HIV/AIDS in Russia is described by some researchers as an epidemic. The first cases of human immunodeficiency virus infection were recorded in the USSR between 1985 and 1987. The first known patient, or patient zero, was officially considered to be a military interpreter who worked in Tanzania in the early 1980s and was infected though sexual contact with a local man. After the 1988–1989 , the disease became known to the general public and the first AIDS centers were established. In 1995–1996, the virus spread among injection drug users (IDUs) and quickly expanded throughout the country. By 2006, HIV had spread beyond the vulnerable IDU group, endangering their heterosexual partners and potentially threatening the broader population.
It is estimated that, in 2017, the Russian Federation had the highest number of HIV-positive people of any country in Europe. In the following five years, the Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing estimated that the number of new infections ranged from 70,000 to 100,000 annually. By the end of 2021, there were 1.137 million HIV-positive people in the country, accounting for 1.5% of the adult population; 424.9 thousand people died during the entire history of the epidemic. Nevertheless, most experts believe that the real number of HIV-positive people is significantly higher, as many carriers of HIV remain undiagnosed. According to Vadim Pokrovsky, 1.25 million Russians are infected with HIV as of 2025.
First cases of infection
First cases
According to the Moscow Scientific and Practical Centre for Addiction Medicine, the first cases of human immunodeficiency virus (HIV) infection in the Soviet Union may have occurred as early as the 1970s through unprotected sexual contact with African students. Diagnosis was impossible at the time, as the first HIV screening was not conducted until 1987. Officially, the first foreign victim of AIDS in the USSR died in 1985. A thirty-year-old student of the Higher School of Trade Union Movement had contracted HIV while on a holiday visit to family in South Africa. He was later admitted to Moscow Infectious Diseases Hospital № 2 with pneumonia and died a month later.
In the next two years, 219 infected foreigners were identified. In 1986, the first specialized unit providing medical care for people living with HIV was opened at an infectious diseases hospital in Moscow. Initially, its patients were solely foreigners; after a course of treatment, they were subject to deportation. By 1989, there were 485 HIV cases among foreigners in the country. Half of them were in Moscow, with the rest spread out across Odesa, Kyiv, Minsk, Leningrad (now Saint Petersburg), and other cities in the USSR. In Soviet state media outlets, incidents of HIV infection were explained as attempts to discredit the USSR's relations with friendly African countries. The newspaper Izvestia claimed in 1987 that AIDS had been 'invented by the Pentagon in a laboratory of biological warfare methods'. HIV was presented as a disease solely affecting capitalist society. State media claimed that HIV could not be spread to the USSR, since homosexuality, drug use and prostitution were allegedly not practiced in the country. Although carriers were subject to deportation, the virus began to spread gradually among Soviet citizens.
There are several versions of the spread of the disease within the country. The officially registered patient zero was Vladimir Krasichkov, an engineer and military translator from Zaporizhzhia, who was on assignment in Tanzania in 1981. During his service, he had sexual contact with a local HIV carrier and had sexual intercourse with 25 Soviet conscripts when he returned to Moscow. Five of the conscipts were later diagnosed with the disease. Krasichkov himself repeatedly sought medical attention and he was diagnosed with HIV with AIDS on 26 February 1987, as a result of an enzyme immunoassay. According to some media reports, the Ministry of Health tried to conceal the circumstances of his illness, allegedly taking a non-disclosure pledge from him in exchange for benign treatment. Krasichkov died in the summer of 1991. Evidence of further spread of the virus varies. It is known that one of Krasichkov's five HIV-positive partners transmitted the virus to his wife and their child was born with HIV. He also donated blood to five other patients, including three children.
The first death from acquired immune deficiency syndrome in the country was registered in September 1988. The victim was Olga Gaevskaya, a 30-year-old evening student at the Leningrad branch of the Moscow Institute of Technology. She had contracted HIV between 1979 and 1985, when she had had repeated sexual contacts with foreigners, particularly Africans. She received treatment in the following years, during which she tested negative for HIV in 1988. No HIV antibodies were found due to poor diagnostic methods, such as doctors mixing the blood of three to ten patients into one sample because said HIV testing kits were scarce at the time. A separate sample was taken from each patient only in case of a positive result. Gaevskaya was diagnosed with AIDS post-mortem, as antibodies to HIV were found in her blood. There is also evidence that the first death from AIDS in the USSR was recorded by Professor Andrey Kozlov in Odesa in 1988. His patient was a child who had been infected by his mother. After the incident, more children were tested for AIDS.
+ Number of HIV-positive people among Soviet citizens, 1985-1989Territories 1987 1988 1989 Total 1985—1989 USSR citizens 3485322441 RSFSR citizens2250268340 Residents of other Soviet republics123554101
Kalmyk outbreak
The first major outbreak happened in Elista, the capital of the Kalmyk Autonomous Soviet Socialist Republic. The patient zero was a former enlisted sailor who was infected in the Congo by a local prostitute. He later transmitted the virus to his wife, and their child became infected during her pregnancy. Shortly after giving birth, the infant was hospitalized at the district pediatric hospital, where he died before the diagnosis was made. In 1988, the first patient from Elista was identified. She was a female donor who had been infected by her infant while breastfeeding. In December of that year, the Vremya newscast reported an outbreak of HIV infection in a children's clinic in Elista, where an infected infant was treated. A total of 75 children and 4 adult women were infected. A medical board headed by Vadim Pokrovsky was called to investigate in early 1989. The doctors found that the child was infected in the hospital due to negligence of the medical personnel, who used the same syringes several times, changing only the needles:
Such practices were common throughout the country. Presumably, local outbreaks of HIV infection could have occurred before, but were not recorded. For example, in Kalmykia, the 'Republican Center for the Prevention and Control of AIDS and Infectious Diseases' was established only a year before the Pokrovsky investigation. Doctors, journalists, and representatives of the RSFSR Ministry of Health also offered unofficial theories of infection: local sheep disease, some blamed recently discovered immunoglobulin. However, later research on the genome of the virus confirmed that it had spread from a single individual and corresponded to subtype G, which has only been recorded in the Congo.
Several patients were transferred from the Elista hospital to large medical centers in Volgograd, Stavropol, Rostov-on-Don, and Shakhty, so the virus began to spread in these regions. By 1989, there were a total of 270 infected people The news about the spread of the HIV virus caused a societal backlash. Pickets were held outside the Elista hospital, local residents began harassing the victims and their families, and they demanded that the infected be placed in isolation wards. USSR citizens began to refuse blood donation and medical procedures on a mass scale, and in some hospitals, doctors allowed patients to bring their own syringes. Under the orders of Yevgeniy Chazov, chief of the Ministry of Health, AIDS centers were established across the country.
+ Children infected in hospitals in southern Russia, by 1996Region Number of infected children Total number of deaths Number of AIDS deaths Rostov Oblast 984140744337 Volgograd Oblast522925 Stavropol Krai1576 Chechnya643 Dagestan544 Astrakhan Oblast211 1354
Virus spreading
1990-2019 The WHO classifies HIV epidemics in three stages. In the first stage, less than 1% of the general population and less than 5% in vulnerable groups are infected. When more than 5% are infected in one vulnerable group, the disease moves to the concentration stage. In the third, generalized stage, HIV infection extends beyond one group, the epidemic spreads to the general population, and the proportion of HIV-infected pregnant women reaches 1%. While in the 1980s there were sporadic outbreaks of infection in the USSR, the 1990s saw a new phase in the spread of HIV, where the disease was most often transmitted through blood by injecting drugs.
According to the WHO, by the 1990s, there were 494 infected people in Russia (307 adults and 187 children). Nevertheless, the actual figures may differ. Before 1990, patients had to provide passport data for HIV testing. Those found to be HIV-positive were required to make a list of their sexual contacts, and the principle of medical confidentiality did not apply to them. For this reason, young people preferred not to be tested for HIV or did it using false documents. Between 1987 and 1995, only 1,096 carriers were identified among the 160 million surveyed people. At the same time, diagnostic laboratories did not provide complete testing: only preliminary tests were performed at blood transfusion stations and AIDS diagnostic laboratories. The results were confirmed at the only AIDS diagnostic laboratory at the Central Research Institute of Epidemiology of the USSR Ministry of Health. The Ministry of Health of the RSFSR admitted tardiness in the deployment of preventive measures. Hospitals did not comply with the anti-epidemic regimen and did not conduct explanatory work among the population satisfactorily. Research institutes of the Ministry of Health of the RSFSR paid little attention to virus research. The work of scientists was not coordinated, there was no republican program of scientific research, no clear system of surveillance and preventive measures.
Researchers call 1996 the beginning of a new phase in the spread of HIV in Russia. It was preceded by an outbreak in the Ukrainian port city of Odesa, where the HIV strain was introduced from Central Africa in 1993. While in 1994 only 3 cases were diagnosed in the city, by 1995 the number had risen to 1021. The virus spread rapidly among injecting drug users (IDUs) in the former Soviet Union. After just one year, their share in the total number of Russian infected was 30.7%. During the first 10 months of 1996, the official number of persons infected with AIDS in Russia increased by 4.5 times; within one year, the total number of those infected almost doubled (from 1,090 to 1,925 carriers). The rapid growth in the number of infected people was attributed to high unemployment, the development of a shadow economy and a low level of living, which led to an increase in the number of drug addicts. HIV prevention measures were mainly aimed at the sexual channel of the virus spread. Special commissions at state AIDS centers distributed medications and determined which infected people to treat. The largest epicenters during this period were major agglomerations, as well as single-industry towns that experienced an economic crisis after the collapse of the Soviet Union.