Highest level of AIDS. Which countries are most susceptible to the spread of HIV?

Highest level of AIDS. Which countries are most susceptible to the spread of HIV?
Highest level of AIDS. Which countries are most susceptible to the spread of HIV?
24.09.2019

The topic of the article is not the most pleasant, but “forewarned is forearmed”, the problem exists and simply turning a blind eye to it is unforgivable carelessness. Travelers often take risks with their health, fortunately, with fewer consequences, but it’s still not worth putting yourself in danger.

South Africa

Although the country is the most developed in African continent, the number of HIV-infected people here is a record - 5.6 million. This despite the fact that there are 34 million patients in the world, and the population of South Africa is about 53 million, that is, more than 15% are living with the virus.

What you need to know: Most people living with HIV are blacks from inner-city suburbs. It is this group that is in the worst social conditions with all the ensuing consequences: drug addiction, promiscuous sex, unsanitary conditions. The most patients were recorded in the provinces of KwaZulu-Natal (capital - Durban), Mpumalanga (Nelspreid), Freestate (Blomfontien), North West (Mafikeng) and Gauteng (Johanesburg).

Nigeria

There are 3.3 million HIV-infected people here, although this is less than 5% of the population: Nigeria recently supplanted Russia, taking 7th place in the world - 173.5 million people. IN big cities the disease spreads due to antisocial behavior, and in rural areas due to constant labor migration and “free” morals and traditions.

What you need to know: Nigeria is not the most hospitable country and Nigerians themselves are well aware of this. Therefore, the receiving party will certainly take care of safety and warn against dangerous contacts.

Kenya

The country accounts for 1.6 million infected people, slightly more than 6% of the population. At the same time, women are more likely to suffer from the disease - about 8% of Kenyans are infected. As in many African countries, the status of women, and therefore their level of security and education, is still very low.

What you need to know: Safari in national park or a beach and hotel holiday in Mombasa are completely safe activities, unless, of course, you specifically look for illegal entertainment.

Tanzania

Quite a friendly country for tourists with a lot of interesting places, is also dangerous from the point of view of HIV infection, although not like many other countries in Africa. According to recent studies, the HIV/AIDS incidence rate in Tanzania is 5.1%. There are fewer infected men, but the gap is not as large as, for example, in Kenya.

What you need to know: Tanzania, by African standards, is a fairly prosperous country, so if you follow the obvious rules, the threat of infection is minimal. The percentage of infected people is high, more than 10, in the Njobe region and the capital Dar es Salaam. Luckily, both of them are far from the tourist route, unlike Kilimanjaro or Zanzibar Island.

Mozambique

The country is deprived not only of attractions, but also of basic infrastructure from hospitals to roads and water supply. Moreover, many consequences civil war still not resolved. Of course, the African country in this state could not avoid the epidemic: according to various estimates, from 1.6 to 5.7 people were infected - conditions simply do not allow for an accurate study. Due to the widespread spread of the immunodeficiency virus, outbreaks of tuberculosis, malaria and cholera often break out.

Uganda

A country with good potential for classic safari tourism, which it has been actively developing lately. Plus, Uganda has been and remains one of the most progressive countries in terms of HIV prevention and diagnosis in Africa. The first specialized clinic was opened here, and there are disease testing centers throughout the country.

What you need to know: the risk groups are the same as everywhere else: drug addicts, former prisoners - it will not be difficult for a sane tourist not to cross paths with them.

Zambia and Zimbabwe

These countries are similar in many ways, even the main attraction is one between them: it is located right on the border - tourists can come to it from both sides. In terms of living standards and AIDS incidence, the countries are also not far from each other - in Zambia there are almost a million infected, in Zimbabwe - 1.2. This is an average figure for Southern Africa - from 5% to 15% of the population.

What you need to know: there are problems with the provision of medicines; in addition, in rural areas, many self-medicate and practice useless rituals. Therefore, the disease, typical of cities, reached remote areas.

India

There are 2.4 million HIV-infected people here, although against the backdrop of a population of 1.2 billion this does not look so scary - less than 1%. The main risk group is sex industry workers. 55% of Indians living with HIV live in four southern states - Andhra Pradesh, Maharashtra, Karnataka and Tamil Nadu. In Goa, the incidence rate is far from the highest for 0.6% of men and 0.4% of women.

What you need to know: fortunately, HIV infection, unlike many other tropical diseases, depends indirectly on unsanitary conditions. Outright dirt and cramped conditions are normal for India. The main thing, as, by the way, in any country, is to try not to appear in in public places, if there are wounds and cuts on the body, do not wear open shoes in the city, and we don’t even talk about dubious entertainment.

Ukraine

Eastern Europe, unfortunately, has been last decades showed positive dynamics in the incidence of HIV/AIDS, and Ukraine consistently tops this sad list. Today in the country a little more than 1% of people are HIV-infected.

What you need to know: several years ago, unprotected sex became the method of spreading the disease, overtaking injections with dirty syringes. The Dnepropetrovsk, Donetsk, Odessa and Nikolaev regions are unfavorable. There, per 100 thousand inhabitants there are 600-700 infected. Kyiv, where tourists most often come, has an average level, and Transcarpathia has the lowest level in the country.

USA

America ranks 9th in the world in the number of HIV carriers - 1.2 million people. Such a high rate in one of the most prosperous countries is due to the high level of drug addiction, unresolved social contradictions, and active migration. And the riotous, dissolute 60s were not in vain for the health of the nation. Of course, the disease is concentrated on specific groups of people who, most often, live not so much separately from everyone else, but localized, in “bad” areas.

What you need to know: here are ten cities where the percentage of HIV-positive patients is the highest (in descending order): Miami, Baton Rouge, Jacksonville, New York, Washington, Columbia, Memphis, Orlando, New Orleans, Baltimore.

Photo: thinkstockphotos.com, flickr.com

According to the report announced at the Fifth international conference on HIV, held in March 2016 in Moscow, the following ranking of 10 countries was compiled by the number of people infected with AIDS. The incidence of AIDS in these countries is so high that it has the status of an epidemic.

AIDS– acquired immune deficiency syndrome due to HIV infection. It is the last stage of the disease of an HIV-infected person, accompanied by the development of infection, tumor manifestations, general weakness and ultimately leads to death.

1.2 million patients out of 14 million population. Therefore, it is not surprising that the average life expectancy there is 38 years.

9th place. Russia

In 2016, the number of people infected with AIDS in Russia exceeded 1 million, according to Russian healthcare, 1.4 million according to the EECAAC-2016 report. Moreover, the number of infected people has been actively growing over the past few years. For example: every 50th resident of Yekaterinburg is HIV positive.

In Russia, more than half of the patients became infected through a needle when injecting a drug. This route of infection is not the main route of infection for any country in the world. Why are there such statistics in Russia? Many say this is due to the shift away from the use of oral methadone as an injectable drug replacement.

Many people mistakenly believe that the problem of infection of drug addicts is only their problem; it is not so scary if the “scum of society” acquire diseases that lead to death. A person who uses drugs is not a monster who can be easily identified in a crowd. He for a long time leads a completely normal life. Therefore, spouses and children of drug addicts are often infected. Cases cannot be excluded when infection occurs in clinics and beauty salons after poor disinfection of instruments.

Until society realizes real threat, until casual partners stop assessing the presence of STDs “by eye”, until the government changes its attitude towards drug addicts, we will rapidly rise in this ranking.

8th place. Kenya

6.7% of the population of this former English colony are HIV carriers, namely 1.4 million people. Moreover, the infection rate is higher among women, since the social level of the female population is low in Kenya. Perhaps the rather free morals of Kenyans also play a role - they approach sex easily.

7th place. Tanzania

Of the 49 million population of this African country, just over 5% (1.5 million) have AIDS. There are areas where the infection rate exceeds 10%: these are Njobe, far from tourist routes, and the capital of Tanzania, Dar es Salaam.

6th place. Uganda

The government of this country is making great efforts to combat the HIV problem. For example, if in 2011 there were 28 thousand children born with HIV, then in 2015 – 3.4 thousand. The number of new infections in adults also decreased by 50%. The 24-year-old king of Toro (one of the regions of Uganda) took control of the epidemic into his own hands and promised to stop the epidemic by 2030. There are one and a half million cases in this country.

5th place. Mozambique

More than 10% of the population (1.5 million people) are infected with HIV, and the country has no own strength to fight the disease. About 0.6 million children in this country are orphans due to the death of their parents from AIDS.

4th place. Zimbabwe

1.6 million infected per 13 million inhabitants. Widespread prostitution, lack of basic knowledge about contraception and general poverty led to these figures.

3rd place. India

Official figures are about 2 million patients, unofficial figures are much higher. Traditional Indian society is quite closed; many people keep silent about health problems. There is practically no educational work with young people; talking about condoms in schools is unethical. Hence, there is almost complete illiteracy in matters of contraception, which distinguishes this country from African countries, where getting condoms is not a problem. According to surveys, 60% of Indian women have never heard of AIDS.

2nd place. Nigeria

3.4 million HIV patients out of 146 million population, less than 5% of the population. The number of infected women is higher than men. Since there is no free healthcare in the country, the worst situation is in the poor.

1 place. South Africa

Country with the highest incidence of AIDS. Approximately 15% of the population is infected with the virus (6.3 million). About a quarter of high school girls already have HIV. Life expectancy is 45 years. Imagine a country where few people have grandparents. Scary? Although South Africa is recognized as the most economically developed country in Africa, most of the population lives below the poverty line. The government is doing a lot of work to curb the spread of AIDS; free condoms and testing are provided. However, poor people are convinced that AIDS is a white invention, just like condoms, and therefore both should be avoided.

Bordering South Africa, Swaziland is a country with a population of 1.2 million people, half of whom are HIV-positive. The average Swazilander does not live to be 37 years old.

Only a third of officially registered Russians with HIV receive antiretroviral therapy (ART) (and this is one of the worst indicators in the world). Due to auction failures, people are left without medicine for months, and the quality of “economical” drugs is such that many quit treatment, unable to bear the side effects. As a result, AIDS deaths are rising in the country.

About this in advance world day fight against AIDS was discussed at one of the few independent platforms - organized social movement“Patient control” press conference “HIV infection in Russia: treatment or epidemic.”

The HIV epidemic in Russia is becoming increasingly alarming. According to UNAIDS, Russia has become the third country in the world in terms of the number of new cases of HIV infection after South Africa and Nigeria. And according to experts from PEPFAR (the United States President's Emergency Organization for AIDS Relief), in 2017 Russia takes first place in the rate of spread of HIV infection.


“We examine, but we also need to treat”

Reporting on the success of the fight against HIV, the official Ministry of Health reports unprecedented testing coverage (trains with mobile laboratories even travel around the country) and support domestic producers antiretroviral medicines. However, the statistics of the epidemic spreading across the country are disappointing.

According to the head of the Federal Scientific and Methodological Center for the Prevention and Control of AIDS, Vadim Pokrovsky, the annually identified number of new cases of HIV infection continues to grow and amounts to about 100 thousand per year. And this could be attributed to the achievements of the Ministry of Health, which promotes testing, if another indicator had not been growing - the number of deaths due to HIV-positive status. According to him, in 2016, according to Rosstat, 18.5 thousand people died from AIDS (in 2014 - 12 thousand, in 2015 - 15 thousand). However, in general, more than 30 thousand people with HIV died, and the cause of death of the remaining 15 thousand is “a question that requires study,” the expert believes.

Speaking about the situation in the world as a whole, Pokrovsky admitted that the increase in the number of HIV-infected people is not an absolutely negative indicator - treatment has appeared, thanks to which people who previously died in a few years can live longer. But this applies to Russia with great reserve. “The tactics and strategy to combat HIV infection are questionable... Unfortunately, only a third of registered people living with HIV are receiving treatment. That is, we examine, but we do not carry out the second part of the “examine and treat” strategy,” Pokrovsky said. Left untreated, people slowly die themselves and infect others.

Behind the entire planet

The situation with access to treatment in Russia is “alarming” and foreign specialists. According to the regional director for Eastern Europe and Asia Joint United Nations Program on HIV/AIDS (UNAIDS) Vinay Saldana, more than half of the world's people with HIV infection (21 million out of 37 million) are on life-saving antiviral treatment. However, out of 900 thousand Russians who have a confirmed diagnosis of HIV infection, only a little more than 300 thousand receive such treatment. And this suggests “that there is a serious gap in access to treatment in Russia.”

Saldana recalled that last year Russia signed up to specific goals adopted as part of the UN General Assembly declaration, according to which, by the end of 2020, 90% of all people living with confirmed HIV status should be on treatment. And as a result of this treatment, an “undetectable viral load” should be achieved. That is, the concentration of the virus in the body should be so low that the risk of HIV transmission is eliminated even through unprotected sex, Saldana explained.

Medicinal "vacations"

Representatives of Patient Control “working on the ground” spoke about the problems faced even by those patients who are formally undergoing treatment.

According to the consultant of the website PEREBoi.RU (Pereboi.ru), which collects information on the provision of drugs for the treatment of HIV infection, hepatitis and tuberculosis, Yulia Vereshchagina, from January 1 to November 27, 2017, the site received more than 700 messages from 52 regions of Russia. But in reality, there are much more patients facing interruptions - many are afraid to complain, or simply do not know about this possibility, Vereshchagina said. According to her, in some regions, contracts for the supply of ARV drugs had not been concluded even by mid-May. By August, even Moscow joined the leaders in the number of complaints. The excitement subsided only in September; at the end of the year, money was finally allocated from the Reserve Fund.

The main problems that patients complain about:

  • refusal to dispense medications (patients are offered to take a “vacation” from treatment)
  • issuing an incomplete and ineffective treatment regimen
  • refusal to prescribe ARV therapy in case of reduced immunity, including at the stage of AIDS
  • replacing medications without medical indications
  • poor tolerability or intolerance to drugs given to replace missing ones
  • refusal to conduct tests to monitor treatment - reports of treatment “at random” were received from 20 regions of Russia

“People diagnosed with HIV need to take therapy daily,” Vereshchagina recalled. - Late appointment, interrupting or taking defective regimens leads to serious consequences, including infections, the treatment of which takes months, and death. With the help of patients, the so-called “reserve first aid kits, mutual aid first aid kits” have been created, thanks to which we are trying to help those who are left without treatment in a serious condition. But those who have not yet been prescribed treatment are forced to wait for officials to respond to their requests. Not everyone is waiting. This year, I personally have repeatedly encountered situations where patients died from AIDS without receiving treatment.”

In addition to patient complaints, Patient Control also has responses from officials confirming serious interruptions and queues for therapy appointments: patients in need of treatment are forced to be denied it due to a shortage of drugs.

Main causes of interruptions:

  • Late announcement of auctions- The Ministry of Health of the Russian Federation posted the first auctions only on February 24, 2017 on the State Procurement website
  • Lack of funds - In February 2017, the Ministry of Health appealed to the regions with a request to involve the local budget in the purchase. At the end of February, auctions were announced in 15 regions out of 85. ( Non-standard approach demonstrated by the deputy. Minister of the Ministry of Social Policy of the Sverdlovsk Region - suggested that patients look for successful HIV+ businessmen in order to create an ARV drug fund)
  • Delivery delays- by the end of May, ARV drugs were supposed to be supplied to all regions, but in fact they began to arrive only in June.
  • Silence of patients- people with HIV, fearing publicity, do not communicate with other patients. Many are afraid that because of complaints they will be left completely without medicine.
  • Silence of problems by government agencies

Better is worse, but more: features of domestic availability

Natalya Egorova, monitoring specialist at the Treatment Preparedness Coalition (ITPCru), spoke about the results of an analysis of more than 1.5 thousand auctions conducted by the Ministry of Health and regions of the Russian Federation. The total amount of purchases in 2017 amounted to about 24 billion rubles. In terms of patients, this is about 352 thousand annual courses - 120 thousand more than the year before. This was achieved by reducing prices for a number of drugs and, most importantly, economical choice assortment.

The cost of the cheapest regimen among the most used regimens in our country is 11,393 rubles (first-line treatment regimen). The cost of the most expensive of the most frequently used regimens is 88,570 rubles (second-line treatment regimen). The cost is easy to use and relatively modern drug“3-in-1”, emtricitabine/tenofovir/rilpivirine 200/300/25 mg is 320,973 rubles per patient per year (1,283 annual courses were purchased in 2017).

“Almost half of all purchased drugs were efavirenz,” said Egorova. - And although this drug is the so-called “gold” standard for naive patients, it has so many negative side effects that people can’t stand it and quit treatment.” According to the data she provided, 19% of patients canceled treatment after an average of 294 days, the reason for this in 71% of cases was toxicity affecting the central nervous system. According to official data, a total of 21,903 patients interrupted ARV therapy in 2017. In turn, this leads to a reduction in the time spent on the first line of ART, an increase in the cost of the subsequent regimen, and even to the emergence of primary resistance and a lack of options for choosing an ART regimen in the future. “That is, one way or another, this drug cannot be a panacea and be prescribed en masse to all patients without exception,” Egorova said.

In addition, due to the fact that procurement prioritizes price over quality, convenient combination drugs are broken down into monocomponents, which can also affect patient adherence to treatment, Egorova said. Thus, in 2017, almost 30 thousand courses of the combined drug abacair/lamivudine were administered. “In general, we can conclude that centralization of procurement made it possible to increase treatment coverage and significantly save budget resources, Egorova summarized. - However, the procurement of ARV drugs cannot be guided by short-term goals. ARV therapy is lifelong, and it is necessary to plan purchases based on pharmacoeconomic principles and cost-effectiveness analysis of ARV treatment regimens prescribed for at least a five-year period. There are such studies and why not be guided by them?”

HIV in Russia has spread beyond marginalized groups

According to Federal Center on the prevention and control of AIDS, the majority of Russians who were diagnosed with HIV in 2017 were infected through heterosexual contact. Another 1.4% of those infected are children born to mothers with the immunodeficiency virus. In addition, over the 10 months of this year, 12 cases of suspected HIV infection were registered during the provision of medical care. And also 12 cases of HIV infection in places of detention due to the use of non-sterile instruments for non-medical purposes. 46.1% of HIV-infected people identified in 2017 were infected through drug use, and 2.3% through homosexual contacts.

The immunodeficiency virus was first identified by scientists in 1983. It was then that the etiological cause of the development of acquired immunodeficiency syndrome was established. However, the attention of specialists is still focused on such a dangerous disease as HIV. Statistics show that it is constantly becoming more common. And the saddest thing is that in modern medicine there are no effective methods treatment of pathology.

Basic statistics of HIV-infected people

The disease is constantly progressing and spreading throughout the population. This is officially confirmed by statistics on the incidence of HIV and AIDS. According to the latest data from scientists, today the number of people infected with HIV reaches 40 million people. Of these, 37.5% contracted the infection in the last 2 years, which is about 15 million.

At the same time, the pathology is constantly progressing, new strains of the pathogen appear as a result of modification. This greatly complicates the process of treating patients.

Infection with a retrovirus occurs more often through sexual contact or through the use of unsterile needles, which is often observed among drug addicts. The number of HIV-infected people is constantly increasing, and in order to slow down the progression of the disease, experts strongly recommend periodic testing for AIDS. Early detection allows you to prescribe full-fledged antiretroviral therapy. According to statistics, only 9.5 million HIV (AIDS) patients receive quality treatment, which is less than a quarter of the total number of carriers.

HIV (AIDS) statistics in Russia

In the Russian Federation, the issue of immunodeficiency is especially acutely discussed twice a year - on the Day against this disease (December 1) and in early May, when the Day of Mourning for those killed as a result of infection with a retrovirus is declared.

The statistics of HIV-infected people in Russia is constantly changing, and not in better side. Behind last years The number of infected people has increased significantly and now reaches 250 thousand people. Experts say that the problem is becoming enormous. Today, the infection is mainly transmitted through sexual and parenteral routes.

Statistics of AIDS patients in Russia confirm that the bulk of those infected are young people aged 19 to 29 years. If we take into account injection drug addicts, then of those who sought medical help, 78% of them were diagnosed with the immunodeficiency virus.

During sexual intercourse without condoms, a considerable number of patients are also infected. It is difficult to determine exactly how many people with HIV received the pathogen this way. However, statistics on HIV infection in Russia state that of those infected through sexual contact, more than half are women. This is due to anatomical features. Women tend to have more close contact with body fluids, particularly semen. It contains a high concentration of retrovirus, which is able to penetrate the body through microcracks in the vaginal mucosa that form during sexual intercourse.

A less common method of transmission is from mother to infant. HIV transmission statistics indicate that over the entire period of the disease, more than 6 thousand cases of birth of infected babies were registered. The infants' mothers were women of fertile age.

As for the male half of the population, according to statistics in Russia, about 2% of the stronger sex is infected with AIDS. The age of patients is in the range of 23-40 years. Among them, infection occurred in the following ways:

  • as a result of drug use - 53%;
  • homosexual relationships - 1.5%;
  • with unprotected sexual intercourse - 43%;
  • boys who received the infection in the womb or during childbirth from their mother - 2.5%.

Why is HIV infection spreading so quickly? Statistics confirm that the vast majority of infected people received their “dose” of the retrovirus through a syringe. In Russia, more than half of drug addicts use potent substances by injection, which poses a huge risk, because syringes are almost always used multiple times and for several people.

Additionally, the progression of AIDS can be explained by the lack of a clear program to combat retroviral infection. At the very beginning, when AIDS began to spread in the Russian Federation, statistics showed a sharp jump - an increase in the number of cases. For several years, international associations against immunodeficiency have allocated a certain amount, which was used to provide antiretroviral therapy to patients. When Russia was recognized as a high-income country, this help was withheld, and the funds allocated from the state budget became insufficient to provide quality therapy to patients.

How many HIV-infected people are there in specific regions of Russia?

The situation with the spread of immunodeficiency leaves much to be desired, however, the homogeneity of the disease is somewhat diverse - in the Russian Federation, some regions require more attention from doctors, while in others the rate of transmission dangerous disease do not cause concern. According to experts, the saddest situation is observed in the Irkutsk region. Here, retrovirus infection reaches 1.5% of the total population.

How many people have HIV (AIDS) and how does it become infected? More than 75% of patients in this region are infected as a result of unprotected sexual intercourse, with a certain percentage occurring in homosexual relationships. The remaining 25% experience pathology when injecting drugs; a small number occur in children born to HIV-positive mothers.

Also among the leaders in the progression of infection with immunodeficiency are the Sverdlovsk, Kemerovo regions, Perm, and Khanty-Mansiysk Okrug. No more rosy statistics for HIV infection in Russia emerge in the following regions:

  • Altaic;
  • Tomsk;
  • Kurgansky;
  • Novosibirsk;
  • Samara;
  • Tyumen;
  • Ulyanovsky;
  • Tverskoy;
  • Omsk;
  • Murmansk;
  • Orenburg;
  • Chelyabinsk;
  • Ivanovsky;
  • Leningradsky.

How many AIDS patients are there in the capital of the country can be answered more precisely. HIV statistics in Moscow at the beginning of the 21st century did not cause much concern among doctors, but this picture quickly changed in the opposite direction. In recent years, the retrovirus has begun to spread among residents of the capital by leaps and bounds. In 2016, more than 10 thousand infected people were registered. Moreover, half of them received the retrovirus through unprotected sex. 23% of those infected in this way became ill as a result of homosexual intercourse. HIV (AIDS) statistics in the regions of Russia remain unfavorable and require the adoption of certain measures to reduce the rate of spread of the disease.

The situation in the world: how quickly is AIDS spreading?

How many AIDS patients are there on the entire planet, which countries are one step away from developing an epidemic? The number of infected people varies from country to country. The most deplorable situation is observed in Africa, or more precisely in the South. The inhabitants of these regions make up only 10% of the total population of the planet. Moreover, out of the total number of HIV-infected people (about 40 million), 25 million are on this continent. These numbers are shocking.

The most unfavorable statistics of people infected with HIV (AIDS) are observed in the following countries of the world:

  • South Africa - more than 5 million;
  • India - 6.5 million;
  • Ethiopia - more than 4 million infected;
  • Nigeria - 3.6 million;
  • Mozambique - almost 2 million;
  • Kenya, Zimbabwe - 1.7 million infected each;
  • USA - 1.3 million;
  • China and Russia have about 1 million retrovirus carriers.

If we take into account the European continent, then approximately half of all infected people are residents of Ukraine and Russia. The main route of transmission of the virus in these countries is parenteral.

The HIV infection rate by country raises concerns for the future of humanity; analyzing the statistics, it can be argued that the massive spread is occurring in underdeveloped regions.

According to statistics, in countries infected with AIDS, the leading route of transmission is sexual and parenteral. The danger of the disease also lies in the fact that most patients do not want to believe in infection and refuse antiretroviral therapy. It can take more than 10 years from the infection to the stage of AIDS, but this indicator depends on the immune defense. In the absence of quality treatment, the disease develops much faster and leads to irreversible consequences.

Over the entire period of known immunodeficiency, more than 24 million patients died from it. At the same time, patients who received timely therapy were able to live fully for decades, no different from healthy people.

It is difficult to say exactly how many people are infected with HIV (AIDS), since the pathology is constantly spreading. However, scientists do not lose hope of finding effective drug and defeat the retrovirus completely.

Official statistics of HIV and AIDS in Russia

At the beginning of 2017 total number cases of HIV infection among Russian citizens have reached 1,114,815 people(there are 36.7 million HIV-infected people in the world). Of them died By various 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 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 newly identified cases of HIV infection, in 2011-2016 annual growth 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 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 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 region(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 the Jewish Autonomous Region.

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 have been registered - every 47 residents of Novosibirsk have HIV (!).
  11. Perm region (950.1% 000 - 25030 people),
  12. St. 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 a younger age; already in the age group of 25-29 years, about 1% were infected with HIV; the proportion of infected women in the age group of 30-34 years is even higher - 1.6%.

Has changed radically over the past 15 years age structure among newly diagnosed patients. 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 greatest number 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 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, Ulyanovsk region, Republic of Adygea, Tambov region, Chukotka Autonomous Okrug, Chuvash Republic, Samara region, Primorsky region, Tula region, Krasnodar, Perm region, Kurgan region.

Treatment coverage

Registered at the dispensary in specialized medical organizationsin 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 purchase was based on 2016 figures). Treatment coverage in 2016 in the Russian Federation was 32.8% of the number of registered persons diagnosed with HIV infection; among those undergoing dispensary observation, 42.3% of patients were covered by antiretroviral therapy. The achieved treatment coverage does not serve as a preventive measure and does not allow to radically reduce the rate of spread of the disease. The number of patients with active tuberculosis in combination with HIV infection is growing; the largest number of such patients is registered in the regions of the Urals and Siberia.

HIV testing coverage

In 2016 in Russia there was tested for HIV 30,752,828 blood samples Russian citizens and 2,102,769 blood samples from foreign citizens. Total tested serum samples of Russian citizens increased by 8.5% compared to 2015, and decreased by 12.9% among foreign citizens.

In 2016 it was revealed maximum amount positive immunoblot results in Russians over 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 during 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 deteriorate 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 actions to combat the HIV epidemic in the country.