Regions with the highest number of HIV infected people. Official statistics of HIV and AIDS in Russia

This virus is related to those diseases, the news of which for many people is equivalent to the news of a death sentence. Fear of AIDS can be provoked by a real danger, as well as the incurability of the infection, as well as the psychological atmosphere surrounding people with AIDS. For this reason, the consequences of infection with AIDS can affect both physical and mental human health. The topic of this article is AIDS, consequences and statistics on the disease in Russia.

AIDS - consequences of the disease

Physically, infection has a variety of consequences. AIDS, if adequately treated, is treated with advanced antiviral drugs, and the patient is able to live for many years with almost no deterioration in his standard of living. Naturally, with the exception of those consequences of AIDS that are provoked by the therapy itself: the need for regular medication, examinations, etc.

If AIDS therapy is not carried out, or it is insufficient, HIV after years can develop into AIDS, which is much more likely to provoke irreversible changes and cause the death of the sick person.

The psychological blow a person receives upon learning of an HIV diagnosis is most often comparable in depth to a physical illness. Only in recent years has public opinion regarding AIDS patients begun to change, and they are no longer seen as outsiders and renegades. However, to achieve positive results, work in this direction must be carried out for many years.

Statistics on AIDS in the world

The virus enters the body through mucous membranes or damaged skin. Therefore, preventing the consequences of AIDS involves creating a barrier on the viral path in the form of using protective equipment, condoms, for example, masks and gloves, and using only sterile instruments and needles for piercing the skin. In the external environment, the virus is unstable; it is negatively affected by high temperature, disinfectants, and even those used in living conditions chlorine-containing preparations.

Excessive use of alcohol and drugs reduces the sense of control regarding the safety of injections or sex (the spread of HIV occurs during the use of contaminated syringes during intravenous drug injections).

Despite the efforts made by the world community to contain the epidemic and bring it under control, the spread of HIV infection has acquired enormous proportions and is now a real threat to the socio-economic development of most of the world's countries.

Today, according to statistics, more than 40 million people in the world are infected with HIV, of which, in the last two years alone, 15 million people have become infected with AIDS (which amounted to 37.5% of the total number of people living with HIV) and more than 24 million .people died from AIDS.

The danger and scale of the problem of the consequences of AIDS require decisions to be made at the highest global level. Two specialized Sessions of the UN General Assembly were entirely aimed at addressing HIV/AIDS issues. We adopted an important political document that defines the main directions of countering the spread of HIV/AIDS not only on a planetary, but also on a regional scale.

AIDS - statistics in Russia

In Russia, the epidemic situation surrounding the spread of AIDS is not a regional problem. The number of people infected with AIDS in the state exceeds 250 thousand; they have been registered in almost every constituent entity of Russia. The rate of HIV infection increased by 29.7% from 121 per 100,000 people in 2001 to 15 at the beginning of 2003. The most difficult situation has arisen in the capital region, as well as St. Petersburg, Samara, Orenburg, Chelyabinsk regions and the Khanty-Mansi Autonomous Okrug.

AIDS, the spread statistics of which are disappointing, is alarming because intravenous drug users account for approximately 76% of newly registered HIV-infected people with a definite fact of infection; approximately 70-80% of those infected are young people aged 15-29 years.

Starting from 2001, according to statistics on AIDS in Russia, the sexual method of spreading HIV infection has become more active; in 2003, more than 15% of new cases of HIV infection were registered among people who did not use drugs. A significant increase in sexual transmission was noted in the Tver, Kaliningrad, Nizhny Novgorod regions and Krasnodar region.

In the overall composition of HIV-infected people, the proportion of women of childbearing (fertile) age has increased significantly. According to statistics on AIDS in Russia, during the entire period of registration of infection (fifteen-year interval), 6,302 children were born to HIV-infected mothers, of which 70% were born in 2003-2003.

14.07.2016 20:33

There are no more risk groups, everyone gets infected. And most people don’t know about this, because it’s not customary for us to get checked, and condoms are not popular. Meanwhile, monopolies are driving up drug prices. If they do not decrease, and Russians do not become more careful, by 2020 the number of patients will increase by 250%.

There are already more than a million infected people in our country, and the number is growing every day. In some regions there is not enough money even to provide patients with the minimum necessary therapy. Prices for medicines are rising because 90% of procurement tenders are held without competition, and 27 billion rubles of budget money are shared fraternally by several private companies.

A huge paddy wagon with the letters HIV on its license plate is traveling through Russia. He stops at a house, commissioners come out of the cab, break into the apartment and take out another average Russian.

“I’m not a drug addict or a homosexual, I’m not guilty of anything, I have a family, children!” - he protests.

“It doesn’t matter,” the commissioners say indifferently and push the new prisoner into the car.

The paddy wagon thundered through the Samara, Irkutsk, Sverdlovsk, and Kemerovo regions. There already more than 1.5% of residents are HIV positive. That is, from each city 10-story building, special transport took five residents.

In Leningrad, Ulyanovsk, Tyumen, Chelyabinsk, Orenburg and many other regions -1-1.5% of infected people among residents. It's hard to find a school there or kindergarten, which HIV would bypass.

On the map you can see how the number of infected people grew in relation to the population of regions in Russia.Data for 1994–2014provided by the Federal Scientific and Methodological Center for the Prevention and Control of AIDS (there is no information on Crimea, since at that time it was not part of Russia).

Proportion of HIV-infected people from the total number of residents of the region

The epidemic has hit Russia unevenly. Half of all infected people live in 20 of 85 regions.

“In all regions, people live differently. There are more infections where drugs were supplied in large quantities and where there have long been a large number of infected drug users,” says Vadim Pokrovsky, head of the Federal Scientific and Methodological Center for the Prevention and Control of AIDS.

These are regions where drug trafficking took place, for example, the Orenburg region. As well as financially prosperous parts of the country, where it was easier to sell drugs (Irkutsk and Sverdlovsk regions).

Residents are unaware of the threat

HIV has ceased to be a disease of “at-risk groups” - now it comes into homes ordinary people. Natalia and Ivan— the most common Russian family. First pregnancy, antenatal consultation, vitamins, examinations and a mandatory HIV test, Natalya turned out to be positive. Testing Ivan also revealed that he had the virus. No drugs, casual relationships, blood transfusions, everything is calm and stable. Where did the virus come from? Ivan divorced his first wife six years ago. We decided to check— She was also diagnosed with HIV. Before his first marriage, Ivan dated a girl - she became the source of infection. If the analysis had been done seven years ago,three people would remain healthy.

However, in our country people do not consider it necessary to get checked. Moreover, they do not think about basic protection. More than a third of Russians surveyed by Lifehave never been tested for HIV, which can be done for free at any clinic. About halfdon't use condomswhen having sex.

The survey was conducted jointly with the research company Vengo Consult (2,277 people took part).

Spending in the regions: not even enough for one package of medicine

HIV-infected have the right to receive free from the state drugs that suppress the virus. But not everyone gets it. Sick either they buy expensive drugs themselves, or they don’t get treatment at all.And then they die quietly, without protesting on federal highways. Because inThe virus kills unnoticed. If you don’t take medication, you can feel quite normal. And then you catch the flu - and due to reduced immunity, it turns out to be fatal.

According to Health Minister Veronika Skvortsova, medications are now being given to 37% of those infected. In the plans - by 2020 to cover 60%.

According to Head of the Federal Scientific and Methodological Center for the Prevention and Control of AIDSVadim Pokrovsky, approximately 25% of Russians with HIV receive medications.

IN WHO recommendations state that All infected people need to be treated from the moment the virus is detected in the blood. But in our country the rules are different: in our country they begin to treat when the infected person’s immunity has already been reduced. Immunity can be measured in CD4 cells. In Russia it is believed that if these cells become less than 350 per 1 cubic mm of blood, then the time has come.An HIV-negative person has 500-1200 of them per 1 cubic mm of blood.

This happens because we simply do not have enough money allocated for treatment, he explained Vadim Pokrovsky.

According to the press service of the Ministry of Health, this year 23.3 billion rubles have been allocated for the purchase of drugs for HIV-infected people. The money is transferred to the regions, and local authorities purchase drugs through government procurement.

It is interesting that the principle “where people are more sick, there are more medicines” does not work at all. Life analyzed all tenders for 2014 and calculated how much money each region spends on one infected person.

Amounts allocated by regions per HIV-infected person per year

For example, in the Perm region there are 23 thousand infected. Drug costs - 14 million rubles(608 rubles per person). In the Vologda region - 2.4 thousand infected, costs - 45 million rubles (19 thousand rubles per person). There are regions where a meager amount is allocated per infected person, including Orenburg (240 rubles per year) and Kaluga (589 rubles per year) regions. This not even enough for a package of ritonavir (one of the most popular drugs, on average costs about 3 thousand rubles).

It would seem that good indicators in the Altai Republic and Stavropol region, there are 30.5 thousand rubles and 43 thousand rubles per year per infected person, respectively. But this is still extremely little.

One year of therapy costs an average of 180 thousand rubles. You need to take tests four times a year - that’s another 40 thousand rubles.

“Money from the federal budget is distributed among regions in proportion to the number of infected people,” said Vadim Pokrovsky. “And how the regions spend them is another question.”

He also named factors that may influence statistics.

“Maybe the region planned to purchase more drugs and more tenders were announced, but no one came to them because the conditions were unfavorable,” said Vadim Pokrovsky. — If few drugs are purchased, the price per package increases - this can also affect the total amount. As for the corruption factor, this is not a question for me, but for the law enforcement agencies.”

Life sent requests to several regions. Answers came from the Kaluga and Yaroslavl regions. Thus, the Ministry of Health of the Kaluga Region (where it costs 589 rubles per sick person per year) reported that drugs are purchased “in accordance with the established budget limits.” They assured that residents of the region who have HIV and need medications were provided with medications “in a timely manner and in full.”

“Treatment coverage was 47% of the number of dispensary HIV-infected patients,” the letter says.

The Department of Health of the Yaroslavl Region (the region spends an average of 2.8 thousand rubles per HIV-positive person per year) responded that purchases of drugs for infected people “are carried out in a timely manner, uninterrupted provision of patients is organized” and “full availability of antiretroviral therapy.”

No competition

Medicines could be cheaper. It’s just that tenders are held without competition in 90% of cases. Life came to this conclusionhaving analyzed all 6966 tenders that were held in 2014-2015.Usually only one participant submits an application and a contract is concluded with him.

In total, 430 companies supply drugs for HIV-infected people through government procurement. At the same time, 10 leaders take 81% of tenders (27 billion rubles out of 34 billion rubles).

It would seem that they must fight for orders. Because they do not differentiate between drugs: they supply similar kits. There is no division by region either: leaders strive to cover everything at once.

But, for example, the Ministry of Economic Development of Bashkortostan announced a tender for the supply of lopinavir and ritonavir with an initial price of 68.5 million rubles. Only R-Pharm submitted an application. Of course, he did not offer a lower price. For what? There are still no competitors in sight.

The contract agency of the Arkhangelsk region announced a tender for the supply of the same drugs with a starting price of 1.5 million rubles. Only Vitalek submitted an application. He didn’t reduce the price either - there was no need to.

“Participants in a given market usually have conceptual agreements on which tenders they can participate in. This does not mean that participants negotiate each tender separately. They can distribute: this group of tenders belongs to me, and this one belongs to you. Although it is possible that someone is negotiating individual tenders in the corridor. This is a normal process," he says. Pavel Gagarin, Chairman of the Board of Directors of the auditing and consulting group Gradient Alpha

“Naturally, they are given a certain matrix of how to play, where to climb, and where not to climb,” he said.

Solving the matrix

Firstly, it can be divided into price categories. For example, for the drugs lopinavir + ritonavir, R-Pharm usually takes larger orders (average price 10.4 million rubles), while Sanalek, Farmakhan and Vitalek take smaller orders (average price 7 million rubles, 5 million rubles and 3.8 million rubles, respectively.

Secondly, there are brother companies. They have common owners or other signs of affiliation.

Thus, five companies - Sanalek, Vitalek, Unilek and Farmakhan, Plexapharm - are registered at one address (Moscow, Varshavskoe highway, 46, A building 4). Interestingly, the general address is fake. It's just a rubber office there. According to the Spark database, this address is “indicated as the location of state registration” for 32 legal entities.

A Life correspondent went to the specified address and discovered a small “island” for car lovers: in four buildings there are auto parts stores, a car wash, and a tire repair shop. There is also a granite workshop. Old-timers of Avtorazvilka (this is the name of this complex) claim that there are no offices here and never have been.

“This situation, unfortunately, is not uncommon,” says lawyer Yuri Sinelshchikov. — If all violations are revealed, then theoretically it will be possible to classify the companies’ actions as fraud. But only if it is possible to calculate the damage. The damage may come from the customer overpaying: that is, he bought at one price, but in fact the price could have been lower if another supplier had won.”

We weren’t even able to call these companies, although more than a dozen of their phone numbers are listed in the Spark database. They did not respond to requests either.

Another scheme: the co-owner of Vitalek and Farmakhan is Alexey Khavanov, who is also the former co-owner of Sanalek. Unilek and Plexpharma also have a common owner - Alexander Maksimov.

It is clear that such brother companies it's not difficult to agree who takes this or that tender.

Another striking example is the Pharmimex brotherhood. There is a CJSC Scientific, Production and Commercial Company Pharmimex. There is a public joint stock company "Pharmimex". They have a common owner - Alexander Apazov. Each of the companies has a daughter, for example, Medilon-Pharmimex LLC and Regul-Pharmimex CJSC.

“This industry is ruled by certain officials, and companies negotiate with them to receive tenders,” said Pavel Gagarin, chairman of the board of directors of the auditing and consulting group Gradient Alpha. — And it won’t look very good from the outside if the same company goes to many tenders and wins everywhere. And if companies with different names do this, formally there’s nothing much to complain about. But it’s still a pretty rough game.”

Thirdly, there is false competition in the market for government procurement of drugs for HIV-infected people. Here are two “brothers” - “Cosmofarm” and “Medresurs”. One of the co-owners of Kosmofarm, Grant Vardanyan, previously had a stake in the Jomed company. Now Nadezhda Shergalina has a share in Jomed, and at the same time she is a co-owner of Medresurs.

Kosmofarm and Medresurs often enter the same tenders. And at first glance, the fight seems fair. For example, the state procurement committee of the government of the Khabarovsk Territory published a tender for the supply of efavirenz with an initial price of 1.7 million rubles. Applications were submitted by Kosmofram and Medresurs. "Cosmopharm" won. And the contract price even decreased - by one percent!

Large figures

Among the market players are people with good connections. The owner of R-Pharm is 36-year-old Alexey Repik. He is also the president of Business Russia, a member of the Public Chamber and a member of the import substitution commission, which was created in 2015 by Dmitry Medvedev. So communication with high-ranking officials is a common thing for him. By the way, he has been working with officials since he was 16 years old. Then he got a job as an economist at a Moscow hospital and coordinated estimates with the health department. He registered his company “R-Pharm” when he was 22 years old, that is, 15 years ago.

Pharmstandard is considered the most influential pharmaceutical company in Russia. Chairman of the Board of Directors is Viktor Kharitonin. The 43-year-old businessman is one of the hundred richest people in Russia according to the Forbes Russia magazine rating. The head of the Accounts Chamber, Tatyana Golikova, who was previously the Minister of Health, has been repeatedly accused of lobbying the interests of Pharmstandard. She even got the nickname “Madame Arbidol” (it is produced by Pharmstandard).

The head of the Pharmimex group is 77-year-old Dmitry Apazov. He is an Honored Healthcare Worker of the Russian Federation. He started working in the system more than 50 years ago. He was the head of the Main Pharmacy Directorate of the USSR Ministry of Health, and then - general director association "Soyuzpharmacia" under the USSR Ministry of Health. Then Soyuzpharmacia was renamed into the state enterprise Pharmimex. In 1995, Pharmimex OJSC was registered.

Will Nacimbio reduce prices?

Another major player is preparing to enter the fight against HIV. In July 2015, the general director of the Rostec state corporation, Sergei Chemezov, sent a letter to President Vladimir Putin with a proposal to make Rostec’s subsidiary, the National Immunobiological Company (Nacimbio), the only supplier of drugs for HIV-infected people, patients with tuberculosis and hepatitis within the framework of government procurement.

According to Chemezov, it is necessary to ensure the “sovereignty Russian Federation in the field of production of medicines and import substitution in the domestic medicine industry.”

A few days later, the president instructed the government to work on this issue. In September 2015, there was another instruction - to return to the centralized purchase of drugs for HIV, hepatitis and tuberculosis (previously, the Ministry of Health purchased drugs centrally, but since 2013 they began to be purchased by the regions).

As Life was told by the press service of the Ministry of Health, the department is already working with Rostec on the topic of HIV. According to the press service, the centralization of government procurement will be “starting in 2017.”

As the press service of Nacimbio said, the company plans to reduce the cost of a course of treatment for HIV-infected people by almost half (from the current $1,170 per course to $650). For this purpose, production of drugs will be organized in Russia. Agreements have been concluded with the Indian manufacturer Cipla and the Russian company ChemRar.

It is interesting that when Nacimbio became the only supplier of tuberculosis drugs for the Federal Penitentiary Service, their prices, on the contrary, increased. Thus, in May 2016, the Federal Penitentiary Service entered into a contract with Nacimbio for the supply of drugs for the treatment of tuberulosis, including ethambutol. Price - 2.8 rubles per 1 gram. In 2013, the Federal Penitentiary Service entered into an agreement for the supply of ethambutol with Medical Leasing Consulting. The price per 1 gram is 2.6, that is, 9% less. But the company itself claims the opposite: previously the FSIN purchased the drug at a price of 3.4 rubles per gram.

The press service of Nacimbio says that the arrival of the company will radically change the market for drugs for HIV-infected people. Its initiatives “protect the interests of Russian manufacturers” and “in many ways infringe on the interests of domestic distributors who specialize in budget supplies and do not engage in their own production,” they say.

And now the top 10 are mainly distributors. According to the Spark database, only R-Pharma, Pharmstandard, Pharmimex and Biotekhmed have their own production.

Nacimbio's revenue in 2015 amounted to 6.5 billion rubles, net profit - 648 million rubles. The company was created in 2013 - to help in the “development of production in the Russian Federation full cycle medicines." She was given shares of the vaccine manufacturer NPO Microgen, and state shares in the pharmaceutical companies Fort and Sintez.

Posters and flyers don't work

“This year, only 400 million rubles have been allocated to inform the population about the threat of HIV,” says Head of the Federal Scientific and Methodological Center for the Prevention and Control of AIDS Vadim Pokrovsky. - This is not enough".

He explained that money for prevention is distributed by region. As a result, each region receives several million rubles. What are they spent on?

According to the government procurement portal, the authorities of the Belgorod region, for example, ordered “the provision of services to inform the population on the prevention of HIV infection through Internet resources” for 189 thousand rubles. The contractor must place banners “with information about HIV/AIDS on Internet resources of the Belgorod region.” This includes a news site (attendance of at least 100 thousand people per month), social media(on the pages of the local HIV prevention center on the VKontakte and Odnoklassniki networks), an online dating portal.

The performer must also create a “Psychologist Consultation” section in Odnoklassniki. There, “users will be able to anonymously ask questions to a psychologist.” And on the VKontakte network, it is necessary to create a section “First hand”, “where HIV-positive people or their relatives can tell their story anonymously.”

“There are no strategic programs to combat AIDS in the regions,” says Vadim Pokrovsky. “As a result, they will print and hang several posters and leaflets - and that’s where the prevention ends.

It turns out a vicious circle:

“People don’t even suspect how difficult the situation with HIV infection is in Russia,” notes Vadim Pokrovsky. — Information is the main method of combating the spread of the disease. In addition, this also saves costs: after all, what less people becomes infected, the less you will have to treat later.

HIV in the media

Over a year and a half (January 2015 to May 2016), Russian media published 34,627 news reports on the topic of HIV.

Key words and phrases: “a antiretroviral therapy and everything connected with it" (3008 news), "l medicine against HIV" (1307 news), "n grab Money"(172 news), "p warnings about the possibility of infection" (108 news), information messages educational nature about what HIV/AIDS is (78 news).

Forewarned is forearmed, but for some reason in this war such weapons do not always work. So far, HIV is winning, and the media are publishing more and more reports from the front: “Since the beginning of the year, 378 people in Udmurtia have become infected with HIV,” “More than 600 Novosibirsk residents died from HIV in 2015.”

What to do?

The growth graph of HIV incidence in Russia is increasingly beginning to resemble an exponential one. If we do not immediately begin to take measures to reduce the cost of therapy and develop truly effective prevention, in addition to printing leaflets and placing banners on websites, the country will “develop a scenario of a generalized HIV/AIDS epidemic, in which by 2020 the number of patients will increase by 250%.”

Well, until the process has begun: look out the window, maybe a paddy wagon with the sign HIV is already standing at your entrance.

Official statistics of HIV and AIDS in Russia

At the beginning of 2017 the total number of cases of HIV infection among Russian citizens has reached 1,114,815 people(there are 36.7 million HIV-infected people in the world). Of them died for different reasons 243,863 HIV-infected according to the Rospotrebnadzor monitoring form “Information on activities 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 was 1 167 581 people, of which 259,156 people died for various reasons ( in the 1st half of 2017 has already died 14 631 HIV-infected people, that 13.6% more than in 6 months of 2016). Population attack rate Russian Federation HIV infection in 2017 amounted to 795,3 infected with HIV per 100 thousand population of Russia.

In 2016. It revealed 103 438 new cases of HIV infection among Russian citizens (excluding those identified anonymously and foreign citizens), which is 5.3% more than in 2015. Since 2005, the country has registered an increase in the number of new identified 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.

In terms of the growth rate of HIV infection, Russia has taken third place after the Republic of South Africa and Nigeria.

For the 1st half of 2017 detected in Russia 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 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. Increasing rate of growth of new cases 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.

HIV in regions and cities

In 2016, according to the incidence rate in the Russian Federation The following regions and cities were in the lead:

1. Kemerovo region (228.8 new cases of HIV infection per 100 thousand population registered - total 6,217 HIV-infected), incl. in the city Kemerovo 1,876 HIV-infected.
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 in the city Irkutsk registered 2 450 new people infected with HIV, in 2017 - 1,107. Almost 2% of the population of the Irkutsk region are infected with HIV.
3. Samara region (161.5%000 - 5,189 HIV-infected, incl. in the city of Samara there are 1,201 HIV-infected people), 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),
6. 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, 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.
7. Tomsk region (138.0%000 - 1,489 people.),
8. Novosibirsk region (137.1%000) regions (3,786 people.), incl. in the city Novosibirsk 3 213 HIV-infected people.
9. Krasnoyarsk Territory (129.5%000 - 3,716 people.)
10. Perm region (125.1%000 - 3,294 people.)
11. Altai Territory(114.1%000 - 2,721 people.)
12. Khanty-Mansiysk Autonomous Okrug (124.7%000 - 2,010 people)
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 7 months of 2017, 1184 cases were identified, the incidence rate was 59.8% 000.
15. Kurgan region (110.1%000 - 958 people.)
16. Ulyanovsk region (97.2%000 - 1,218 people.), per 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.) region, 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.), per 1 sq. 2017 - 688 people. (16.9%000).
23. Moscow (62.2%000 - 7 672 people)

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

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 increase (speed, growth rate of the emergence of new HIV cases per unit of time) incidence in 2016 was observed in 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

Affection 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.

To the most affected subjects of the Russian Federation relate:

1. Sverdlovsk region (1647.9% of 000 people living with HIV per 100 thousand population are registered - 71354 people. In 2017, there were already about 86 thousand people infected with HIV), including in the city of Yekaterinburg More than 27,131 HIV-infected people have been 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.
2. Irkutsk region (1636.0%000 - 39473 people). Total number of HIV-infected people identified at the beginning 2017— 49,494 people, at the beginning of June (almost six months) 2017 51,278 people diagnosed with HIV infection are registered. IN city ​​of Irkutsk Over the entire period, more than 31,818 people were identified.
3. Kemerovo region (1582.5% 000 - 43000 people), including in the city of Kemerovo More than 10,125 patients with HIV infection are registered.
4. Samara region (1476.9% 000 - 47350 people),
5. Orenburg region (1217.0% 000 - 24276 people) regions,
6. Khanty-Mansiysk Autonomous Okrug (1201.7% 000 - 19550 people),
7. Leningrad region (1147.3% 000 - 20410 people),
8. Tyumen region (1085.4% 000 - 19768 people), as of July 1, 2017 - 20787 people.
9. Chelyabinsk region (1079.6% 000 - 37794 people),
10. Novosibirsk region (1021.9% 000 - 28227 people) regions. As of May 19, 2017 in the city of Novosibirsk More than 34 thousand HIV-infected people are registered - every 47 residents of Novosibirsk have HIV (!).
11. Perm region (950.1% 000 - 25030 people),
12. G. Saint Petersburg(978.6%000 - 51140 people),
13. Ulyanovsk region (932.5% 000 - 11,728 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 - 12,741 people), as of August 1, 2017, 16,099 cases of HIV infection were registered, the incidence rate is 813.7% 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)

Age structure

Most high level defeat HIV infection of the population is observed in the group 30-39 years old, 2,8% Russian men at the age of 35-39 years lived with an established diagnosis of HIV infection. Women become infected with HIV at more at a 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 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%.

Age and gender of HIV-infected people.

HIV infection was predominantly detected in Russians aged 30-40 years (46.9%) and 40-50 years (19.9%), the share of young people aged 20-30 decreased to 23.2%. An increase in the proportion of newly identified cases was also observed in older age groups, cases of sexually transmitted HIV infection in old age have become more frequent.

It should be noted that when low level of testing coverage among adolescents and young people, more than 1,100 cases of HIV infection are registered annually among people aged 15-20 years. According to preliminary data 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 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, Chuvash Republic, Samara region, Primorsky region, Tula region, Krasnodar, Perm regions, Kurgan region.

Treatment coverage

Registered 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 Rospotrebnadzor monitoring form.

In 2016, 285,920 patients received antiretroviral therapy in Russia, including patients who were in prison. In the 1st half of 2017 received antiretroviral therapy 298,888 patients, approximately 100,000 new patients were added to therapy in 2017 (there probably won’t be enough drugs for everyone, since the purchases were 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 in Russia there was tested for HIV 30,752,828 blood samples of Russian citizens and 2,102,769 blood samples of foreign citizens. 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 results among Russians in the immunoblot for 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.

Distribution of HIV-infected people by mode of infection.

conclusions

1. In the Russian Federation in 2016, the HIV epidemic situation continued to worsen and the 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.
2. The incidence of HIV infection remained high, the total number and number of deaths of HIV-infected people increased, and the spread of the epidemic from vulnerable groups to the general population intensified.
3. 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.
4. It is necessary to intensify organizational and preventive measures to counter the HIV epidemic in the country.

A real AIDS epidemic has begun in Russia - a critical level of HIV incidence has already been recorded in 10 regions of the country, as officially reported by the Russian Ministry of Health.

According to data announced by the Minister of Health Veronika Skvortsova, in 57% of cases the source of HIV infection is injections with “dirty” syringes, mainly among heroin addicts. At the same time, the most deplorable situation is observed in regions of Russia located along the routes of major drug trafficking channels.

The most critical situation with HIV incidence in 2016 is observed in the Irkutsk, Sverdlovsk, Samara and Kemerovo regions, where for every 100 thousand living population, from 1,500 to 1,700 people are already infected with HIV.

At the same time, for Last year The rate of new cases of the disease has increased sharply - the record holder here is the Kemerovo region, where 234.5 cases of infection per 100 thousand population were recorded over the year. According to estimates, if this rate continues, in just 6 years the number of infected people in the region will double.

In medium-sized and large cities, the HIV situation is usually worse than in rural areas. The authorities of Yekaterinburg, for example, admitted that one out of every 50 city residents is already infected. That is, for clarity, you can imagine that in every filled city trolleybus or bus there is at least one person with HIV.

As is known from general statistics, as of January 1, 2016, there were officially 1,006,388 citizens registered as HIV-infected living in Russia. At the same time, 212,578 HIV-infected people died in 2015, which is 12.9% more than in 2014 (27,564 people).

According to the well-known Russian expert dealing with AIDS, Academician Pokrovsky, in fact, to the 1 million officially infected with HIV, we can safely add at least another 1 million unregistered patients. At the same time, only 30% of the first million are at least trying to get treatment.

The reason is the banal absence in Russia of clinics with HIV treatment programs, for which funds are simply not allocated. The country's main federal AIDS center, located in Moscow, is in disrepair. And over the years, the government and the Ministry of Health have not even managed to create a suitable Internet resource with systematized information for those infected, databases of clinics and rehabilitation programs offered to patients.

According to Pokrovsky, the situation in Russia with the AIDS epidemic can only be saved by emergency measures with funding in the amount of no less than 100 billion rubles. And their effective distribution in three areas - prevention, detection and treatment. However, according to preliminary data for 2017, the Ministry of Health does not provide such funds in the budget.