Russia's AIDS epidemic is at a dangerous tipping point after the number of people registered HIV-positive passed the 1 million mark, the country's top AIDS specialist said on Thursday, warning the rate of infection had reached record levels.
Vadim Pokrovsky, the head of the federal AIDS center, told Reuters that the prevalence of the disease was on the verge of becoming common throughout the population, instead of concentrated primarily within a certain group.
Almost 20 percent of the country's drug users and nearly 10 percent of the country's gay people were HIV-positive, he said. Between 55 and 60 percent of cases are linked to drug use and around 40 percent to heterosexual sex. Gay sex accounted for only about 1.5 percent.
Russia registered its millionth HIV-positive patient — a 26-year-old woman in the south of the country — on Wednesday, said Pokrovsky. But he added the real number of HIV-positive Russians could be as high as 1.5 million, or 1 percent of the population, based on his and other expert estimates.
"The epidemic is gathering strength. Unfortunately the measures that have been taken have clearly not been enough," Pokrovsky said.
He warned that Russia was "on the threshold" of moving from a concentrated epidemic, where HIV is highly prevalent in one subset of the population, to a generalized epidemic, where HIV rates among the general population are sufficient for sexual networking to drive new infections.
"We're in a transitional phase," he said. "In separate regions we can say there is already a generalized HIV epidemic."
The Russian epidemic has been driven by very harsh drug laws and a lack of harm reduction and needle exchange programs, as well as repressive homosexuality laws, according to UNAIDS and the World Health Organization.
A report released by UNAIDS in 2014 called out Russia for its "appalling record" on HIV and drug policy. "The Russian Federation… continues to steadfastly deny the evidence on the effectiveness of harm reduction, and the rates of HIV infection among people who inject drugs in the country are among the highest in the world," it said.
A federal law banning "gay propaganda" has also hindered access to HIV prevention services among the LGBT community, according to activists.
Pokrovsky said 204,000 people had died of HIV in Russia since the first case was recorded in 1987. He expected the number of new cases in 2015 to be at least 93,000, up from just under 90,000 in 2014.
That, he said, would be the largest number of new cases since Russia began keeping data almost 30 years ago.
The escalation comes as Russia struggles financially, beset by low oil prices, Western sanctions and a falling ruble.
Russian Prime Minister Dmitry Medvedev called last October for a series of urgent measures to respond to the growing epidemic. The government plans to spend 40 billion rubles ($475.20 million) on fighting HIV/AIDs in 2016. Pokrovsky said 100 billion rubles was needed.
Government data shows 24,000 HIV-positive people died in 2014, the last full year for which data is available. Of those, around 12,000 died as a direct result of AIDS. Pokrovsky said the real number who died from AIDS was likely to be higher.
He said he expected data for 2015 to show a 5-10 percent increase in the number of deaths.