The spread of HIV in the world: the incidence rate in different countries. AIDS: disease and statistics

Last week it became known that every 50th inhabitant of Yekaterinburg is infected with HIV. Today, the Ministry of Health officially announced that an increased level of the spread of the disease is observed in 10 regions, including the Sverdlovsk region. Life found out which regions of the country are most likely to contract a deadly disease.

On November 2, Tatyana Savinova, First Deputy Head of the Health Department of the Administration of the City of Yekaterinburg, announced a pandemic of the immunodeficiency virus in the Ural capital. According to her, the disease is firmly rooted in all segments of the city's population and the spread of the disease no longer depends on risk groups. In total, 26,693 cases of HIV infection have been registered in Yekaterinburg, but this includes only officially known cases, so the actual incidence is much higher.

Later, the city health department informed about the epidemic, and the refutation was made by herself Savinova. According to her, on P press conference, journalists asked her a question about the situation in Yekaterinburg. And in response she just " voiced the data broadcast in the media."

Of course, for us, physicians, this has long been an HIV epidemic, since many people are sick in Yekaterinburg, the official said. - It didn't happen yesterday and nothing has been officially announced.

Today, the head of the Ministry of Health of the Russian Federation, Veronika Skvortsova, that an increased level of the spread of HIV disease has been recorded in 10 regions Russia.

In our country, 57% of all sources of HIV infection are the injection route, as a rule, among heroin addicts, she added.

Meanwhile, according to experts, it is really high time to declare the epidemic officially, moreover, on a national scale.

The epidemic is spreading throughout the country, and only one administrator had the courage (the administration of one region. - Approx. ed.) admit it. There is unevenness: the population of cities is more affected. And where the urban population is higher than the rural population, the percentage of those affected is higher there. This is the Volga region, the Urals, Siberia. These are signs of the general epidemic which at us goes, - Life reported. Director of the Federal Methodological Center for the Prevention and Control of AIDS, Deputy Director of the Central Institute of Epidemiology Vadim Pokrovsky.

To prove what was said, the head of the center cited figures.

Now we have 1% of the population infected with HIV, and in the age group of 30-40 years - 2.5%. On the day we register a total of 270 new cases of HIV infection in the country, every day 50-60 people die from AIDS. What else is needed to talk about the epidemic? asked Pokrovsky.

In Yekaterinburg, the situation with HIV is not even the worst. Every 50th inhabitant of the city (2% of the population) is infected there. But in Tolyatti (Samara region), as told by p Head of the Federal Scientific and Methodological Center for the Prevention and Control of AIDS Vadim Pokrovsky,already 3% of the population are HIV-positive.

On the Life map, you can find your region and see how many cases are among your fellow countrymen.

The share of HIV-infected people in the total number of inhabitants of the region

As you can see, the epidemic covered Russia unevenly. Half of all those infected live in 20 of the 85 regions. The worst situation is in the Irkutsk and Samara regions (1.8% of the inhabitants are infected with HIV). In third place is the Sverdlovsk region, the capital of which is Yekaterinburg (1.7% of the inhabitants are infected with HIV).

Slightly fewer infected in the Orenburg region (1.4%), the Leningrad region (1.3%), the Khanty-Mansi Autonomous Okrug (1.3%).

And here are the statistics on the mortality of HIV-infected people by region (data from the Federal AIDS Center, dated 2014, no more recent statistics yet).

As of December 31, 2014 in Russia 148,713 HIV-positive adults and 683 children died. In 2014, 24.4 thousand HIV-positive people died.

Pokrovsky explained why HIV "selected" these regions:

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

Yekaterinburg Mayor Yevgeny Roizman also said that the majority of HIV-positive people became infected due to drugs.

I started talking about it in 1999,” he said. - Of those addicts who passed through my hands, the guys are heroin addicts, of which 40% were HIV-positive. The girls are heroin addicts, if without HIV infection, it was an event. Moreover, they were all, as a rule, also prostitutes. Then, when what was called a crocodile started, everyone there was HIV-infected. They could buy disposable syringes, but they recruited from one bowl. Now there is a sexual spread. Indeed, we are ahead of the whole of Russia. The situation in the Sverdlovsk region is worse than in Yekaterinburg. Ahead of all of Russia - this was due to drug addiction, - said Evgeny Roizman.

Vadim Pokrovsky stressed that among the main problems in this area is the lack of medicines.

Now we need to treat a little more than 800 thousand HIV-infected people. 220,000 have died, and, according to estimates, another 500,000 have not yet been diagnosed with us,” Pokrovsky noted.

Previously Pokrovsky, which is bad with prevention.

There are no strategic programs to fight AIDS in the regions, Vadim Pokrovsky says. - As a result, they will print and hang several posters and flyers. This is where prevention ends.

It turns out a vicious circle.

People do not even suspect how difficult the situation with HIV is in Russia, Vadim Pokrovsky notes. - Information is the main method of combating the spread of the disease. In addition, it is also cost savings, because the fewer people get infected, the less you will have to treat later.

Official statistics of HIV, AIDS in Russia

At the beginning of 2017 The total number of HIV infections among Russian citizens has reached 1,114,815 people(in the world - 36.7 million HIV-infected). Of them died for different reasons 243,863 HIV-infected according to the monitoring form of Rospotrebnadzor "Information on measures to prevent HIV infection, hepatitis B and C, identify and treat 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 amounted to 1 167 581 people, of which 259,156 people died for various reasons ( in the 1st half of 2017 years already dead 14 631 HIV-infected that 13.6% more than for 6 months of 2016.). Population stricken rate RF HIV infection in 2017 was 795,3 infected with HIV per 100 thousand of the population of Russia.

In 2016. It revealed 103 438 new cases of HIV infection among Russian citizens (excluding those identified anonymously and foreign citizens), which is 5.3% more than in 2015 the annual growth averaged 10%. HIV incidence rate in 2016 made up 70.6 per 100 thousand population.

In terms of the rate of growth in the incidence of HIV infection, Russia has taken 3rd place after the Republic of South Africa and Nigeria.

For the 1st half of 2017 in Russia revealed 52 766 HIV-infected citizens of the Russian Federation. HIV incidence rate in 1st half of 2017 made up 35,9 cases of HIV infection per 100,000 population. Most new cases in 2017 were detected in the Kemerovo, Irkutsk, Sverdlovsk, Chelyabinsk, Tomsk, Tyumen regions, as well as in the Khanty-Mansi Autonomous Okrug. Increasing the rate of growth of new cases HIV infections in 2017(but the overall incidence of HIV infection is low) is observed in the Vologda Oblast, 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, in terms of incidence in the Russian Federation The following regions and cities were in the lead:

  1. Kemerovo region (228.8 new cases of HIV infection were registered per 100,000 population — total 6,217 HIV-infected), including in the town Kemerovo 1,876 HIV-infected.
  2. Irkutsk region (163.6% 000 - 3,951 HIV-infected). In 2017, 1,784 new HIV-infected people were detected in the Irkutsk region over 5 months. In 2016 in the city Irkutsk registered 2 450 new 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, including in the city of Samara 1,201 HIV-infected), for 7 months of 2017 - 1,184 people. (59.8% 000).
  4. Sverdlovsk region (156.9% 000 - 6,790 HIV-infected), including in the city of Yekaterinburg 5,874 HIV-infected (the most HIV-infected city in Russia / Or well reveal? 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), for the first half of 2017, 1,019 new cases of HIV infection were detected in the Tyumen region (an increase of 14.4% compared to the same period last year, then 891 HIV-infected people were registered), incl. 3 teenagers. The Tyumen region is one of the regions where HIV infection is recognized as an epidemic.
  7. Tomsk region (138.0% 000 - 1 489 people.),
  8. Novosibirsk region (137.1% 000) regions (3 786 people.), incl. in the town Novosibirsk 3 213 HIV-infected.
  9. Krasnoyarsk Territory (129.5% 000 - 3 716 people.)
  10. Perm Territory (125.1% 000 - 3 294 people.)
  11. Altai Territory (114.1% 000 - 2 721 people.)
  12. Khanty-Mansi Autonomous Okrug (124.7% 000 - 2010 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 detected, the incidence rate was 59.8% 000.
  15. Kurgan region (110.1% 000 - 958 people.)
  16. Ulyanovsk region (97.2% 000 - 1 218 people.), in 1 sq. 2017 - 325 people (25.9% 000).
  17. Tver region (74.0% 000 - 973 people.)
  18. Nizhny Novgorod region (71.1% 000 - 2 309 people.) areas, in 1 sq. 2017 - 613 people (18.9% 000).
  19. Republic of Crimea (83.0% 000 - 1 943 people),
  20. Khakassia (82.7% 000 - 445 people),
  21. Udmurtia (75.1% 000 - 1 139 people.),
  22. Bashkortostan (68.3% 000 - 2 778 people.), in 1 sq. 2017 - 688 people (16.9% 000).
  23. Moscow (62.2% 000 - 7 672 people)

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

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

Subjects of the Russian Federation most affected by HIV infection.

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

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

afflicted HIV infection of the population of Russia as of December 31, 2016 amounted to 594.3 per 100 thousand people Cases of HIV infection have been registered in all subjects of the Russian Federation. In 2017, the incidence was 795.3 per 100,000 of us.

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

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

To the most affected regions of the Russian Federation relate:

  1. Sverdlovsk Region (1,647.9%,000 people living with HIV were registered per 100,000 population - 71,354 people. In 2017, there were already about 86,000 people infected with HIV), including in Yekaterinburg more than 27,131 HIV-infected people have been registered, i.e. every 50th city dweller is infected with HIV It's a real epidemic. Serov (1454.2% 000 - 1556 people). Infected with HIV - 1.5 percent of the population of the city of Serov.
  2. Irkutsk region (1636.0% 000 - 39473 people). Total identified HIV-infected at the beginning 2017- 49,494 people, at the beginning of June (almost six months) 2017 51,278 people were registered with a diagnosis of HIV infection. AT the city of Irkutsk more than 31,818 people have been identified for all the time.
  3. Kemerovo region (1582.5% 000 - 43000 people), including in the city of Kemerovo more than 10,125 patients with HIV infection have been registered.
  4. Samara region (1476.9% 000 - 47350 people),
  5. Orenburg region (1217.0% 000 - 24276 people) regions,
  6. Khanty-Mansi Autonomous Okrug (1201.7% 000 - 19550 people),
  7. Leningrad region (1147.3% 000 - 20410 people),
  8. Tyumen region (1085.4% 000 - 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) region. As of May 19, 2017 in the city of Novosibirsk more than 34 thousand HIV-infected people have been registered - every 47 resident of Novosibirsk has HIV (!).
  11. Perm Territory (950.1% 000 - 25030 people),
  12. St. Petersburg (978.6% 000 - 51140 people),
  13. Ulyanovsk region (932.5% 000 - 11728 people),
  14. Republic of Crimea (891.4% 000 - 17,000 people),
  15. Altai Territory (852.8% 000 - 20268 people),
  16. Krasnoyarsk Territory (836.4% 000 - 23970 people),
  17. Kurgan region (744.8% 000 - 6419 people),
  18. Tver region (737.5% 000 - 9622 people),
  19. Tomsk region (727.4% 000 - 7832 people),
  20. Ivanovo region (722.5% 000 - 7440 people),
  21. Omsk region (644.0% 000 - 12741 people), as of 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

The highest level of damage HIV infection of the population is observed in the group 30-39 years old, 2.8% of Russian men aged 35-39 lived with an established diagnosis of HIV infection. Women become infected with HIV 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%.

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

Age and sex 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 detected cases was also observed in older age groups, and cases of sexually transmitted HIV infection in old age have become more frequent.

It should be noted that when low testing coverage of adolescents and youth, more than 1100 cases of HIV infection are registered annually among people aged 15-20 years. According to preliminary data the largest number of HIV-infected adolescents (15-17 years old) was registered in 2016 in Kemerovo, Nizhny Novgorod, Irkutsk, Novosibirsk, Chelyabinsk, Sverdlovsk, Orenburg, Samara regions, Altai, Perm, Krasnoyarsk territories and the Republic of Bashkortostan. The main cause of HIV infection among adolescents is unprotected sex with an HIV-infected partner (77% of cases in girls, 61% in boys).

Structure of the deceased

In 2016, 30,550 (3.4%) patients with HIV infection died in the Russian Federation (10.8% more than in 2015) according to the Rospotrebnadzor monitoring form “Information on measures to prevent HIV infection, hepatitis B and C, detection and treatment of HIV patients”. The highest annual mortality was registered in 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, the Chuvash Republic, the Samara Region, the Primorsky Territory, the Tula Region, Krasnodar, Perm Territories, Kurgan region.

Treatment coverage

At the dispensary in specialized medical organizations in 2016 there were 675,403 patients infected with HIV, which amounted to 77.5% of the number of 870,952 Russians living with a diagnosis of HIV infection in December 2016, according to the monitoring form of Rospotrebnadzor.

In 2016, 285,920 patients received antiretroviral therapy in Russia, including patients who were in places of deprivation of liberty. In the 1st half of 2017 received antiretroviral therapy 298 888 patients, about 100,000 new patients were added for therapy in 2017 (drugs for all most likely will not be enough, because the purchase was according to the figures of 2016). Treatment coverage in 2016 in the Russian Federation was 32.8% of the number of registered persons diagnosed with HIV infection; among those on dispensary observation, 42.3% of patients were covered by antiretroviral therapy. The achieved treatment coverage does not play the role of a preventive measure and does not allow to radically reduce the rate of spread of the disease. The number of patients with active tuberculosis in combination with HIV infection is growing, the largest number of such patients is registered in the regions of the Urals and Siberia.

HIV testing coverage

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

In 2016, the maximum number of positive results in the immunoblot in Russians over the entire history of observation was revealed - 125,416 (in 2014 - 121,200 positive results). The number of positive results in the immunoblot includes those identified anonymously, not included in the statistical data, and children with an undifferentiated diagnosis of HIV infection, therefore it differs significantly from the number of newly registered cases of HIV infection.

For the first time, 103,438 patients tested positive for HIV. Representatives of vulnerable groups of the population in 2016 made up an insignificant part of those tested for HIV in Russia - 4.7%, but among these groups 23% of all new cases of HIV infection were detected. When testing even a small number of representatives of these groups, it is possible to identify many patients: in 2016, among the examined drug users, 4.3% of HIV-positive people were detected for the first time, among MSM - 13.2%, among contact persons during epidemiological investigation - 6.4%, prisoners - 2.9%, STI patients - 0.7%.

Transmission path structure

In 2016, the role of sexual transmission of HIV infection has grown significantly. According to preliminary data, among those newly identified in 2016 HIV-positive with established risk factors for infection, 48.8% were infected through drug use with non-sterile instruments, 48.7% - through heterosexual contacts, 1.5% - through homosexual contacts, -0, 45% were children infected from mothers during pregnancy, childbirth and breastfeeding. The number of children infected through breastfeeding is growing: in 2016, 59 such children were registered, in 2015 - 47, 2014 - 41 children. In 2016, 16 cases were registered with suspected infection in medical organizations when using non-sterile medical instruments and 3 cases when blood components were transfused 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 means of infection.

conclusions

  1. In the Russian Federation in 2016, the epidemic situation of HIV infection 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, began to decline.
  2. The incidence of HIV infection remained high, the total number and number of deaths of HIV-infected people increased, and the emergence of the epidemic from vulnerable groups of the population into the general population intensified.
  3. With the current rate of HIV infection spreading and the lack of adequate systemic measures to prevent its spread, the forecast for the development of the situation remains unfavorable.
  4. It is required to intensify organizational and preventive measures to counteract the HIV epidemic in the country.

Thanks to HIV statistics, it is possible to track the number of people who suffer from this disease and, on this basis, to prepare preventive and curative measures. The problem of HIV in Russia is very urgent. Recently, there has been a real HIV epidemic in Russia, which requires the correct development of methods for treating pathology.

With untimely treatment of pathology, the rapid development of AIDS in the world is observed. The disease is characterized by gradual progression and spread among the population. Statistics show that HIV is spreading rapidly around the world. The degree of development of HIV in countries directly depends on their economic, moral and social development. In Eastern Europe and Central Asia, the prevalence of the disease is at its highest level. Latin America is in second place. The third adult HIV prevalence by country is found in North America and Western and Central Europe.

The HIV statistics in Russia are deplorable. Officially, this disease is diagnosed in one million 200 thousand people. The number of HIV-infected people is increasing against the background of a variety of addictions - drug addiction, alcoholism. Among the countries of the world, HIV in Russia is diagnosed quite often.

The level of HIV incidence in Russia by city is quite high. People who live in St. Petersburg, Moscow, etc. suffer most often from the virus.

The main thing about the prevention of HIV and AIDS infection

In order to stop AIDS in Russia, it is necessary to carry out its prevention in a timely manner. To reduce the number of people infected with HIV in Russia , several directions are recommended. In order to limit the development of HIV infection in Russia, it is recommended to limit the amount of vertical transmission of pathology.

Vaccines are used to fight and prevent various infectious diseases. In order to reduce the spread of AIDS in Russia, it is also necessary to use vaccination. But, unfortunately, to date, an effective preventive method has not been developed.

In most cases, the pathological process is transmitted sexually. That is why a variety of educational programs are being developed that teach people the correct sexual behavior. They argue that by excluding sexual intercourse without barrier contraception with untested partners, the amount of infection is significantly reduced.

A variety of educational programs are quite effective. They talk about the features of the course of the pathological process, as well as its complications. Programs are built on training and support methods, which make it possible to reduce the individual risk of infection.

The type of contact directly affects the risk of contracting the disease. It can be sexual - vaginal and anal. The infection is also transmitted through injections. That is why it is often diagnosed in people who regularly take drugs. Quite rarely, an accidental infection with an infection that enters through the wounds on the human body is diagnosed.

During the period of prevention of the pathological process, it is recommended to take into account the fact of vulnerability. This group includes people who, under various circumstances, cannot protect themselves from infection. In this case, constant monitoring of events in a person's life is recommended. This greatly increases the possibility of dangerous contacts and human infection.

The occurrence of pathology is diagnosed only upon contact with an infected person. Through contact with animals and insects, HIV infection is impossible. The infection is found in various fluids - vaginal secretions, blood, breast milk, semen. That is why there are three ways of infection:

  • Through the blood. Transfusion of this fluid, transplantation of tissues and organs are common causes of infection. The disease can be diagnosed when using a non-sterile instrument during medical manipulations and cosmetic procedures. If a person uses non-sterile syringes to inject drugs, then this can cause pathology.
  • From mother to child. When a child passes through the birth canal of an infected mother during the childbearing process, this can cause illness. One of the ways of transmission of infection is breastfeeding a newborn baby.
  • Unprotected sexual contact. Transmission of infection is observed not only in heterosexual, but also in homosexuality.

People should remember that HIV is not transmitted by contact, through household items, food and money. With the simultaneous use of common personal belongings and premises, the development of the pathological process is not observed.

HIV infection is a rather severe infectious process, which is quite difficult to treat. The disease can lead to a variety of undesirable effects, one of which is death. That is why the prevention of pathology should be carried out regularly.

Statistics

The HIV statistics are frightening. As of January 1, 2017, the number of HIV-infected people in Russia was 870,952 people. In accordance with HIV statistics in Russia, the disease is most often diagnosed in patients whose age is 30-39 years old - men and 25-29 years old - women. In recent years, there has been a more frequent diagnosis of the pathological process in adolescence and adolescence.

Official HIV and AIDS statistics in Russia show the number of deaths that occur with the disease. In the previous year, 30,550 deaths were registered. In Russia, HIV statistics annually give figures that are dynamically increasing.

If we consider HIV in Russia by region, the disease is most often diagnosed in the Sverdlovsk region. In second place is the Irkutsk region, and in the third place is the Kemerovo region. Further, according to the degree of reduction in the spread of infection, HIV statistics indicate the following areas:

  • Chelyabinsk;
  • Novosibirsk;
  • Ulyanovsk, etc.

The percentage of HIV-infected people in Russia is constantly increasing. HIV statistics in Russian cities provides information that the pathology develops most often in Moscow, St. Petersburg, Sverdlovsk, Kemerovo, Chelyabinsk, Kaliningrad, etc. A sufficient number of HIV patients is in Ulyanovsk and Novosibirsk. The leaders in the spread of HIV infection in Russia are such cities as Orenburg and Tyumen. The incidence is quite intensively increasing in Tyumen and Samara.

With untimely treatment of the pathological process, people often die. This year, 243,863 people died of AIDS. Top Acquired Immune Deficiency Syndrome rating opens Tyva and Mordovia. Mortality and birth rate of affected children is constantly increasing.

How many people have AIDS in Russia directly depends on the age, region of residence and lifestyle of the person.

conclusions

The number of AIDS patients in Russia is constantly increasing. Among residents of various countries, HIV prevalence is observed in the adult population. The disease is diagnosed most often in people who lead an immoral lifestyle. Country statistics confirm that AIDS is more common in immunocompromised people.

There are 1,114,815 registered cases of the disease in our country. At the same time, a constant registration of new identified cases of HIV infection is carried out. There are 700,000 deaths per million infected. Every fifth person infected with HIV dies. Treatment of patients with HIV should be given due attention.

To reduce the growth of new cases of infection, it is recommended to carry out the prevention of the disease in a timely manner. In this case, it is necessary to limit unverified sexual contacts between men and women. The most disadvantaged are recommended to be trained with the help of special educational programs. This will reduce the total number of carriers of the infection. To fight HIV, the patient must seek help from a doctor who, after an appropriate diagnosis, will prescribe adequate treatment.

Of all countries in the world, the highest growth rate in the number of new cases of HIV infection (human immunodeficiency virus) was recorded in Russia. Deborah Burks, coordinator of global AIDS programs, said this in her speech at the US State Department on the occasion of World AIDS Day celebrated annually on December 1st. She said that "the largest increase in the number of new HIV infections worldwide is observed in Russia due to the lack of response in the fight against the breadth and depth of the epidemic in the country."

She did not provide any figures or data to support her words. However, official statistics confirm these words of the representative of the US State Department. At the beginning of 2017, there were about 36.7 million people living with HIV in the world, mostly in developing countries, including countries in Africa. Russia accounts for about 900,000 of them, according to official statistics. The real figures in the Russian Federation, according to domestic experts,.

In 2016, 1.8 million new infections were recorded worldwide, in other words, about five thousand people are infected with HIV every day on the planet - one every 17 seconds. In Russia, the annual increase in the number of new cases of infection with the virus averages 10%: in 2014 - 89808 cases of new infections, in 2015 - 98232 people newly infected, in 2016 - 103438 cases. And this year will be no exception. Mortality from HIV infection, according to Rosstat, in Russia is also growing annually: in 2014 - 12540 deaths, in 2015 - 15520, in 2016 - 18575 deaths.

The World Health Organization (WHO), which has kept HIV statistics by region since the 1980s, when they began collecting and analyzing them, reports that the total number of people infected in the European Region has reached 2,167,684, including 1,114,815 cases registered in Russia.

Over the past year, according to WHO, in the European Region, 160 thousand new cases This is the maximum in the history of observations. The European region is the only one where the number of new infections is on the rise. But this does not mean that these threatening data refer to Europe. WHO statistics "for the European Region" unites 53 countries with a population of almost 900 million people - in addition to the countries of the European Economic Area (EU / EEA), this also includes Azerbaijan, Tajikistan, Turkmenistan, and Russia.

In the EU countries themselves, only 29,000 new HIV infections were recorded last year. Russia is spoiling the "European statistics", since out of the total regional figure of 160 thousand, more than 103 thousand cases are in our country.

A joint report by the WHO and the European Center for Disease Prevention and Control (ECDC) says this is the highest number of cases reported in a single year. "If the trend continues, we will miss our target of ending the spread of the HIV epidemic by 2030," says Zsuzsanna Jakab, WHO Regional Director for Europe.

In Russia, the highest incidence rates were also noted in 2016 - 70.6 cases per 100,000 population, in Ukraine this figure is 33.7 per 100 thousand, in Belarus - 25.2, in Moldova - 20.5. The number of newly diagnosed HIV infections in Russia and Ukraine is 73% of the number of infections in the European Region and 92% of the total in the east of the European Region.

In 2014, more than 142,000 new cases of HIV infection were recorded in the European Region (of which 89,808 cases were in the Russian Federation), in 2015 - 153,407 (of which 98,232 were in the Russian Federation). By the end of 2017, there will also be at least 100 thousand new infected people in Russia, Vadim Pokrovsky, head of the Federal Scientific and Methodological Center for the Prevention and Control of AIDS, is convinced.

According to him, the number of deaths due to HIV-positive status is also growing. "Last year, 18.5 thousand people, according to Rosstat, died precisely from AIDS (acquired immunodeficiency syndrome). In fact, more than 30 thousand people died with HIV, but why the remaining 15 thousand died is a question that needs to be studied," Pokrovsky said.

It cannot be said that the increase in the incidence rate is decreasing in Russia, one can only speak of a decrease in the increase in new cases. "We do not reduce growth, but as it was, it remains such, it is added," says Vadim Pokrovsky, head of the scientific and methodological Center for the Prevention and Control of AIDS.

Since 2016, the Ministry of Health has taken into account only non-anonymous infected people - those who have been tested in state medical institutions with a passport and an insurance certificate in their hands. There were 86,800 such people in 2016 compared to 100,000 in 2015. And taking into account anonymous analyzes, Rospotrebnadzor counted 125,000 new cases of laboratory confirmation of HIV infection in 2016. Thus, the Ministry of Health closed its eyes to at least 20% of those infected. And a large part of HIV-infected people is not yet aware of their diagnosis, since the latent form can last 10-20 years.

At the same time, there is not enough money in the state budget for the treatment of HIV / AIDS. WHO recommends immunosuppressive antiretroviral therapy (ARV) to all those diagnosed with HIV, while in Russia the coverage of ARV therapy is 46% of the 650,000 people with HIV registered by the Ministry of Health, or 33% of the 900,000 living carriers of the virus registered Rospotrebnadzor as of the end of 2016.

State strategy of the Russian Federation to combat HIV: there is no prevention, only those who are already infected are identified

Recall that the state strategy to combat the spread of HIV, adopted by the Ministry of Health of the Russian Federation, set the task of bringing the coverage of antiretroviral therapy (ARV), which suppresses the immunodeficiency virus, to 90% of all infected by 2020 - this would stop the epidemic.

However, it is not easy for Russian citizens to receive such treatment, and in the countryside it is completely unrealistic, the medicines given to patients are far from the most modern, with a large number of side effects and mostly generics - medicines that differ in composition from the original medicine both in the amount of active substance and by its quality.

In February 2015, due to the unfavorable dynamics of the spread of HIV infection in the Russian Federation, the Ministry of Health developed an AIDS response strategy until 2020. Officials planned to reduce prices for drugs vital to the infected through import substitution and the creation of cheaper Russian analogues.

But the Russian drug for the treatment of HIV will be registered at best only in 5-10 years, TASS reports. The development of the domestic gene therapy drug Dinavir, which is being developed by a group of scientists from the Central Research Institute of Epidemiology of Rospotrebnadzor, is now only at the stage of preclinical trials.

As for existing medicines, Vadim Pokrovsky, head of the Scientific and Methodological Center for the Prevention and Control of AIDS, says that only a quarter of patients receive them.

Despite the fact that the government of the Russian Federation in April announced an increase in spending on the fight against AIDS, only 60,000 people will feel the positive effect - "a drop of water on a hot stone," Pokrovsky believes.

In general, according to him, there are no pre-exposure prophylaxis programs (PrEP) in Russia, when antiretroviral drugs are taken by people with a potentially high risk of contracting HIV. There are no funds for this, because there are not enough medicines even for already infected citizens. Against this background, the only concept that works and is officially approved in Russia is the “test and treat” strategy, recalls Medvestnik. “Prevention should prevent infection, and we are identifying those who are already infected, and every year more and more. At the same time, next year the State Duma is going to reduce the budget for the treatment of HIV infection from 17.5 to 16.5 billion rubles. Therefore, it is not surprising that that our epidemic is on the rise," Pokrovsky said.

“The Russian state does not stand on ceremony with those who criticize it. As soon as Pokrovsky complained about the insufficiently active fight against the epidemic, the Ministry of Health deprived the Federal AIDS Center in June of this year of state funds under a far-fetched pretext. Non-governmental organizations also face an increased number of obstacles. Many of them are forced to curtail their work, since, according to the law that came out in 2012, they are required to register as "foreign agents," recalls the Swiss newspaper Neue Zuercher Zeitung... By the way, in Switzerland the situation is almost stable - in 2016, the virus was detected in 539 people there, in 2015 - 537.

Sex between men remains a major mode of HIV transmission

Despite the existence of specialized prevention programs in many European countries, sex between men continues to be the predominant mode of HIV transmission in the European Economic Area (EU/EEA).

In all previous years, cases of diagnosing HIV infection among men who have sex with men have grown at an alarming rate - from 30% in 2005 to 42% in 2014.

According to acting Director of the European Center for Disease Prevention and Control (ECDC) Andrea Ammon, to reduce these statistics, it is necessary to adopt new strategies, such as pre-exposure prophylaxis for HIV infection (PrEP) and access to health care for EU citizens living in other countries.

In Russia, the official statistics are different: 40% of all HIV-infected people are people of traditional sexual orientation, from 55% to 60% of those infected were infected as a result of drug use, and only less than 2% were infected through homosexual contacts.

However, these figures are again far from reality due to the fact that in Russia, due to the high level of condemnation, gays cannot even tell doctors that they had same-sex contacts. “In AIDS centers there is a system of codes that are assigned to different groups. For men who have sex with men, this is 103. But they are given other codes, for example 105 (persons with promiscuity). And in this way gays replenish the statistics of the heterosexual path But according to studies by public organizations, every sixth gay person in Russia is already infected,” Yevgeny Pisemsky, head of the Phoenix Plus NGO in Oryol, told Radio Liberty.

"Specialists in AIDS centers are well aware of such underestimated statistics. But they are always under the sword of Damocles of the law on the so-called propaganda among minors and interpret it in such a way that "just in case, we will not even mention it, otherwise we will be accused of propaganda homosexuality. But only real numbers could convince society that the problem exists," says Pisemsky.

According to the Open Institutes of Health Foundation, the results of a 2017 biobehavioral study show that the average prevalence of HIV infection among gay men in Russia is 18% (in Moscow - 13%, in St. Petersburg - 24%, in Yekaterinburg - 16%).

According to Pisemsky, the state will not be able to fight HIV without recognizing that it is in this risk group that it spreads very quickly. This means that no prevention is carried out in this environment, and gays themselves receive a deceptive confidence that the HIV problem does not concern them.

Every second HIV-infected person is diagnosed at a late stage

Nearly half of HIV infections across the European Region, which includes Russia, are diagnosed at a late stage, increasing the risk of ill health, death and HIV transmission.

The large number of AIDS cases in Russia and other Eastern European countries is evidence that late diagnosis, late initiation of antiretroviral therapy and low treatment coverage contribute to the development of the disease, the World Health Organization notes.

HIV/AIDS surveillance data from 2016 suggests that the likelihood of late diagnosis increases with age. For example, 65% (63% in the EU/EEA) of people over 50 in the European Region were diagnosed with HIV at a late stage.

Testing for HIV infection for certain diseases, such as other sexually transmitted infections, viral hepatitis, tuberculosis and some types of cancer, can improve the quality of diagnosis.

According to Russian statistics, more than half (51%) of registered cases of HIV infection are diagnosed at a late stage of the disease.

Ten regions of Russia are in critical condition in terms of HIV prevalence. This was stated by the Minister of Health of the Russian Federation Veronika Skvortsova. The sad list is headed by the Sverdlovsk and Kemerovo regions.

“HIV is distributed very unevenly across the country,” the head of the Ministry of Health noted. “The prevalence is significantly higher, several times higher, in those regions through which drug trafficking routes pass. Therefore, there are 10 critical regions out of 85. In the first place is the Sverdlovsk region, Yekaterinburg, which got (in connection with this) to the press," said Skvortsova.

According to the minister, "57% of all sources of HIV infection are injections, usually among heroin addicts." As for such a traditional risk group as homosexuals, this trend is less pronounced in Russia.

“40% of cases of sexually transmitted infections relate to heterosexual couples,” Skvortsova said, stressing that the increase in the number of infections is due to well-off women who have picked up the virus from their own husband.

According to the Federal Center for Prevention and Control of AIDS, at the end of last year the list of the most HIV-affected regions was as follows: areas.

During the year, anonymous testing was conducted in problem regions, which was passed by 23.5 thousand young people under 30 years old. Among them, 2.3% of HIV-infected people were identified.

In early November, the Ministry of Health of Yekaterinburg announced that every 50th inhabitant of the city had AIDS.

"We have an infection rate of 1,826 people per hundred thousand, which is 1.8% of the city's population, 26,693 thousand infected," Tatyana Savinova, deputy head of the Yekaterinburg city health department, said. "And these are only known cases, the real incidence is even higher," she stressed.

But this situation in Yekaterinburg has been developing for decades, so doctors do not make announcements about the beginning of the epidemic, the city health department emphasized.

According to the criteria of WHO and the Joint United Nations Program on HIV, more than 1% of those infected means that the infection is firmly rooted among the population and its spread is practically independent of risk groups.

Meanwhile, the Federal Center for Prevention and Control of AIDS believes that Russia is now on the verge of transition to the third, last stage of the HIV epidemic.

“An epidemic is a conditional concept. There are three stages in HIV. Initial - the first cases are imported from abroad. The second is concentrated, risk groups are affected. We now have 10% of men who have sex with men and 20% of drug addicts are infected. And when more than 1% of pregnant women are infected, then it is generalized. Here we are now at the stage of transition from the second to the third, "Vadim Pokrovsky, head of the center, academician of the Russian Academy of Medical Sciences, told the L!fe portal.

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