As Russia conceals HIV data, report finds rising infection rates among pregnant women

December 1 is World AIDS Day. Last week, the project To Be Precise published two reports about how HIV is transmitted in contemporary Russia and what living with the illness looks like. Meduza summarizes the group’s findings.

The exact number of people living with HIV in Russia is unknown. Data on HIV-related deaths is no longer published.

Two government agencies track how many people in Russia are living with HIV. According to the Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing (Rospotrebnadzor), there were 1.2 million such individuals by late 2024. The Health Ministry, however, reported 863,000 cases — almost a third fewer. A third figure comes from the Federal State Statistics Service (Rosstat), which relies on data from organizations subordinate to the Health Ministry: 928,000 people.

It’s no longer clear how many people in Russia have died of HIV. Starting in 2025, the authorities stopped releasing these statistics, along with most demographic metrics. Data on new cases, now published annually rather than monthly, is also harder to find.

Foreign nationals in Russia test positive for HIV less often than Russian citizens

Like Egypt, Syria, and Iraq, Russia is one of the few countries that deport foreigners with HIV. Foreign nationals are required to undergo HIV testing if they want to live in Russia for more than 90 days, work there, obtain a residence permit, or if they are refugees or have applied for refugee status.

In 2024, Russian authorities collected 3.2 million blood samples from foreign nationals for HIV testing. Eighty-eight out of every 100,000 tests came back positive. Among Russian citizens, the rate was 139 per 100,000. This comparison may be misleading, however, since the vast majority of long-term foreign residents in Russia undergo such testing, whereas only 37 percent of Russian citizens do. Additionally, Russians’ numbers come mostly from select groups, like people with HIV symptoms, pregnant women, and those who decided to get tested voluntarily.

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According to official data, HIV in Russia is transmitted primarily through heterosexual contact

Testing among vulnerable groups — such as men who have sex with men, sex workers, and people who inject drugs — has become far less common in Russia. These groups now constitute just 2 percent of those tested, despite typically having higher rates of HIV infection. For instance, in 2023, HIV was diagnosed in 20,807 out of every 100,000 men who have sex with men. By contrast, among people tested while receiving different kinds of medical care — for example, during hospitalization — the detection rate was far lower, at 138 per 100,000.

According to official statistics, HIV in Russia is transmitted through heterosexual contact in 81 percent of cases. Homosexual contact accounts for 4 percent, and injection drug use accounts for 14 percent. In the European Union, the picture is fundamentally different: transmission through homosexual and heterosexual contact occurs in nearly equal proportions (47 and 46 percent, respectively). To Be Precise’s research attributes this discrepancy to the following factors:

In E.U. countries, HIV prevalence and incidence are significantly lower, and the epidemic is concentrated primarily among vulnerable groups. In Russia in 2023, there were 37.5 new HIV cases per 100,000 people tested, while in the E.U., the average was five cases per 100,000. Public health initiatives for HIV prevention and testing are aimed primarily at vulnerable populations.

Moreover, the percentage of infections attributed to homosexual contact and other vulnerable groups in Russia may be undercounted, Rospotrebnadzor notes. This is not only because testing is geared mainly toward the general population, but also because stigma discourages people from disclosing their actual transmission routes.

Russia’s worst HIV rates are in the Urals and Siberia. Conservative-leaning Vologda is among the regions with the highest number of HIV-positive pregnant women.

To assess HIV prevalence across Russia’s regions, To Be Precise examined several indicators, such as the share of infected pregnant women and the proportion of people with HIV receiving antiretroviral therapy. The situation proved most severe in the following regions:

• Kemerovo
• Tomsk
• Chelyabinsk
• Altai
• Krasnoyarsk
• The Leningrad region
• The Komi Republic
• Irkutsk
• Perm
• The Chukotka Autonomous Okrug

Because all pregnant women in Russia are advised to undergo HIV testing, this indicator provides an indirect measure of the situation in each region. “If more than 1 percent of pregnant women in a region are infected for three consecutive years, it means the virus has spread beyond vulnerable groups,” To Be Precise’s authors conclude. On average, the rate across Russia is 0.6 percent, but it exceeds 1 percent in 14 regions, 11 of which have reported infection rates at this level for several years already.

Vologda Governor Roman Filimonov has lobbied to end local abortion services and promoted the region as a proving ground for “conservative” values. However, the data show that HIV among pregnant women is rising, from 0.17 percent in 2022 to 1 percent in 2023 and then 2 percent in 2024.