Report on the HIV/AIDS situation in Russia in 2023–2025, with a focus on the consequences for LGBTQ+ communities and organizations
Executive Summary
Official picture:
According to Rospotrebnadzor, ≈52.8 thousand new HIV cases were registered in 2024 (incidence 36.08 per 100,000; –9.9% vs. 2023). >52 million people were tested (≈37% of the population); prevalence as of 31 Dec 2024 was ≈831 per 100,000 (implying ~1.2 million people living with HIV, PLHIV). The downward incidence trend was reaffirmed by the agency in 2025. (Source: Medvestnik Library)
Data transparency has deteriorated:
Since 2023–2024, the Ministry of Health has stopped publishing the full set of key metrics, including the exact number of PLHIV, even as the ARV (antiretroviral therapy) procurement budget rose to ~₽42 bn (from ~₽31.7 bn in 2023). (Source: If Be Precise / tochno.st)
Key populations are under-tested:
Despite record overall testing, the share of tests performed among key populations—MSM (men who have sex with men), PWID (people who inject drugs), sex workers, people in detention, etc.—was only ~3% in 2023, reducing surveillance quality and limiting confidence in the data. (Source: SPID.Center)
Regional hotspots:
The most severe situation is in Siberia and the Urals (Kemerovo, Irkutsk, Sverdlovsk, Krasnoyarsk Krai, etc.); in a number of regions the share of rural cases and markers of generalization are growing. (Source: If Be Precise / tochno.st)
Legal environment has tightened sharply:
The Supreme Court of the Russian Federation (30 Nov 2023) designated the “international LGBT movement” an extremist organization; enforcement in 2024–2025 is creating systemic barriers to prevention, information, and services for MSM/trans people—as well as to testing and care. In 2025, the Elton John AIDS Foundation was labeled “undesirable,” and funding/grant renewals for PLHIV-serving funds and organizations have not been extended. (Source: Human Rights Watch)
Treatment and supply disruptions:
Despite higher budgets in 2024–2025, ARV shortages, forced regimen switches, and complaints from dozens of regions were recorded. (Source: SPID.Center) Reports of viral load/CD4 test-kit shortages in 16 regions in 2025 point to a deterioration in treatment monitoring.
War as a factor:
Independent reviews point to a sharp, multiplicative rise in HIV detections in the military in 2022–2024, posing indirect risks to the civilian sector (migration, treatment interruptions, criminal prosecutions). Independent investigations also show the emergence of special recruitment postings for people with HIV in the Russian armed forces and the exploitation of PLHIV. (Source: Carnegie Endowment)
Official picture:
According to Rospotrebnadzor, ≈52.8 thousand new HIV cases were registered in 2024 (incidence 36.08 per 100,000; –9.9% vs. 2023). >52 million people were tested (≈37% of the population); prevalence as of 31 Dec 2024 was ≈831 per 100,000 (implying ~1.2 million people living with HIV, PLHIV). The downward incidence trend was reaffirmed by the agency in 2025. (Source: Medvestnik Library)
Data transparency has deteriorated:
Since 2023–2024, the Ministry of Health has stopped publishing the full set of key metrics, including the exact number of PLHIV, even as the ARV (antiretroviral therapy) procurement budget rose to ~₽42 bn (from ~₽31.7 bn in 2023). (Source: If Be Precise / tochno.st)
Key populations are under-tested:
Despite record overall testing, the share of tests performed among key populations—MSM (men who have sex with men), PWID (people who inject drugs), sex workers, people in detention, etc.—was only ~3% in 2023, reducing surveillance quality and limiting confidence in the data. (Source: SPID.Center)
Regional hotspots:
The most severe situation is in Siberia and the Urals (Kemerovo, Irkutsk, Sverdlovsk, Krasnoyarsk Krai, etc.); in a number of regions the share of rural cases and markers of generalization are growing. (Source: If Be Precise / tochno.st)
Legal environment has tightened sharply:
The Supreme Court of the Russian Federation (30 Nov 2023) designated the “international LGBT movement” an extremist organization; enforcement in 2024–2025 is creating systemic barriers to prevention, information, and services for MSM/trans people—as well as to testing and care. In 2025, the Elton John AIDS Foundation was labeled “undesirable,” and funding/grant renewals for PLHIV-serving funds and organizations have not been extended. (Source: Human Rights Watch)
Treatment and supply disruptions:
Despite higher budgets in 2024–2025, ARV shortages, forced regimen switches, and complaints from dozens of regions were recorded. (Source: SPID.Center) Reports of viral load/CD4 test-kit shortages in 16 regions in 2025 point to a deterioration in treatment monitoring.
War as a factor:
Independent reviews point to a sharp, multiplicative rise in HIV detections in the military in 2022–2024, posing indirect risks to the civilian sector (migration, treatment interruptions, criminal prosecutions). Independent investigations also show the emergence of special recruitment postings for people with HIV in the Russian armed forces and the exploitation of PLHIV. (Source: Carnegie Endowment)
Important Stories (iStories) investigation “A Hero Without Limitations.”
Important Stories found dozens of job postings for people with HIV and hepatitis that promise an official contract with the Ministry of Defense.
Important Stories found dozens of job postings for people with HIV and hepatitis that promise an official contract with the Ministry of Defense.
Methodology and Sources
Selection and verification are based on:
(1) official releases and bulletins from Rospotrebnadzor/Ministry of Health (incidence, testing coverage, prevalence);
(2) analysis by If Be Precise (tochno.st) and regional rankings;
(3) reports from specialized NGOs/patient initiatives (Patient Control, ITPC EECA, SPID.Center) and academic publications;
(4) human-rights analysis by HRW and others on law enforcement practices;
(5) independent media reviews and investigations (Carnegie Politika, Important Stories, Verstka).
All key statements below are sourced.
Selection and verification are based on:
(1) official releases and bulletins from Rospotrebnadzor/Ministry of Health (incidence, testing coverage, prevalence);
(2) analysis by If Be Precise (tochno.st) and regional rankings;
(3) reports from specialized NGOs/patient initiatives (Patient Control, ITPC EECA, SPID.Center) and academic publications;
(4) human-rights analysis by HRW and others on law enforcement practices;
(5) independent media reviews and investigations (Carnegie Politika, Important Stories, Verstka).
All key statements below are sourced.
Epidemiological Trends (2023–2025)
New cases and incidence
Testing
According to government sources, 52 million tests were conducted in 2024 (≈37% of the population)—a historical high; the agency emphasizes “pre-clinical” diagnosis. However, the share of tests among key populations remains low (see below). (Source: Vedomosti)
Based on open data from the Ministry of Health and Rospotrebnadzor, primary incidence has shown a steady ten-year decline: from 68.2 per 100,000 in 2015 to 33.1 per 100,000 in 2024. Over the same period, testing coverage increased by 74.8% (from 28 million tests in 2014 to 49 million in 2023; equivalent to growth from 19.2 to 33.4 tests per 100 residents). Meanwhile, the share of key populations in total testing nearly halved—from 5.8% (2014) to 3.0% (2023); positivity among key populations has been, on average, 9.4× higher than in the general population. This is a key indicator of systemic under-testing of vulnerable groups amid expanding “mass” screening. (SPID.Center source: “Rosstat published today the data on the number of residents in Russia newly diagnosed with HIV”)
The positivity rate among all tested individuals fell by 57.8% in 2014–2023 (from 398.1 to 168.0 per 100,000 tested), which aligns with the downward trend in incidence but does not eliminate the risk of “blind spots” due to the low testing share among MSM/PWID/SW and people in detention.
Epidemic structure and age
A shift toward older age groups (30–49 dominate); men constitute the majority of newly diagnosed; the share of 15–20-year-olds is declining. (Source: HIVhub)
Regional variation
Prevalence (PLHIV per 100,000) remains consistently highest in Kemerovo, Irkutsk, Sverdlovsk and other regions; in Siberia/Urals, markers of generalization persist. Updated 2023–2024 rankings confirm this picture. (Source: If Be Precise / tochno.st)
Co-infections (TB and resistance)
Over the past decade, tuberculosis incidence in Russia has halved, but progress is hampered by HIV co-infection and drug resistance—a driver of excess mortality among PLHIV and a threat to regimen durability. According to independent investigations, the war in Ukraine has contributed to the recent rise in TB incidence. (Source: If Be Precise / tochno.st)
New cases and incidence
- 2023: According to the If Be Precise analytical project, ~55,000 new cases; the lowest incidence since 2007 (≈37.5 per 100,000). (Source: If Be Precise / tochno.st)
- 2024: 52,783 new cases (per Form No. 2); incidence 36.08 per 100,000 (–9.9% vs. 2023); prevalence 831.4 per 100,000 as of 31 Dec 2024. (Source: Medvestnik Library)
- 2025: In June 2025, Rospotrebnadzor and federal media confirmed the downward trend and a record >52 million tests; some reviews cite a ~9–10% reduction in new cases for 2024. However, these data cannot be fully trusted: they have not been independently verified, and the share of testing among key populations remains extremely low. (Source for decline: Interfax.ru)
Testing
According to government sources, 52 million tests were conducted in 2024 (≈37% of the population)—a historical high; the agency emphasizes “pre-clinical” diagnosis. However, the share of tests among key populations remains low (see below). (Source: Vedomosti)
Based on open data from the Ministry of Health and Rospotrebnadzor, primary incidence has shown a steady ten-year decline: from 68.2 per 100,000 in 2015 to 33.1 per 100,000 in 2024. Over the same period, testing coverage increased by 74.8% (from 28 million tests in 2014 to 49 million in 2023; equivalent to growth from 19.2 to 33.4 tests per 100 residents). Meanwhile, the share of key populations in total testing nearly halved—from 5.8% (2014) to 3.0% (2023); positivity among key populations has been, on average, 9.4× higher than in the general population. This is a key indicator of systemic under-testing of vulnerable groups amid expanding “mass” screening. (SPID.Center source: “Rosstat published today the data on the number of residents in Russia newly diagnosed with HIV”)
The positivity rate among all tested individuals fell by 57.8% in 2014–2023 (from 398.1 to 168.0 per 100,000 tested), which aligns with the downward trend in incidence but does not eliminate the risk of “blind spots” due to the low testing share among MSM/PWID/SW and people in detention.
Epidemic structure and age
A shift toward older age groups (30–49 dominate); men constitute the majority of newly diagnosed; the share of 15–20-year-olds is declining. (Source: HIVhub)
Regional variation
Prevalence (PLHIV per 100,000) remains consistently highest in Kemerovo, Irkutsk, Sverdlovsk and other regions; in Siberia/Urals, markers of generalization persist. Updated 2023–2024 rankings confirm this picture. (Source: If Be Precise / tochno.st)
Co-infections (TB and resistance)
Over the past decade, tuberculosis incidence in Russia has halved, but progress is hampered by HIV co-infection and drug resistance—a driver of excess mortality among PLHIV and a threat to regimen durability. According to independent investigations, the war in Ukraine has contributed to the recent rise in TB incidence. (Source: If Be Precise / tochno.st)
Data: quality and opacity
Since 2023–2024, the Ministry of Health has effectively closed access to a number of key metrics (including the total number of PLHIV); at the same time, public reports by agencies diverge, and independent verification of the claimed “over-performance of strategic targets” is difficult—and at times effectively impossible. (Source: If Be Precise / tochno.st)
Share of testing among key populations:
According to Rosstat/analysts, this declined and by 2023 was ≈3% of all tests (amid growth in “mass” testing), leading to systematic under-detection among MSM (men who have sex with men) and PWID (people who inject drugs). (Source: SPID.Center)
Since 2023–2024, the Ministry of Health has effectively closed access to a number of key metrics (including the total number of PLHIV); at the same time, public reports by agencies diverge, and independent verification of the claimed “over-performance of strategic targets” is difficult—and at times effectively impossible. (Source: If Be Precise / tochno.st)
Share of testing among key populations:
According to Rosstat/analysts, this declined and by 2023 was ≈3% of all tests (amid growth in “mass” testing), leading to systematic under-detection among MSM (men who have sex with men) and PWID (people who inject drugs). (Source: SPID.Center)
Moscow AIDS Center
Photo: Vladimir Andreev / URA.RU / TASS
Photo: Vladimir Andreev / URA.RU / TASS
Access to treatment (ART), procurement, and disruptions
Budget:
By the end of 2024, the ARV procurement budget had increased to ≈₽42 bn (from ~₽31.7 bn in 2023), but the estimated need to cover everyone under clinical follow-up is higher (~₽67.5 bn) at current prices. (Source: If Be Precise / tochno.st)
Disruptions:
In 2023–2024, shortages and regimen switches were widely documented (Patient Control, SPID.Center, media). Complaints came from dozens of regions; deficits were acknowledged for several key molecules (abacavir, tenofovir, dolutegravir, etc.). (Source: Pereboi.ru)
According to the Rospotrebnadzor monitoring form, in 2024 ART coverage reached 89.8% among those in the dispensary cohort and 62.9% of the estimated total number of PLHIV. Among people on therapy, 43,754 interrupted treatment, and in 42.7% of cases the reason was death. Viral suppression was achieved in 76.8% of patients on ART (49.6% of all PLHIV), underscoring a substantial gap to the 95-95-95 goal and the risk of onward transmission among a significant share of diagnosed people. (Source: “Over 30,000 deaths, nearly 44,000 discontinued ART: HIV data for Russia in 2024”)
In 2025, NGOs and media documented viral load (VL)/CD4 test-kit shortages in at least 16 regions (≥40 complaints since the start of the year), leading to denials of the mandated semiannual assessments; some regions acknowledged disruptions and cited procurement delays/under-funding. This directly affects retention in care and timely regimen optimization.
LA-ART / injectable therapy:
Long-acting cabotegravir and rilpivirine have been registered, but there has been no large-scale rollout—reasons cited include pricing/regulatory factors. (Source: ITPC Global)
Budget:
By the end of 2024, the ARV procurement budget had increased to ≈₽42 bn (from ~₽31.7 bn in 2023), but the estimated need to cover everyone under clinical follow-up is higher (~₽67.5 bn) at current prices. (Source: If Be Precise / tochno.st)
Disruptions:
In 2023–2024, shortages and regimen switches were widely documented (Patient Control, SPID.Center, media). Complaints came from dozens of regions; deficits were acknowledged for several key molecules (abacavir, tenofovir, dolutegravir, etc.). (Source: Pereboi.ru)
According to the Rospotrebnadzor monitoring form, in 2024 ART coverage reached 89.8% among those in the dispensary cohort and 62.9% of the estimated total number of PLHIV. Among people on therapy, 43,754 interrupted treatment, and in 42.7% of cases the reason was death. Viral suppression was achieved in 76.8% of patients on ART (49.6% of all PLHIV), underscoring a substantial gap to the 95-95-95 goal and the risk of onward transmission among a significant share of diagnosed people. (Source: “Over 30,000 deaths, nearly 44,000 discontinued ART: HIV data for Russia in 2024”)
In 2025, NGOs and media documented viral load (VL)/CD4 test-kit shortages in at least 16 regions (≥40 complaints since the start of the year), leading to denials of the mandated semiannual assessments; some regions acknowledged disruptions and cited procurement delays/under-funding. This directly affects retention in care and timely regimen optimization.
LA-ART / injectable therapy:
Long-acting cabotegravir and rilpivirine have been registered, but there has been no large-scale rollout—reasons cited include pricing/regulatory factors. (Source: ITPC Global)
Prevention and treatment modalities: PrEP/PEP, harm reduction, OST
PrEP:
Russia’s federal clinical guidelines contain no provisions on pre-exposure prophylaxis; access is sporadic, often commercial and/or via NGO programs; scale is extremely limited, and in some places effectively criminalized due to homophobic government policies. (Source: life4me.plus)
OST (methadone/buprenorphine):
Prohibited by federal law; international bodies have repeatedly documented the harm this causes to HIV prevention among PWID, including in Crimea. The ban remains a key barrier. (Source: HUDOC)
LA-ART:
International data on long-acting injectable cabotegravir + rilpivirine (CAB+RPV LA) confirm high efficacy and patient acceptance: in the BEYOND study (USA), 97% had VL <50 copies/mL at 12 months; 97% preferred injections to pills.
In Russia, cabotegravir LA (“Vocabria”) was registered in December 2022, rilpivirine LA (“Rekambys”) in 2023; a tablet form of cabotegravir was registered in April 2024. Russia’s 2024 clinical guidelines permit their use to optimize ART in virally suppressed patients; however, a combined co-pack (Cabenuva analog) is not yet available, which constrains the scale-up of LA regimens. Access to new medicines in the country is hampered by sanctions.
PrEP:
Russia’s federal clinical guidelines contain no provisions on pre-exposure prophylaxis; access is sporadic, often commercial and/or via NGO programs; scale is extremely limited, and in some places effectively criminalized due to homophobic government policies. (Source: life4me.plus)
OST (methadone/buprenorphine):
Prohibited by federal law; international bodies have repeatedly documented the harm this causes to HIV prevention among PWID, including in Crimea. The ban remains a key barrier. (Source: HUDOC)
LA-ART:
International data on long-acting injectable cabotegravir + rilpivirine (CAB+RPV LA) confirm high efficacy and patient acceptance: in the BEYOND study (USA), 97% had VL <50 copies/mL at 12 months; 97% preferred injections to pills.
In Russia, cabotegravir LA (“Vocabria”) was registered in December 2022, rilpivirine LA (“Rekambys”) in 2023; a tablet form of cabotegravir was registered in April 2024. Russia’s 2024 clinical guidelines permit their use to optimize ART in virally suppressed patients; however, a combined co-pack (Cabenuva analog) is not yet available, which constrains the scale-up of LA regimens. Access to new medicines in the country is hampered by sanctions.
Takie Dela investigation: “What saved me was that I live openly and write about my status.” How Russians are prosecuted for the threat of transmitting HIV. January 16, 2024.
Legal-political context and impact on LGBTQ+
The Supreme Court of the Russian Federation (30 Nov 2023) designated the “international LGBT public movement” an extremist organization; the ruling took effect in January 2024 and led to a surge in cases, content blocks, and self-censorship by NGOs/media. This directly undermines prevention (materials on sex/condoms/PrEP, outreach, etc.), also creates risks for physicians, and has forced some to refuse patients. (Source: Human Rights Watch)
2025:
Authorities designated the Elton John AIDS Foundation an “undesirable organization,” a blow to international partnerships and funding for HIV services linked to LGBTQ+ support. If this step becomes a trend, the situation will worsen significantly. (Source: The Guardian)
Criminalization:
Article 122 of the Criminal Code (“creating a danger of infection” and “transmission”) is actively enforced, including in family/consensual contexts, which deters testing and status disclosure. (Source: Consultant Plus)
In May 2025, Yulia Razumovskaya, coordinator of the St. Petersburg branch of SPID.Center, launched a petition to revise/decriminalize Article 122 (threat of HIV transmission/HIV transmission), citing the scientifically established U=U principle and the disproportionate harms of enforcement (blackmail, stigma, avoidance of testing). The fund’s position aligns with UNAIDS recommendations to repeal the criminalization of non-disclosure/exposure/transmission of HIV as a counterproductive public-health measure.
The legal service of SPID.Center and the PLHIV Forum consistently document typical discrimination cases (disclosure of diagnosis, employment bans, denial of services) and publish practical guides on protecting PLHIV rights (medical confidentiality, labor rights, procedural steps in Article 122 cases). This is highly relevant to communications with MSM/trans people amid intensified repression.
High-risk regions (scenarios for media and NGO monitoring):
Kuzbass (Kemerovo), Irkutsk, Sverdlovsk, Krasnoyarsk Krai, Perm Krai, Altai Krai, Tomsk/Novosibirsk Regions — high prevalence/incidence; signs of generalization (including >1% HIV among pregnant women in some years). Targeted prevention and retention in treatment need strengthening. (Source: If Be Precise / tochno.st)
The Supreme Court of the Russian Federation (30 Nov 2023) designated the “international LGBT public movement” an extremist organization; the ruling took effect in January 2024 and led to a surge in cases, content blocks, and self-censorship by NGOs/media. This directly undermines prevention (materials on sex/condoms/PrEP, outreach, etc.), also creates risks for physicians, and has forced some to refuse patients. (Source: Human Rights Watch)
2025:
Authorities designated the Elton John AIDS Foundation an “undesirable organization,” a blow to international partnerships and funding for HIV services linked to LGBTQ+ support. If this step becomes a trend, the situation will worsen significantly. (Source: The Guardian)
Criminalization:
Article 122 of the Criminal Code (“creating a danger of infection” and “transmission”) is actively enforced, including in family/consensual contexts, which deters testing and status disclosure. (Source: Consultant Plus)
In May 2025, Yulia Razumovskaya, coordinator of the St. Petersburg branch of SPID.Center, launched a petition to revise/decriminalize Article 122 (threat of HIV transmission/HIV transmission), citing the scientifically established U=U principle and the disproportionate harms of enforcement (blackmail, stigma, avoidance of testing). The fund’s position aligns with UNAIDS recommendations to repeal the criminalization of non-disclosure/exposure/transmission of HIV as a counterproductive public-health measure.
The legal service of SPID.Center and the PLHIV Forum consistently document typical discrimination cases (disclosure of diagnosis, employment bans, denial of services) and publish practical guides on protecting PLHIV rights (medical confidentiality, labor rights, procedural steps in Article 122 cases). This is highly relevant to communications with MSM/trans people amid intensified repression.
High-risk regions (scenarios for media and NGO monitoring):
Kuzbass (Kemerovo), Irkutsk, Sverdlovsk, Krasnoyarsk Krai, Perm Krai, Altai Krai, Tomsk/Novosibirsk Regions — high prevalence/incidence; signs of generalization (including >1% HIV among pregnant women in some years). Targeted prevention and retention in treatment need strengthening. (Source: If Be Precise / tochno.st)
Takie Dela investigation: “What saved me was that I live openly and write about my status.” How Russians are prosecuted for the threat of transmitting HIV. January 16, 2024.
Impact of the war and mobilization
Independent estimates record a sharp rise in HIV registrations in the Russian Armed Forces in 2022–2024 (about ×13 by the end of 2022 and up to ×20 by the end of 2024 relative to the pre-war level), indicating risks for the civilian sector (logistics, treatment interruptions, migration). (Source: Carnegie Endowment)
Independent investigations also document targeted recruitment of people with HIV/viral hepatitis through job postings on marketplaces (including Avito), as well as reports about the formation of separate units.
In parallel, a scientific article in the Military Medical Journal (analyzed by Verstka) indicates a multiplicative increase in detected HIV cases among service members by Q4 2023. (Source: “A Hero Without Limitations” investigation)
Independent estimates record a sharp rise in HIV registrations in the Russian Armed Forces in 2022–2024 (about ×13 by the end of 2022 and up to ×20 by the end of 2024 relative to the pre-war level), indicating risks for the civilian sector (logistics, treatment interruptions, migration). (Source: Carnegie Endowment)
Independent investigations also document targeted recruitment of people with HIV/viral hepatitis through job postings on marketplaces (including Avito), as well as reports about the formation of separate units.
In parallel, a scientific article in the Military Medical Journal (analyzed by Verstka) indicates a multiplicative increase in detected HIV cases among service members by Q4 2023. (Source: “A Hero Without Limitations” investigation)
You can now find job postings on Avito for fighters with HIV. Source: Important Stories investigation.
What this means for LGBTQ+ projects.
Recommendations from international organizations and Russian NGOs
(communications, advocacy, monitoring)
“Health and rights” messaging: Emphasize that repression of LGBTQ+ people and the ban on OST are not only human-rights issues but also risk factors for the spread of HIV (reduced access to prevention/PrEP, outreach, and psychosocial support). (Source: Human Rights Watch)
Data vs. reality: Use official trends (declining incidence, rising testing), but clearly state the low share of tests in key populations and the data opacity at the Health Ministry—this explains “optimistic” aggregates despite hidden vulnerability among MSM/PWID. (Source: SPID.Center)
Regional focus: Build targeted regional stories/cases from Siberia and the Urals—ARV shortages, late diagnosis, access barriers for MSM/trans people; draw on testimonies from patient initiatives. (Source: SPID.Center)
PrEP/PEP education (with legal caution): Explain the scientific consensus and international recommendations, with fact-checking on Russia’s status and enforcement risks related to “propaganda.” (Source: life4me.plus)
Monitoring law enforcement: Track cases under “extremism” (for rainbow symbols/“propaganda”) and their impact on prevention coverage and the resilience of NGO services. (Source: Human Rights Watch)
Recommendations from international organizations and Russian NGOs
(communications, advocacy, monitoring)
“Health and rights” messaging: Emphasize that repression of LGBTQ+ people and the ban on OST are not only human-rights issues but also risk factors for the spread of HIV (reduced access to prevention/PrEP, outreach, and psychosocial support). (Source: Human Rights Watch)
Data vs. reality: Use official trends (declining incidence, rising testing), but clearly state the low share of tests in key populations and the data opacity at the Health Ministry—this explains “optimistic” aggregates despite hidden vulnerability among MSM/PWID. (Source: SPID.Center)
Regional focus: Build targeted regional stories/cases from Siberia and the Urals—ARV shortages, late diagnosis, access barriers for MSM/trans people; draw on testimonies from patient initiatives. (Source: SPID.Center)
PrEP/PEP education (with legal caution): Explain the scientific consensus and international recommendations, with fact-checking on Russia’s status and enforcement risks related to “propaganda.” (Source: life4me.plus)
Monitoring law enforcement: Track cases under “extremism” (for rainbow symbols/“propaganda”) and their impact on prevention coverage and the resilience of NGO services. (Source: Human Rights Watch)
Possible indicators to track in 2025–2026
- Share of tests in key populations (MSM, PWID, SW, people in detention): target increase ≥10% of all testing—crucial for surveillance sensitivity. (Source: SPID.Center)
- Continuity of ARV supply: monitor not only budget volume but also contract cadence (complaints/failed tenders, forced regimen switches by region). (Source: SPID.Center)
- Prevalence/incidence in leading regions and the share of rural cases as a marker of generalization. (Source: If Be Precise / tochno.st)
- PrEP/PEP availability (generic pricing, prescribing practices, local NGO pilots). (Source: ITPC Global)
- Law enforcement after Nov 2023 (number of cases/fines/content blocks; impact on prevention for MSM/trans people). (Source: Human Rights Watch)
- Share of PLHIV with viral suppression out of all PLHIV (target ≥70% by 2026; 2024 baseline: 49.6%). (Source: SPID.Center)
- Diagnostics cadence: share of patients receiving VL/CD4 ≥ 2 times/year; real-time monitoring of test-kit shortages by region. (Source: Vedomosti)
- LA-ART pilots: number of centers offering CAB+RPV LA to retain “low-adherence risk groups”; barriers (procurement/pricing/lack of combined co-pack). (Source: OUP Academic)
Limitations and risks of interpretation
Partial data closure by the Ministry of Health and methodological heterogeneity across agencies (Ministry of Health vs. Rospotrebnadzor) and independent sources. The reduced share of testing in key populations alongside growth in “mass” testing can distort incidence trends. (Source: If Be Precise / tochno.st)
Data on the military and the “new territories” are politically sensitive within Russia’s authoritarian system and may be falsified or ignored; cite only with sources and explicitly label them as independent estimates, not official statistics. (Source: Carnegie Endowment)
Partial data closure by the Ministry of Health and methodological heterogeneity across agencies (Ministry of Health vs. Rospotrebnadzor) and independent sources. The reduced share of testing in key populations alongside growth in “mass” testing can distort incidence trends. (Source: If Be Precise / tochno.st)
Data on the military and the “new territories” are politically sensitive within Russia’s authoritarian system and may be falsified or ignored; cite only with sources and explicitly label them as independent estimates, not official statistics. (Source: Carnegie Endowment)
Key sources used for the report
Official and business media:
Rospotrebnadzor communications and their coverage in Interfax/TASS/Kommersant/Vedomosti (2024 incidence, 52 million tests, prevalence). (Link: Medvestnik Library)
Analytics and regional rankings:
If Be Precise (tochno.st) — 2023–2024 dynamics, data closure, regional differences; material on TB and HIV co-infection. (Link: If Be Precise)
Key populations and testing:
Rosstat and SPID.Center on changes in testing structure and the decline of the key-population share to ~3% (2023). (Link: SPID.Center)
Prevention/PrEP/OST:
ITPC EECA and sector reviews; absence of PrEP in clinical guidelines; the OST ban and its consequences (ECHR/OSF/sector reviews). (Link: life4me.plus)
ARV disruptions:
Patient Control, SPID.Center, and media reports from both pro-government and independent outlets. (Link: Pereboi.ru)
Legal-political context:
HRW on the Supreme Court ruling and enforcement; designation of EJAF as “undesirable” in 2025. (Source: Human Rights Watch)
War and risks:
Carnegie Politika — rise in detections in the military and analytical context, with additions from Verstka, Important Stories, The Insider, etc. (Source: Carnegie Endowment)
SPID.Center::
BEYOND study (OFID, 2025):
Results on CAB+RPV LA. (Link: OUP Academic)
GRLS/official registries for Vocabria and Rekambys (registration in Russia). (Link: id.pharm-portal.ru)
Vedomosti/Mediazona:
Shortages of test kits in the regions (2025). (Link: Vedomosti)
Important Stories + Current Time TV:
Recruitment of people with HIV and data on rising HIV registrations in the army (via the Military Medical Journal, through Verstka). (Link: istories.media)
Appendix: talking points for editorial/advocacy work
Official and business media:
Rospotrebnadzor communications and their coverage in Interfax/TASS/Kommersant/Vedomosti (2024 incidence, 52 million tests, prevalence). (Link: Medvestnik Library)
Analytics and regional rankings:
If Be Precise (tochno.st) — 2023–2024 dynamics, data closure, regional differences; material on TB and HIV co-infection. (Link: If Be Precise)
Key populations and testing:
Rosstat and SPID.Center on changes in testing structure and the decline of the key-population share to ~3% (2023). (Link: SPID.Center)
Prevention/PrEP/OST:
ITPC EECA and sector reviews; absence of PrEP in clinical guidelines; the OST ban and its consequences (ECHR/OSF/sector reviews). (Link: life4me.plus)
ARV disruptions:
Patient Control, SPID.Center, and media reports from both pro-government and independent outlets. (Link: Pereboi.ru)
Legal-political context:
HRW on the Supreme Court ruling and enforcement; designation of EJAF as “undesirable” in 2025. (Source: Human Rights Watch)
War and risks:
Carnegie Politika — rise in detections in the military and analytical context, with additions from Verstka, Important Stories, The Insider, etc. (Source: Carnegie Endowment)
SPID.Center::
- 2024 HIV results (ART 89.8/62.9; 43,754 interruptions; VL 76.8/49.6). (Link: SPID.Center)
- Testing trends 2014–2023 (decline in key-population share; dynamics of tests and positivity). (Link: SPID.Center)
- Petition to revise Criminal Code Article 122. UNAIDS: fact sheet on criminalization. (Link: SPID.Center)
BEYOND study (OFID, 2025):
Results on CAB+RPV LA. (Link: OUP Academic)
GRLS/official registries for Vocabria and Rekambys (registration in Russia). (Link: id.pharm-portal.ru)
Vedomosti/Mediazona:
Shortages of test kits in the regions (2025). (Link: Vedomosti)
Important Stories + Current Time TV:
Recruitment of people with HIV and data on rising HIV registrations in the army (via the Military Medical Journal, through Verstka). (Link: istories.media)
Appendix: talking points for editorial/advocacy work
- Cite the numbers, show the caveats: “Incidence ↓ by ~10% in 2024, >52 million tested — but key-population share ≈3% → systematic under-detection.” (Source: Medvestnik Library)
- Link “legal regime → epidemiological risks”: cases under “extremism” against LGBTQ+ people and the OST ban = prevention barriers, reduced access to PrEP/outreach/information. (Source: Human Rights Watch)
- Highlight treatment continuity: even with a larger budget, disruptions persist — it’s crucial to monitor supply continuity and regimen quality. (Source: If Be Precise / tochno.st)