Rapid increase in HIV rates--Orel Oblast, Russian Federation, 1999-2001

During 1999-2001, the estimated number of cases of human immunodeficiency virus (HIV) reported officially in the Russian Federation increased approximately 16-fold, from 11,000 to 177,000. In 2001, of 49,434 HIV-infected persons for whom a risk factor was identified, 46,274 (94%) were injection-drug users (IDUs). However, the actual number of HIV-infected persons in Russia is estimated to be four to 10 times higher than reported. Rapid increases in HIV have been reported in urban areas (e.g., Kaliningrad, Moscow, and St. Petersburg) and also might be occurring in rural areas. During 1997-2000, HIV seroprevalence reportedly increased 33-fold in Orel Oblast, a predominantly rural, agricultural province (1999 population: 900,000) in central European Russia. To confirm and describe this increase and evaluate the risk for continued rapid increase of HIV, CDC collaborated with the Orel Oblast AIDS and Infectious Diseases Prevention Center (AIDS Center) to assess recent HIV trends and the prevalence of risk behaviors among IDUs in Orel Oblast. This report summarizes the results of that assessment, which indicate continued increases in HIV rates and underscore the need for interventions directed at IDUs and their sex partners to limit further spread of HIV.