HIV spreads beyond risk groups in 27 Russian regions

Russia's consumer-protection agency Rospotrebnadzor now classifies 27 of the country's regions as having a generalised HIV epidemic — the epidemiologist's term for the stage at which a virus circulates in the general population rather than within risk groups. The classification rests on surveillance data showing HIV diagnosed in more than one percent of pregnant women in all 27 regions. The situation is gravest in the Kemerovo, Irkutsk and Sverdlovsk regions.

The headline numbers point the other way. The Central Research Institute for the Prevention and Control of AIDS counted 45,000 new HIV cases in 2025, 13.4 percent fewer than the year before. Yet the same year set a record for HIV and hepatitis infections contracted inside medical institutions — the highest figure in fifteen years, according to the specialist portal Medvestnik. Eight clusters in healthcare facilities infected 104 patients, and investigations continue into eleven further clusters across ten regions where transmission in medical organisations is suspected. In Moscow, 22 cases of viral hepatitis C are under investigation in a single cluster. The largest confirmed cluster of the past two years infected 82 people at a sanatorium in Kabardino-Balkaria; oncology hospitals in Kamchatka and Buryatia infected 147 and 42 patients respectively, and dialysis centres in the Samara and Kursk regions account for another 26.

The mechanism is not mysterious. Yelena Igonina, head of Rospotrebnadzor's department for the epidemiological wellbeing of the population, attributes the outbreaks to single-use catheters and glucometers being used on several patients, and describes such violations as systemic, gross and entrenched in today's Russia. In 2026, for the first time in six years, two people were infected with HIV through transfusions of blood components.

International HIV consultant Aleksei Verter reads the hospital outbreaks as a signal about the country as a whole: when medical facilities keep receiving large numbers of patients with undiagnosed infections, the infectious process is latent and hidden, and a great many people do not know they carry the virus. Testing for hepatitis C RNA — the more sensitive of the two available markers — covers blood, organ and tissue donors well, but lags for dialysis, haematology and transplant patients, the groups most exposed to repeated procedures.

Russia's HIV incidence and mortality are both falling. The number of people living with the virus is not: for every HIV-related death, the registers record one and a half new infections.