Epidemiology and Infections Trends in Hiv Epidemic Development in the Northwest of the Russian Federation

The northwest of the Russian Federationbecame involved in HIV epidemic earlier than other region did and is currently a leader in HIV prevalence, which, while being still high, shows some positive trends discussed in the present paper. Objective: To characterize the current state of HIV epidemic in the Northwest Federal Region (NWFR) of the Russian Federation and to delineate the main routes of HIV transmission and the factors that destabilize the epidemic situation. Materials and methods: HIV epidemiological surveillance data related to all of 11 administrative units of NWFR in the year 2014 are reviewed. Results: Most of HIV patients are residents of Saint-Petersburg and Leningrad Oblast. The main routes of HIV spread during the last 15 years are intravenous drug use, which recently has been matched by the sexual transmission, which is characteristic of the newly found cases. Increasing HIV prevalence among MSM raises much concern as evidencing HIV accumulation in this subpopulation. In some administrative units, injection drug use remains to be a destabilizing factor. The perinatal HIV spread tends to decrease and is now responsible to 3,7% on average, being the lowest in Saint-Petersburg (1,1%) and the highest in Komi Republic (6,6%). People living with HIV are becoming older, the peak of HIV prevalence having shifted to 35 years, and the proportion of HIV patients younger than 30 years having decreased. About 40% of HIV patients in NWFR received ART, which is higher than in Russia on average. To increase the number of HIV patients involved in HAART, additional funding and personnel are required. HIV epidemic in NWFR is stabilized at high levels of epidemiological parameters and ahigh number of people living with HIV.