Stellit HIV and associated infections among youth in Russia

Total number of registered HIV cases among citizens of Russian Federation (2012) Total registered HIV cases newly registered HIV cases in 2012

Estimated number of total number of people living with HIV (2011) Estimated number of people living with HIV [730, ,300,000]. Adults aged 15 to 49 estimated prevalence rate % [0.80% %] UNAIDS 2011

Incidence rate is 48,4 per , prevalence rate is 437,6 per Most affected regions are the following : Irkutsk region ,4 Samara region ,6 Sverdlovsk region ,3 Leningrad region ,1 Orenburg region ,6 St. Petersburg - 996,5 Khanty-Mansi AO - 956,6 Kemerovo region - 887,8 Number of HIV cases registered in different Russian regions 0,4% of the total country population are people living with HIV/AIDS 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%.

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 years and the shift of the center of the epidemic in the older age group years is observed.

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%

Epidemic stage : concentrated generalized

Number of new HIV cases in different age groups

Number of new HIV cases among males and females  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 In 2012 the cumulative number of women living with HIV/ AIDS was 2,2 times higher comparing to 2005 – 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

The number of people living with HIV/Tb is being increased There were newly registered HIV/Tb cases in 2011 ( , , , в ) The total number of registered HIV/Tb cases in 2011 was Туберкулез остается наиболее частой причиной смерти больных ВИЧ - инфекцией ЮФО - 64% СКФО -58,1% Активная форма туберкулеза выявлена ЮФО -54,7% в СКФО -55,1% Показатель сочетанных форм ВИЧ / туберкулез ЮФО -12% СКФО - 12,3%.

The number of people living with HIV/Tb is being increased There were newly registered HIV/Tb cases in 2011 ( , , , в ) The total number of registered HIV/Tb cases in 2011 was 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%

Youth at high risk of HIV/AIDS and AI

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

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

Youth Groups of high risk of getting HIV (by research) (2) HIV/HCV among IDU partners

HIV + IDU, who are aware of their HIV status

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

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 years old youth in North-West Russia (ESPAD 2011). Have ever used any drugs: 24% of years old youth in North-West Russia (ESPAD 2011).

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