Generalized HIV epidemic in 27 Russian regions: what epidemiologists say and where the agencies' data diverge

Generalized epidemic in 27 regions

The Central Research Institute of Epidemiology of Rospotrebnadzor reported, that a generalized HIV epidemic has taken hold in 27 regions of Russia — a stage at which the virus spreads in the general population, not only in risk groups. The criterion: the virus is detected in more than 1% of pregnant women. The most severe situation is in the Kemerovo, Irkutsk and Sverdlovsk regions, Euronews reports, citing the institute. In total, more than 1.232 million people with a confirmed HIV diagnosis live in Russia — 0.8% of the population, added the institute's director, Rospotrebnadzor academician Vasily Akimkin.

New cases are declining, but healthcare-associated infections are at record levels

In 2025, 45,000 new HIV cases were detected in Russia — 13.4% fewer than in 2024. However, according to statistics from the Medvestnik portal, that same year set a 15-year record for the number of HIV and hepatitis infections in medical facilities: eight outbreaks were recorded, with 104 patients affected. In 2026, investigations are ongoing into 11 outbreaks in ten regions; in Moscow, an outbreak with 22 hepatitis C cases is under investigation. Among the largest confirmed outbreaks of the past two years are the infection of 82 people at a sanatorium in Kabardino-Balkaria (76 with hepatitis C, six with mixed infections), 147 patients at an oncology dispensary in Kamchatka and 42 in Buryatia, as well as 26 people at dialysis centers in the Samara and Kursk regions. The main cause cited is violations of sanitary and epidemiological rules — for example, the use of single-use catheters and glucometers on multiple patients; the source is usually patients with undiagnosed infections. Yelena Igonina, head of the department of population epidemiological well-being at Rospotrebnadzor, notes that such

The number of infected people is growing despite declining mortality

Although HIV incidence and mortality have been declining over the past three years, the number of infected people continues to grow: for every death there are one and a half new infections, explains Natalya Ladnaya, head of the research department for AIDS prevention and control at the Central Research Institute of Rospotrebnadzor. HIV mortality in Russia remains at 30,000–34,000 people per year; according to her, only 15 countries in the world record more than 15,000 HIV deaths, including Russia. HIV has become the leading cause of death among Russians of working age; among men aged 40–49, more than 3% are infected, the average age of those infected has risen from 32 to 44 over 15 years, and two-thirds of new transmissions occur through heterosexual contact. Rospotrebnadzor warns, based on a mathematical model, that if current approaches are maintained, the number of people with HIV could reach 1.47 million by 2030, and annual deaths could rise to 51,000.

Discrepancies between agencies' data and patients lost to follow-up

According to an analysis by several Russian media outlets, Rospotrebnadzor and the Ministry of Health count differently: the former relies on laboratory notifications of every positive immunoblot, the latter on the number of people registered for dispensary follow-up. As a result, the gap between the total number of people with a confirmed diagnosis (1.23 million according to Rospotrebnadzor) and those actually under follow-up (846.5 thousand according to the Ministry of Health) stands at 385,555 people. By the end of 2025, only half of people living with HIV had a suppressed viral load, Ladnaya reported at the 'Epidemiological Surveillance of HIV Infection' conference; in her conclusion, at least 600 thousand people 'continue to play an active role in transmitting the virus.' Viral load suppression is achieved in 77.9% of those receiving antiretroviral therapy, whereas WHO standards call for a 95-95-95 cascade. 72% of infected individuals were under dispensary follow-up. Testing grew by 75% over the decade — to 54 million tests per year — but its effectiveness is declining: the share of people at the highest risk among those tested fell from 5.8% in 2014 to 3% in 2023.

Funding and individual assessments

HIV-related expenditures in 2025 were estimated at 279 billion rubles, Ladnaya noted. In her view, the virus may spread more actively among vulnerable groups and in regions bordering Ukraine that are characterized by high migration; Rospotrebnadzor also allows for rising incidence and mortality in the Far Eastern, Southern and North Caucasus federal districts. A number of Russian media outlets emphasize that most donors who funded HIV prevention have left the country, while domestic funding is insufficient: Evgeny Pisemsky, editor of the 'Parni+' media outlet, commented to Current Time that with 45 thousand new cases in 2025, the draft budget for 2027 provides additional funding for medicines for only 30 thousand new carriers. Blogger Anastasia Kashvarova stated that hepatitis, HIV and tuberculosis are spreading in the army and in frontline regions, and that there is a 'threat of an epidemic of socially dangerous diseases'; The Insider previously reported on shortages of life-saving medications among HIV patients in the occupied territories of the Donetsk and Luhansk regions, some of which were not included by the Ministry of Health in centralized procurement. These assessments belong to the named authors and outlets; the editorial team has not independently verified them.