The social and economic burdens of HIV in the Russian Federation

Despite the measures taken to fight the HIV infection epidemic, the incidence, prevalence, and mortality rates of the disease in Russia are higher than those in other countries of Eastern and Central Europe. This leads to negative consequences that go beyond the healthcare system and retards the further socioeconomic development of our country. Objective. To estimate the social and economic burdens of the spread of HIV infection in Russia. Materials and methods. When estimating the burden, the negative effects and costs associated with the spread of HIV infection in Russia as of 2019 were taken into account. The social burden of HIV infection was measured by the contribution of the disease to increased mortality rates, decreased life expectancy at birth, by fertility, natality, and population size. To estimate the burden, a difference was calculated between the actual values of the 2019 indicators and the hypothetical scenario proposing that there was no spread of HIV in Russia. To quantify the economic burden, allowance was made for the direct state medical costs of screening for, diagnosis, and treatment of HIV infection, including antiretroviral therapy expenditures; for direct non-medical costs for the payment of pensions and disability benef its, as well as for indirect costs as the lost output of goods and services due to premature mortality and disability. Results. As of 2019, the spread of HIV infection in Russia resulted in additional 19,941 deaths and declined birth rates by 5,845 children. Life expectancy at birth became lower by 0.31 years. The negative contribution of HIV infection to the natural growth of population was 25,786persons whereas that to the average annual population size was 12,893. The total economic burden of HIV infection was estimated at 220.1 billion rubles, or about 0.2% of GDP. Indirect economic costs made up the bulk of the expenses (172.7 billion rubles, or 78.4%). The second component of the expenses was direct medical costs (34.6 billion rubles, or 15.7%). Conclusion. The obtained estimates of the social aeconomic burden of HIV infection in Russia are significant, which requires the improvement of measures to fight this disease.

HIV infection, economic burden, social burden