Stellit

1
HIV and associated infections among youth in
Russia

• Stellit

2
Total number of registered HIV cases among
citizens of Russian Federation (2012)
720014Total registered HIV cases 69 849newly
registered HIV cases in 2012
3
Estimated number of total number of people
living with HIV (2011)

• Estimated number of people living with HIV
  730,000 - 1,300,000. Adults aged 15 to 49
  estimated prevalence rate 0.80 - 1.40

UNAIDS 2011
4
Number of HIV cases registered in different
Russian regions
Incidence rate is 48,4 per 100 000, prevalence
rate is 437,6 per 100 000
0,4 of the total country population are people
living with HIV/AIDS

• Most affected regions are the following
• Irkutsk region - 1458,4
• Samara region - 1351,6
• Sverdlovsk region - 1160,3
• Leningrad region - 1111,1
• Orenburg region - 1051,6
• St. Petersburg - 996,5
• Khanty-Mansi AO - 956,6
• Kemerovo region -
  887,8

Regions with the most significant incidence
rates Tomsk region growth at 76,5 Sakhalin
region - growth at 67,5 Altay Republic - growth
at 51,9 Kemerovo region growth at
44,9 Novgorod region growth at 44,4 Nishniy
Novgorod region - growth at 38,3 Republic of
Khakassia- growth at 33,8 R. of North
Ossetia-Alania- growth at 30,9 Stavropol region
- growth at 27.
5
Number of new HIV cases is growing

• The number of citizens who have been tested for
  antibodies to HIV in 2012 was 26,049,194 people,
  or 18.2 of the population.
• The number of detected positive results increased
  by 13.1 compared to the prior year.
• A decline in the proportion of adolescents and
  young adults aged 15-20 years and the shift of
  the center of the epidemic in the older age group
  - 30-40 years is observed.

6
Epidemic state

• Epidemic state depends on the region.
• In 34 Russian regions HIV prevalence among
  pregnant women in 2012 was more than 0,5
• in 9 subjects of Russia it was more than 1
  Samara region - 2,2, Sverdlovsk region -1,8,
  Leningrad region -1,7, Ulyanovsk region -1,7,
  Khanty-Mansi AO, Kemerovo region, Novosibirsk
  region -1,3

7
Epidemic stage concentrated
generalized

• HIV among sex workers (St.Petersburg) 12,9 of
  brothel based SWs are HIV positive (Vinogradova
  et al 2012), 87.2 of street based SW have
  injected drugs and 48,0 of them are HIV positive
  (Yakovleva et al. 2007)
• HIV among IDU (St.Petersburg) - 61,4
  (UNODC/Stellit, 2011)
• HIV prevalence among street youth 15-19 years in
  St. Petersburg  is 37.4, which is the highest
  HIV rate in Europe for this age group
  (Doctors2Children, 2007).
• High potential for HIV spread from core groups to
  general population through unsafe sex contacts
  (Niccolai et al., 2012)

8
Number of new HIV cases in different age groups
9
Number of new HIV cases among males and females

• In 2012 the cumulative number of women living
  with HIV/ AIDS was 2,2 times higher comparing to
  2005 258 000 people, 43 of registered HIV
  cases
• In 2012 HIV prevalence among pregnant women was
  0,62 which is 2 times higher than in 2003
  (0,3)
• In 2011in 13 subjects of Russia and in 2012 in
  11 subjects of Russia more than 50 of newly
  registered HIV cases were registered among women

• During the last years the number of sexually
  transmitted HIV cases is being increased. In 2012
  in 41,2 of newly registered cases HIV has been
  transmitted via heterosexual contacts (2011
  41,4, 2010 38,9, 2009 36,2, 2008 35,1)

9
10
The number of people living with HIV/Tb is being
increased

• There were 11 839 newly registered HIV/Tb cases
  in 2011 (2007 - 5 985, 2008 -7 387, 2009 - 9 253,
  ? 2010 - 10 617)
• The total number of registered HIV/Tb cases in
  2011 was 29 977.

11
The number of people living with HIV/Tb is being
increased

• There were 11 839 newly registered HIV/Tb cases
  in 2011 (2007 - 5 985, 2008 -7 387, 2009 - 9 253,
  ? 2010 - 10 617)
• The total number of registered HIV/Tb cases in
  2011 was 29 977
• HIV/Tb cases South Federal District 12,0, The
  North Caucasus Federal District 12,3
• Active Tb South Federal District 54,7, The
  North Caucasus Federal District 55,1
• Tb is still one of the most widespread reasons of
  death of people living with HIV/AIDS South
  Federal District 64, The North Caucasus
  Federal District 58,1

12
Youth at high risk of HIV/AIDS and AI
13
HIV among youth

• Definitions
• Child 0-17 years old, Adolescent 10-14 or 14-17
  (???????, 2012)
• Youth 14-30 years old (Strategy for Youth Policy
  in Russian Federation, 2006 1760p)
• Medical statistics available for 14-17 age group,
  and
• In the Russian Federation, HIV infection affects
  mainly young population. 10,1 of PLWH are aged
  15-20 years, 55,8 are aged 20-30 years (2011
  data).

14
Youth Groups of high risk of getting HIV (by
research) (1)

• Lack of evidence
• No possible to ask sex/drugs questions if target
  group is under 18 years old
• Young alcohol and drug users (Koshkina et al.,
  2004 Hibell et al., 2012) increased likelihood
  of occasional sex and unsafe sex
• Orphans and youth living in dormitories (Goodwin
  et al., 2004) - more sexually active, less
  knowledgeable about HIV
• Orphans (Zapata et al., 2013) childhood abuse
  increases the likelihood of unplanned pregnancy

15
Youth Groups of high risk of getting HIV (by
research) (2) HIV/HCV among IDU partners
16
HIV IDU, who are aware of their HIV status
17
Group at risk female partners of IDUs

• 50-65 of IDUs had sex with NON IDU sex partners
  (las 12 months)
• Low HIV testing, low HIV communication in couples
• Low awareness
• High potential for HIV spread by heterosexual way
  from IDU to general population

18
HIV risk behaviors among youth

• Having sex by the age 15 18 of girls and 37 of
  boys (Godeau et al., 2011) (WHO study).
• Having sex under alcohol intoxication 7 of
  15-16 years old youth in North-West Russia (ESPAD
  2011).
• Have ever used any drugs 24 of 15-16 years old
  youth in North-West Russia (ESPAD 2011).

19
Conclusions

• HIV is concentrated in risk groups (IDU, sex
  workers), but general population is getting more
  and more involved
• Sexually active young people at at high risk for
  getting HIV
• Drug and alcohol use and abuse increases
  likelihood for unsafe sex
• Young people living in students' dormitories and
  young people who were orphaned are at increased
  risk for HIV because of higher rates of sex work
  involvement, sex abuse and low HIV knowledge
• HIV awareness and HIV voluntarily testing in
  insufficient