the edges,
12. Khanty-Mansi Autonomous Okrug - Ugra (124.7% 000 - 2,010 people, every 92nd inhabitant is infected),
13. Orenburg region (117.6% 000 - 2 340 people), in 1 sq. 2017 - 650 people (32.7% 000).
14. Omsk region (110.3% 000 - 2 176 people), for 8 months of 2017, 1360 cases were detected, the incidence rate was 68.8% 000.
15. Kurgan region (110.1% 000 - 958 people),
16. Ulyanovsk region (97.2% 000 - 1 218 people), in 1 sq. 2017 - 325 people (25.9% 000).
17. Tver region (74.0% 000 - 973 people),
18. Nizhny Novgorod region (71.1% 000 - 2 309 people) area, in 1 sq. 2017 - 613 people (18.9% 000).
19. Republic of Crimea (83.0% 000 — 1 943 people),
20. Khakassia (82.7% 000 - 445 people),
21. Udmurtia (75.1% 000 - 1 139 people),
22. Bashkortostan (68.3% 000 - 2 778 people), in 1 sq. 2017 - 688 people (16.9% 000).
23. Moscow city (62,2 % 000 — 7 672 people)

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

Table number 1. The number of HIV-infected people and the incidence of HIV infection by regions and regions of Russia (TOP 15).

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

Subjects of the Russian Federation most affected by HIV infection.

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

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

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

afflicted HIV infection of the population of Russia as of December 31, 2016 amounted to 594.3 per 100 thousand people Cases of HIV infection registered in all subjects Russian Federation. AT 2017 year affection - 795.3 per 100 thousand of us.

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

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

Morbidity, prevalence of HIV in the Russian Federation.

To the most affected regions of the Russian Federation relate:

1. Sverdlovsk region (1,647.9% of 000 people living with HIV were registered per 100,000 people - 71,354 people, including more than 27,131 HIV-infected people registered in the city of Yekaterinburg, i.e. every 50th resident of the city is infected with HIV - this is a real epidemic. In 2017(as of 01.11.17) already 93,494 people infected with HIV — Approximately 2% of the population of the Sverdlovsk region are infected with HIV, and 2% of pregnant women are HIV-infected women, i.e. every 50th pregnant woman has HIV infection). As of 11/01/2017 in AIDS Capital according to the rapper "Purulent") is already registered 28 478 HIV-positive ( the HIV prevalence of the city's population is 2%!!! ) and this is only official. AT Serov- 1454.2% 000 (1556 people). Infected with HIV - 1.5 percent of the population of the city of Serov. The Sverdlovsk region ranks first in the number of children born to HIV-infected mothers - 15,000 children.
2. Irkutsk region (1636.0% 000 - 39473 people). Total identified HIV-infected at the beginning 2017 of the year— 49 494 people, for the beginning of June 2017 of the year 51,278 people were cumulatively registered with a diagnosis of HIV infection. AT the city of Irkutsk more than 31,818 people have been identified for all the time.
3. Kemerovo region (1582.5% 000 - 43000 people), including in the city of Kemerovo more than 10,125 patients with HIV infection have been registered.
4. Samara region (1476.9% 000 - 47350 people), as of November 1, 2017, 50,048 HIV-infected people were detected.
5. Orenburg region (1217.0% 000 - 24276 people) regions,
6. Khanty-Mansi Autonomous Okrug (1201.7% 000 - 19550 people),
7. Leningrad region (1147.3% 000 - 20410 people),
8. Tyumen region (1085.4% 000 - 19,768 people), as of July 1, 2017 - 20,787 people, as of November 1, 2017 - 21,382 people.
9. Chelyabinsk region (1079.6% 000 - 37794 people), as of 01.11.2017 — more than 48,000 people., incl. Chelyabinsk - 19,000 HIV-infected.
10. Novosibirsk region (1021.9% 000 - 28227 people) regions. As of May 19, 2017 at city ​​of Novosibirsk more than 34 thousand HIV-infected people have been registered - every 47 resident of Novosibirsk has HIV (!). On 01.11.2017 in Novosibirsk region 36,334 HIV-infected people were registered. The region is in the top ten in Russia, and in terms of the level of HIV infection of the population, it is in fourth place in the country.
11. Perm Territory (950.1% 000 - 25030 people) - Berezniki, Krasnokamsk and Perm are mostly heavily affected by HIV,
12. St. Petersburg (978.6% 000 - 51140 people),
13. Ulyanovsk region (932.5% 000 - 11728 people),
14. Republic of Crimea (891.4% 000 - 17000 people),
15. Altai Territory (852.8% 000 - 20268 people),
16. Krasnoyarsk Territory (836.4% 000 - 23970 people),
17. Kurgan region (744.8% 000 - 6419 people),
18. Tver region (737.5% 000 - 9622 people),
19. Tomsk region (727.4% 000 - 7832 people),
20. Ivanovo region (722.5% 000 - 7440 people),
21. Omsk region (644.0% 000 - 12741 people), as of September 1, 2017, 16,275 cases of HIV infection were registered, the incidence rate is 823.0% 000.
22. Murmansk region (638.2% 000 - 4864 people),
23. Moscow region (629.3% 000 - 46056 people),
24. Kaliningrad region (608.4% 000 - 5941 people).
25. Moscow (413.0% 000 - 50909 people)

Table number 3. Rating of Russian regions by the prevalence of HIV infection among the population (TOP 15).

Age structure

Most high level prevalence of HIV infection in the population is observed in the group 30-39 years old, 2.8% of Russian men aged 35-39 lived with an established diagnosis of HIV infection. Women become infected with HIV in more than young 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 years is even higher - 1.6%.

Over the past 15 years has changed dramatically age structure among newly diagnosed patients. In 2000, 87% of patients were diagnosed with HIV before the age of 30. Adolescents and young people aged 15-20 years accounted for 24.7% of newly diagnosed HIV infections in 2000, as a result of an annual decrease in 2016, this group was only 1.2%.

Diagram. Age and sex 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 share of young people aged 20-30 decreased to 23.2%. An increase in the proportion of newly detected cases was also observed in older age groups, cases of sexually transmitted HIV infection in old age have become more frequent.

“0.6% of all Russians live with an HIV diagnosis. But Russians aged 30-39 are especially affected by HIV - among them, HIV is diagnosed in 2%. For men, this percentage is higher. With age, the risks of contracting HIV accumulate, and people continue to age with the virus in their blood. 87% of HIV-positive people are economically active, which is explained by their young age, among them there is a disproportionately large proportion of Russians with an average special education is the working class, without which the future of the country will become foggy.” (V. Pokrovsky)

It should be noted that at low testing coverage of adolescents and youth, more than 1100 cases of HIV infection are registered annually among people aged 15-20 years. According to preliminary data the largest number of HIV-infected adolescents (15-17 years old) was registered in 2016 in Kemerovo, Nizhny Novgorod, Irkutsk, Novosibirsk, Chelyabinsk, Sverdlovsk, Orenburg, Samara regions, Altai, Perm, Krasnoyarsk territories and the Republic of Bashkortostan. The main cause of HIV infection among adolescents is unprotected sex with HIV-infected partner (77% of cases in girls, 61% in 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, detection and treatment of HIV patients”. The highest annual mortality was registered in Jewish Autonomous Region, Republic of Mordovia, Kemerovo Region, Republic of Bashkortostan, Ulyanovsk Region, Republic of Adygea, Tambov Region, Chukotka Autonomous Region, Chuvash Republic, Samara Region, Primorsky Territory, Tula region, Krasnodar, Perm region, Kurgan region.

According to Rosstat 18,575 people died from HIV infection (AIDS) in 2016. (in 2015 - 15,520 people, in 2014 - 12,540 people), i.e. The number of deaths from AIDS is on the rise.

The HIV mortality index (number of deaths per 1,000 population) has grown 10 times since 2005!

“Among women in their 20s and 30s, who shouldn’t die at all, more than 20% of deaths are related to HIV. is growing in the world. The death of young people from AIDS is the result of poorly organized medical care.” (V. Pokrovsky)

For 6 months of 2017, 14,631 HIV-infected people died, i.e. Approximately 80 people diagnosed with HIV die every day. This is 13.6% higher than in the same period in 2016. Perhaps this is due to the interruptions in the supply of medicines for the treatment of HIV-infected people, because only one third of HIV-infected people received antiretroviral therapy in 2017 (32.9% - 298,888). Especially many died in the regions most disadvantaged in the treatment of HIV infection: Kemerovo, Samara and Irkutsk.

Treatment coverage

At the dispensary in specialized medical organizations in 2016 there were 675,403 patients infected with HIV, 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 monitoring form of Rospotrebnadzor.

Video. Shortage of medicines for HIV-infected people. V. Pokrovsky.

In 2016, 285,920 patients received antiretroviral therapy in Russia, including patients who were in places of deprivation of liberty. AT 1st half of 2017 received antiretroviral therapy 298 888 patients, about 100,000 new patients were added for therapy in 2017 (there will most likely not be enough drugs for everyone, since the purchase was according to the figures of 2016). Treatment coverage in the Russian Federation in 2016 was 32.8% of the number of registered people diagnosed with HIV infection (the worst indicator in the world); among those on dispensary observation, 42.3% of patients were covered by antiretroviral therapy.

“The World Health Organization (WHO) has been recommending life-long treatment for all HIV-positive people for five years now, but the Ministry of Health still provides only 300,000, that is, 46% of the 650,000 “registered by the Ministry of Health”, or 33% of 900,000. still alive, registered by Rospotrebnadzor. The reason is that there is not enough money for HIV/AIDS treatment in the state budget. In order to increase treatment coverage, the Ministry of Health is trying to reduce the cost of treatment by lowering purchase prices, which partially compensates for the shortage, but worsens the quality of treatment, as cheaper copies of medicines (generics) are purchased, which are obsolete by status. Russians should take 10-12 tablets a day, while Europeans only need one. It is clear that because of this trouble, 20% of those who started treatment stop it. And this is another reason for the increase in mortality.” (V. Pokrovsky)

The achieved treatment coverage does not play the role of 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 in Russia there were tested for HIV 30 752 828 blood samples Russian citizens and 2,102,769 foreign blood samples. Total of tested serum samples of Russian citizens compared to 2015. increased by 8.5%, and among foreign citizens decreased by 12.9%.

In 2016, the maximum number of positive results in the immunoblot in Russians over the entire history of observation was revealed - 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, therefore it differs significantly from the number of newly 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 an insignificant part of those tested for HIV in Russia - 4.7%, but among these groups 23% of all new cases of HIV infection were detected. 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% of HIV-positive people were detected for the first time, among MSM - 13.2%, among contact persons during epidemiological investigation - 6.4%, prisoners - 2.9%, STI patients - 0.7%.

In the first half of 2017, the number of people tested for HIV did not increase much, only by 8.1% compared to the first half of 2016. This is minuscule, so it’s sad to hear when the main reason for the increase in HIV growth is the increase in the number of people tested, all much more serious and deeper.

Transmission path structure

In 2016 significantly the role HIV infection, in 2017 this trend only strengthened, moreover, the sexual route overtook the drug route: in the first half of 2017, the share of the sexual route of HIV infection was 52.2% (including 1.9% through homosexual transmission, the HIV epidemic among homosexuals flares up once again), through the use of injecting drugs - 46.6%. According to preliminary data, among those newly identified in 2016 HIV-positive with established risk factors for infection, 48.8% were infected with non-sterile instruments, 48.7% - with heterosexual contacts, 1.5% - with homosexual contacts, 0.45% - made up. The number of children infected through breastfeeding is growing: in 2016, 59 such children were registered, in 2015 - 47, 2014 - 41 children.

“The root of all problems is the rapid increase in the number of new cases due to the transition of the HIV epidemic to sexual transmission. Of the 100,000 new cases in 2016, half were sexual contacts between men and women, just under half were drug use, and only 1-2% were homosexual contacts between men. Dozens of cases of HIV infection in medical institutions should be attributed to the Ministry of Health, which should control the safety of medical manipulations.” (V. Pokrovsky)

In 2016, 16 cases were registered with suspected infection in medical organizations when using non-sterile medical instruments and 3 cases when transfusing 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. For 10 months of 2017 12 cases were registered with suspected HIV infection while providing medical care. Also, 12 cases of HIV infection were registered in places of detention when using non-sterile instruments for non-medical purposes.

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

conclusions

• In the Russian Federation in 2016, the epidemic situation of HIV infection continued to deteriorate and this unfavorable trend continues in 2017, which may even affect the resurgence of the global HIV epidemic , which, according to the UN in July 2016, began to decline.
• Saved high incidence of HIV infection , the total number of HIV carriers and the number of deaths of HIV-infected people is increasing, the number of deaths from AIDS is increasing every year, the epidemic has intensified the exit of the epidemic from vulnerable groups of the population into the general population.
• While maintaining the current pace of the spread of HIV infection and the lack of adequate systemic measures to prevent its spread the forecast for the development of the situation remains unfavorable .
• Radical actions of the Government of Russia are required to stop trafficking, distribution of drugs and, the most difficult thing, to change the sexual behavior of the inhabitants of the Russian Federation (clamps are wonderful, but the number of people practicing abstinence and practicing with one heterosexual sexual partner throughout their lives is one and it is impossible to change, p .e development with minimal side effects is required (drank a pill and do what you want)).

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

The material was prepared on the basis of a certificate from the Federal Scientific and Methodological Center for the Prevention and Control of AIDS of the Central Research Institute of Epidemiology of Rospotrebnadzor and other official sources.

PS: I hope that is clear, to get an idea of ​​the real scale of the HIV epidemic, you need to multiply the official figures by 5-10, because. this is just the tip of the iceberg.

Sincerely, Dr.

Key Facts

• HIV remains a major global public health problem, with more than 39 million deaths to date. In 2014, 1.2 million people worldwide died from HIV-related causes.
• At the end of 2014, there were approximately 36.9 million people living with HIV in the world, and 2 million people in the world acquired HIV infection in 2014.
• Sub-Saharan Africa is the most affected region, with 25.8 million people living with HIV in 2014. The region also accounts for almost 70% of the global total of new HIV infections.
• HIV infection is often diagnosed using rapid diagnostic tests (RDTs), which detect the presence or absence of antibodies to HIV. In most cases, test results can be obtained on the same day; this is important for same-day diagnosis and early treatment and care.
• There is no cure for HIV infection. However, thanks to effective treatment With antiretroviral drugs (ARVs), the virus can be controlled and people with HIV can have healthy and productive lives.
• It is currently estimated that only 51% of people with HIV know their status. In 2014, approximately 150 million children and adults in 129 low- and middle-income countries received HIV testing services.
• Globally, 14.9 million people with HIV were receiving antiretroviral therapy (ART) in 2014, of whom 13.5 million lived in low- and middle-income countries. These 14.9 million people on ART represent 40% of the 36.9 million people with HIV worldwide.
• The coverage of children is still insufficient. In 2014, 3 out of 10 children with HIV had access to ART compared to one in four among adults.

Human Immunodeficiency Virus (HIV)) affects the immune system and weakens people's systems to control and protect against infections and some types of cancer. The virus destroys and weakens the function of immune cells, so infected people gradually develop immunodeficiency. Immune function is usually measured by the number of CD4 cells. Immunodeficiency leads to increased susceptibility to a wide range of infections and diseases that people with healthy immune systems can resist. The most advanced stage of HIV infection is Acquired Immune Deficiency Syndrome (AIDS), which can take 2-15 years for different people to develop. AIDS is characterized by the development of certain types of cancer, infections, or other severe clinical manifestations.

Signs and symptoms

The symptoms of HIV vary depending on the stage of the infection. During the first few months, people with HIV tend to be most contagious, but many of them do not know their status until later. During the first few weeks after infection, people may not develop any symptoms or develop a flu-like illness, including fever, headache, rash or sore throat.

As the infection gradually weakens the immune system, people may develop other signs and symptoms, such as swollen lymph nodes, weight loss, fever, diarrhea, and cough. If left untreated, they can develop serious diseases such as tuberculosis, cryptococcal meningitis, such oncological diseases like lymphomas and Kaposi's sarcoma, and others.

Transmission

HIV can be transmitted through various body fluids of infected people, such as blood, breast milk, seminal fluid and vaginal discharge. People cannot become infected through normal everyday contact, such as kissing, hugging, and shaking hands, or by sharing personal items and drinking food or water.

Risk factors

Behaviors and conditions that increase people's risk of contracting HIV include the following:

• unprotected anal or vaginal sex;
• having another sexually transmitted infection such as syphilis, herpes, chlamydia, gonorrhea, and bacterial vaginosis
• sharing contaminated needles, syringes and other injecting equipment and drug solutions while injecting drugs;
• unsafe injections, blood transfusions, medical procedures involving unsterile incisions or punctures;
• accidental needle stick injuries, including among healthcare workers.

Diagnosis

Serological tests such as RDT or enzyme immunoassay (ELISA) detect the presence or absence of antibodies to HIV-1/2 and/or HIV-p24 antigens. Carrying out such tests as part of a testing strategy in accordance with an approved testing algorithm makes it possible to detect HIV infection with a high degree accuracy. It is important to note that serological tests do not directly detect HIV itself, but detect antibodies produced by the human body as its immune system fights foreign pathogens.

Most people develop antibodies to HIV-1/2 within 28 days and therefore early stage infections, during the so-called period of the seronegative window, antibodies are not detected. This early period of infection is the period of greatest infectivity, but HIV transmission can occur at all stages of infection.

It is good practice to retest all people initially diagnosed as HIV positive prior to enrollment in care and/or treatment programs to rule out any potential errors in testing or reporting.

Testing and counseling

HIV testing should be voluntary and the right to refuse testing should be recognized. Mandatory or mandatory testing at the initiative medical workers, health authority, partner or family member is not acceptable as it undermines good public health practice and violates human rights.

Some countries have introduced self-testing or are considering introducing it as an option. HIV self-testing is a process in which a person who wishes to know their HIV status collects semen, performs the test, and interprets the results in confidence. Self-testing for HIV does not provide a definitive diagnosis; this is an initial test that requires further testing by a healthcare professional using a nationally approved testing algorithm.

All testing and counseling services should take into account the five components recommended by WHO: informed consent, confidentiality, counseling, correct test results, and communication with care and treatment and other services.

Prevention

The risk of HIV infection can be reduced by limiting exposure to risk factors. Key HIV prevention approaches often used in combination include the following:

1. Use of male and female condoms

Proper and consistent use of male and female condoms during vaginal or anal sex can protect against the spread of sexually transmitted infections, including HIV. Evidence suggests that male latex condoms protect 85% or more against transmission of HIV and other sexually transmitted infections (STIs).

2. HIV and STI testing services

Testing for HIV and other STIs is strongly recommended for all people exposed to any risk factor so that they can know their infection status and have immediate access to necessary prevention and treatment services. WHO also recommends offering testing to partners or couples.

Tuberculosis is the most common disease among people with HIV. If not detected and treated, it is fatal and is the leading cause of death among people with HIV, with approximately one in four HIV-related deaths due to tuberculosis. Early detection of this infection and prompt provision of anti-TB drugs and ART can prevent these deaths. It is strongly recommended that TB screening be included in HIV testing services and prompt provision of ART to all people diagnosed with HIV and active TB.

3. Voluntary medical male circumcision

Medical male circumcision (circumcision foreskin) when administered safely by properly trained healthcare professionals, reduces the risk of men acquiring HIV infection through heterosexual intercourse by about 60%. It is one of the main interventions in epidemics with high levels HIV prevalence and with low rates of male circumcision.

4. Use of antiretroviral therapy (ART) for prevention

4.1. Antiretroviral therapy (ART) as prevention

A 2011 trial showed that if an HIV-positive person adheres to an effective ART regimen, the risk of transmitting the virus to their uninfected sexual partner can be reduced by 96%. For couples where one partner is HIV positive and the other HIV negative, WHO recommends that the HIV positive partner be offered ART regardless of his/her CD4 count.

4.2 Pre-exposure prophylaxis (PrEP) for the HIV-negative partner

Oral HIV PrEP is the daily use of ARVs by people who are not infected with HIV to prevent HIV infection. There have been over 10 randomized controlled trials demonstrating the effectiveness of PrEP in reducing HIV transmission rates in a range of populations, including serodiscordant heterosexual couples (couples in which one partner is infected and the other is not), men who have sex with men, women, gender reassignment, high-risk heterosexual couples and injecting drug users. WHO recommends that countries undertake projects to gain experience in using PrEP safely and effectively.

In July 2014, WHO released the Consolidated Guidelines on HIV Prevention, Diagnosis, Treatment and Care for Key Populations at Risk, recommending PrEP as an additional HIV prevention option as part of a comprehensive HIV prevention package for men with sex with men.

4.3 HIV Post-Exposure Prophylaxis (PEP)

Post-exposure prophylaxis (PEP) is the use of ARVs within 72 hours of exposure to HIV to prevent infection. PEP includes counseling, first aid, HIV testing, and a 28-day course of ARV treatment followed by medical care. In a new addendum released in December 2014, WHO recommends PEP for both work-related and non-work-related exposures, and for adults and children. The new recommendations contain simplified ARV regimens already used for treatment. Implementation of the new guidelines will simplify drug prescribing, improve compliance, and increase completion rates of PEP for HIV prevention in people who are accidentally exposed to HIV, such as healthcare workers, or in people exposed to HIV through unprotected sex or sexual assault .

5. Harm reduction for injecting drug users

People who inject drugs can take precautions to prevent HIV infection by using sterile injecting equipment, including needles and syringes, for each injection. A complete HIV prevention and treatment package includes:

• needle and syringe programs
• evidence-based opioid substitution therapy for drug users and treatment of dependence on other psychoactive drugs,
• HIV testing and counseling,
• HIV treatment and care,
• providing access to condoms, and
• management of STIs, tuberculosis and viral hepatitis.

6. Eliminate mother-to-child transmission of HIV

Transmission of HIV from an HIV-positive mother to her child during pregnancy, labor, childbirth, or breastfeeding is called vertical transmission or mother-to-child transmission (MTCT). In the absence of any intervention, rates of HIV transmission from metaria to child range from 15-45%. Such transmission can be almost completely prevented if both mother and child receive ARVs at stages where infection can occur.

WHO recommends a range of options for preventing mother-to-child transmission of HIV, which include providing ARVs to mothers and children during pregnancy, childbirth and the postpartum period, or offering lifelong treatment to HIV-positive pregnant women regardless of their CD4 count.

In 2014, 73% of the estimated 1.5 million pregnant women with HIV in low- and middle-income countries received effective antiretroviral drugs to prevent transmission to their children.

Treatment

HIV can be attenuated with combination antiretroviral therapy (ART), consisting of three or more antiretroviral drugs (ARVs). ART does not cure HIV infection, but it controls the replication of the virus in the human body and helps to strengthen the immune system and restore its ability to fight infections. Thanks to ART, people with HIV can have healthy and productive lives.

At the end of 2014, approximately 14.9 million people with HIV were receiving ART in low- and middle-income countries. About 823,000 of them are children. In 2014, the number of people on ART increased significantly, by 1.9 million in one year.

Coverage of children is still insufficient, with 30% of children receiving ART compared to 40% of HIV-infected adults.

WHO recommends starting ART at the stage when the CD4 count falls to 500 cells/mm³ or below. ART regardless of CD4 count is recommended for all people with HIV in serodiscordant couples, pregnant and lactating women with HIV, people with tuberculosis and HIV, and people co-infected with HIV and hepatitis B with severe chronic liver disease. Similarly, ART is recommended for all children with HIV under five years of age.

WHO activities

As humanity approaches the deadline for achieving the Millennium Development Goals, WHO is working with countries to implement the Global Health Sector Strategy on HIV/AIDS 2014-2015. WHO has set 6 operational targets for 2014-2015 to best support countries as they move towards the global HIV targets. They aim to support the following areas:

• strategic use of ARVs for HIV treatment and prevention;
• eliminating HIV among children and increasing access to treatment for children;
• improved health sector response to HIV among key risk groups;
• further innovation in HIV prevention, diagnosis, treatment and care;
• strategic information for efficient scaling;
• strengthening links between HIV and related health outcomes.

WHO is one of the sponsors of the Joint United Nations Program on AIDS (UNAIDS). Within UNAIDS, WHO leads work on HIV treatment and care and co-infection with HIV and tuberculosis, and coordinates work with UNICEF to eliminate mother-to-child transmission of HIV. WHO is currently developing a new strategy for the global health sector response to HIV 2016-2021.

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