The global burden of HIV/AIDS in Russia in terms of public health. Part 1

Objective. Evaluation of the global HIV burden in Russia, identification of progress made and outstanding problems for 1987–2021.

Materials and methods. The analysis of national and foreign publications, data obtained from Rosstat, from forms of federal statistical observation and the FNM of the AIDS Center of Rospotrebnadzor was carried out. The study used information-analytical, epidemiological and statistical methods. Mathematical calculations were performed using the SPSS-26 program.

Results and discussion. In Russia, the target indicators of the state program of HIV/AIDS response strategy is being provided in different directions: the greatest success has been achieved in conducting chemoprevention of mother to child HIV transmission, somewhat less in the coverage of the population with HIV testing, which amounted to 26.1% versus the target indicator of 30.0% in 2021, the number of newly detected cases of HIV infection is decreasing (from 73.7 to 71.0 thousand people in 2020–2021, versus the target indicators of 76.1 and 72.3 thousand people, respectively), there is decreasing the HIV incidence (40.4 per 100 thousand. in 2021 versus 68.5 in 2015). Antiretroviral therapy (ART) coverage of patients registered in AIDS Centers went up from 12.4% to 78.9% in 2007–2021. Meanwhile, the determining factor in the HIV/AIDS epidemic progress in Russia is a heterosexual route (F=75.1, p<0.0001) leading to the penetration of infection into all population segments. In addition, despite the increase in the coverage of ART for people living with HIV (PLWH), the HIV mortality rate is remaining high (11.6 per 100 thousand population in 2021, versus 7.9 in 2007).

Conclusion. In recent years, there has been a positive trend in the coverage of three-stage HIV chemoprophylaxis in pregnant women, women in labor and newborns. The number of HIV population based screening tests is increasing annually. There is an increase in the ART coverage of patients and a decrease in the number of newly diagnosed cases of the disease. However, along with the observed increase in the HIV spread through heterosexual contacts, it is necessary to strengthen information and preventive measures, especially among the reproductive age group. The high HIV mortality rate is continuing to remain, despite the increase in ART coverage of PLWH. The identified problems need to be solved comprehensively based on the results of large-scale sociological research conducted in various regions of Russia.

1. Pokrovskiy V.I. Epidemiology as a base for developing measures for prevention of infectious diseases. Health care of the Russian Federation, 2013, No. 2, рр. 10–11 (In Russ.).

2. Baker R.E., Mahmud A.S., Miller I.F. et al. Infectious disease in an era of global change. Nature review // Microbiology. 2022. Vol. 20. Р. 193–205.

3. Briko N.I., Pokroskiy V.I., Malyshev N.A. Globalization and outspread of infectious diseases. Applied microbiology, 2015, Vol. 2, No. 1 (4), рр. 20–28 (In Russ.).

4. Pokrovskiy V.V. Wait-and-see strategy // Epidemiology and infectious diseases, 2015, No. 1, рр. 4–9 (In Russ.).

5. Smith J.H., Whiteside A. The history of AIDS exceptionalism // J. Int. AIDS Socity. 2010. Vol. 13, No. 47. Available at: https://www.ncbi.nlm.nih.gov/pubmed/21129197.

6. WHO. The global health observatory. https://www.who.int/data/gho/data/themes/mortality-and-global-health-estimates/global-health-estimates-leading-causes-of-dalys.

7. Blokh A.I., Pasechnik O.A. The burden of diseases and potential life loss due to HIV infection. HIV infection and immunosuppressive disorders, 2017, Vol. 10, No. 3, рр. 91–97 (In Russ.).

8. Redko A.N., Lebedeva I.S., Lebedev P.V., Schvedova M.O. Aspects of socio-economic significance of HIV-infection. Natural-humanitarian research, 2023, Vol. 45, No. 1, рр. 187–193 (In Russ.).

9. Sterlikov S.A., Mikhaylova Yu.V., Golubev N.A. et al. Mortality from major infectious and parasitic diseases: diseases caused by HIV, tuberculosis and parenteral viral hepatitis in the Russian Federation and its dynamics in 2015–2020. Current problems of health care and medical statistics, 2022, No. 3, рр. 40–65 (In Russ.).

10. De Cock K.M, Brun-Vezinet F. Epidemiology of HIV-2 infection // AIDS 3. 1989. Suppl. 1. S89–S95.

11. Worobey M., Joy J.B., Santiago M.L., Sharp P.M. Origin of AIDS: contaminated polio vaccine theory refuted // Nature. 2004. Vol. 428. Available at: www.nature.com/nature.

12. Zhu Т., Korber В.Т., Nahmias A.J. et al. An African HIV-1 sequence from 1959 and implications for the origin of the epidemic // Nature. 1998. Vol. 391. Р. 594–597.

13. Worobey М., Gemmel М., Teuwen D.E. et al. Direct Evidence of Extensive Diversity of HIV-1 in Kinshasa by 1960 // Nature. 2008. Vol. 455, No. 7213. Р. 661–664. doi: 10.1038/nature07390.

14. Pape J., Johnson W.D. Jr. AIDS in Haiti 1982–1992 // Clin. Infect Dis. 1993. Vol. 17 (Suppl. 2). Р. S341–S345.

15. Corbitt G., Bailey A.S., Williams G. HIV infection in Manchester, 1959 // Lancet. 1990. Vol. 336. Р. 51.

16. Williams G., Stretton T.B., Leonard J.C. Cytomegalic inclusion disease and pneumocystis carinii infection in an adult // Lancet II. 1960. Р. 951–955.

17. Evans D.J., Williams E.D. Cytomegalic inclusion disease in the adult // J. Clin. Path. 1968. Vol. 21. Р. 311–316.

18. Vermund S.H., Leigh-Brown A.J. The HIV Epidemic: High-Income Countries // Cold Spring Harb Perspect Med. 2012. Vol. 2. a007195.

19. Bolinger R.C., Tripathy S.P., Quinn Th.C. The Human Immunodeficiency Virus in India // Medicine. 1995. Vol. 74, No. 2. 0025-7974/95/7402-0097$03.00/0.

20. Bobkov A.F., Kazennova E.V., Selimova L.M. et al. HIV-1 subtype in Russia in 1987–1988. Journal of microbiology, 1999, No. 1, рр. 43–45 (In Russ.).

21. Morbidity & Mortality Weekly Report. Kaposi’s sarcoma and pneumocystis pneumonia among homosexual men — New York City and California // MMWR Weekly. 1981. No. 30. Р. 305–308.

22. Green W.C. A history of AIDS: Looking back to see ahead // Eur. J. Immunol. 2007. Vol. 37. S94–102.

23. Coffin J., Haase A., Levy J.A. et al. What to call the AIDS virus? // Nature. 1986. Vol. 321. Р. 10.

24. Lederman М.М., Pike E. Pathogens and Immunity — Ten Years HIV Free: An Interview with «The Berlin Patient», Timothy Ray Brown // Pathogens and Immunity. 2017. Vol. 2, No. 3. Р. 422–430. doi: 0.20411/pai.v2i3.226.

25. UNAIDS 2016–2021 Strategy. UNAIDS // UNAIDS. 2015. URL: http://aidsinfo.unaids.org.

26. Pokrovskiy V.V., Ulumbekova G.E., Petrachkov I.V. Organization of medical care for infection caused by human immunodeficiency virus. Healthcare management: news, opinions, education. Bulleten of VSHOUZ, 2022 (In Russ.). https://orgzdrav.vshouz.ru/ru/jarticles_orgzdrav/239.html?SSr=4001348b3217ffffffff27c__07e60716112838-1be3.

27. Kozlov A.P. New stage of HIV/AIDS in Russia and our new challenges. Russian journal of HIV/AIDS and related problems, 1997, Vol. 1, No. 1, рр. 84–85 (In Russ.).

28. Lobzin Yu.V., Zhdanov K.V., Pastuschenkov V.L. HIV: clinic, diagnostic, treatment. St. Petersburg: Folio, 2003. 144 р. (In Russ.).

29. Rakhmanova A.G., Yastrebova E.B., Vinogradova E.N. et al. HIV-infection in children. Children infections, 2004, Vol. 4, рр. 7–10 (In Russ.).

30. Kirzhanova V.V., Koschkina E.A., Mugantseva L.A. et al. Drug addiction and HIV-infection in Russia: data analysis and determining of correlations. Narcology, 2006, Vol. 12, рр. 21–28 (In Russ.).

31. Nechaeva O.B., Podymova A.S. Impact of HIV infection on demographic situation in Russia. Medical Alliance, 2018, No. 1, рр. 6–16 (In Russ.).

32. Zagdyn Z.M. The HIV case reporting system in the Russian Federation. Current problems of health care and medical statistics, 2019, Vol. 3, рр. 122–131 (In Russ.). doi: 10.24411/2312–2935–2019–10057.

33. Belyakov N.A., Rassokhin V.V., Bobreshova A.C. Countermeasures vs HIV and increased HIV incidence in Russia. HIV infection and immunosuppressive disorders, 2017, Vol. 9, No. 2, рр. 82–90 (In Russ.).

34. Zakharova N.G., Dvorak S.I., Plavinskiy S.L. et al. The causes of unfavorable outcomes among patients taking HAART. HIV infection and immunosuppressive disorders, 2015, Vol. 7, No. 4, рр. 52–63 (In Russ.).