Prevalence of human immune deficiency virus infection in the territories of the Russian Federation in 2021

In recent years there has been a decline in the number of new cases of human immunodeficiency virus (HIV) infection and in that of deaths associated with this infection in the world, but since modern therapy prolongs survival in people living with HIV (PLHIV), their total number is constantly increasing. At the same time, the prevalence of the disease is growing unevenly in different geographical regions and population groups. Objective. To assess trends in the development of the HIV epidemic in different territories of the Russian Federation in 2021. Materials and methods. The authors analyzed personalized data on all HIV infection cases identified in Russia in 1987-2021; data from federal state statistical observation forms Nos. 2, 4, 61, and 11; and data from the departmental monitoring form of the Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being. The HIV epidemic stages in the country’s regions were determined according to the WHO and the UNAIDS recommendations. Results. In 1987to December 31, 2021, Russia registered a total of1,562,570 Russians with a laboratory-confirmed diagnosis of HIV infection; 424,974 people of them died. In 2021, a total of 71,019 HIV-infected Russians were diagnosed for the first time and 34,093 deaths were reported; as a result, the overall HIV incidence rates increased to 782.0per 100,000. At the end of2021, there were 1,137,596 PLHIV, i.e. 0.8% of the total population of Russia or 1.5% of the population aged 15 to 49 years. 67.8% of the PLHIV first identified in 2021 reported to have heterosexual contacts only; 27.8% used intravenous narcotic drugs; 3.0% had homosexual contacts, which indicates that the heterosexual population that is not particularly vulnerable groups is increasingly involved in the epidemic process. At the same time, the HIV incidence rates reached high levels among the most vulnerable groups: injecting drug users (27%), men who had sex with men (13%). In 2021, the concentrated HIV epidemic stage was observed in the Russian Federation as a whole and in its most regions, since in 2019 the incidence of HIV infection did not exceed 1% and was significantly more than 5% in vulnerable population groups. At the same time, the generalized HIV epidemic stage was determined in 27 regions, the disease was diagnosed in more than 1% of pregnant women. These regions were inhabited by 35,9% of the population of the Russian Federation. In 2021, only 3.3% lived in 9 regions with the initial HIV epidemic stage. Conclusion. In 2021, the generalization of the epidemic process of HIV infection continued in the Russian Federation due to the spread of HIV among both heterosexuals and in vulnerable groups, which indicates the insufficient effectiveness of antiepidemic measures.

HIV infection, morbidity, incidence, HIV infection epidemic stages, Russian Federation, Federation’s subjects