HIV Now Spreading Through Whole Populations in 27 Russian Regions

Scientists at Rospotrebnadzor's Central Research Institute of Epidemiology have classified 27 Russian regions as facing a generalised HIV epidemic — the stage where the virus circulates in the wider population, not just among groups traditionally deemed at risk. The marker they use: more than 1% of pregnant women in those regions are diagnosed with HIV. Kemerovo, Irkutsk and Sverdlovsk are the worst hit.

The headline numbers look better than they are. Russia detected 45,000 new HIV cases in 2025, down 13.4% on 2024, according to the Central Research Institute for the Prevention and Control of AIDS. Yet infections traced to medical facilities hit their highest level in 15 years, Medvestnik reported. Yelena Igonina, who heads Rospotrebnadzor's population wellbeing department, said clusters of hepatitis C and mixed HIV-hepatitis infections dominate, with eight clusters and 104 infected patients recorded in healthcare settings in 2025.

The investigations haven't stopped. In 2026 authorities are probing 11 suspected clusters across ten regions, including 22 hepatitis C cases in Moscow. Among recent confirmed outbreaks: 82 people infected at a sanatorium in Kabardino-Balkaria, 147 in oncology hospitals in Kamchatka Territory, 42 in Buryatia, and 26 across dialysis centres in Samara and Kursk. Igonina blamed "systemic and gross violations" of sanitary rules, including reusing single-use catheters and glucometers on multiple patients. Testing for hepatitis C RNA lags badly among dialysis, haematology and transplant patients, she added. For the first time in six years, two HIV infections via blood component transfusion were logged in 2026.

Overall, 1.232 million people in Russia live with a confirmed HIV diagnosis — 0.8% of the population, per institute director Vasily Akimkin. Deaths run between 30,000 and 34,000 a year, and HIV is now the leading cause of death among working-age Russians. More than 3% of men aged 40 to 49 carry the virus, and the average age of the infected has climbed from 32 to 44 in 15 years. Two-thirds of new transmissions come through heterosexual contact.

Treatment coverage is the weak link. Natalya Ladnaya, who heads the institute's AIDS prevention research, said only half of people with HIV had a suppressed viral load by the end of 2025, meaning at least 600,000 may still be transmitting the virus. Among those on antiretroviral therapy, 77.9% achieved suppression — well short of the WHO's 95-95-95 targets. Just 72% of the infected were under medical follow-up last year. Testing has grown 75% in a decade to 54 million tests, but Ladnaya said it increasingly misses the highest-risk groups, whose share of testing fell from 5.8% in 2014 to 3% in 2023.

Rospotrebnadzor's model warns that without a change in prevention and treatment, 1.47 million people could be living with HIV in Russia by 2030, with 31,000 to 51,000 new cases and up to 51,000 deaths a year. The agency and the Health Ministry also count differently: Rospotrebnadzor's 1.23 million confirmed diagnoses against the ministry's 846,500 under medical supervision leaves a gap of 385,555 people.