A highly detailed statistical investigation of Russian HIV/AIDS data funded by the US Agency for International Development suggests the Russian government dramatically underestimates what may be the world's fastest-growing AIDS epidemic.
Murray Feshbach, a demographer at the Woodrow Wilson International Center for Scholars in Washington, DC, who has tracked Russian AIDS since the 1980s, used a variety of sources including Russian Army physicians' reports, morbidity and mortality data from a number of diseases associated with AIDS and data provided by the Russian Ministry of Health's Federal AIDS Center in Moscow, to conclude there are as many as 900 000 Russians infected with HIV rather than the 300 000 cases officially reported in late 2004.
Feshbach also concluded Russian HIV/AIDS deaths are severely underreported. He suggests the official figure of 4780 deaths to August 2004 should be revised to a total of 17 500.
HIV began spreading among intravenous drug users in Russia in the 1990s but heterosexual sex is now the epidemic's main transmission path. “It is perhaps too late to prevent the concentrated epidemic from eventually generalizing to the entire population,” says Feshbach, who is urging aggressive use of drug therapy, prevention and education. Since 2001, more than 80% of reported Russian HIV cases were in the 15 to 29 age group; in Western Europe and North America 70% of reported cases are among people over 30. The number of affected Russian women is also on the rise: in 2000, they accounted for 20% of cases; by 2003 they accounted for one third.
Figures from Russia's Federal AIDS Center have been repeatedly challenged by UNAIDS and by the Center's director, Vadim Pokrovsky. Like Feshbach, UNAIDS and Pokrovsky have suggested that the official figures should be tripled.
Feshbach says the unreliability of official Russian data is due to physicians who are unfamiliar with AIDS symptoms and cases where families wish to conceal AIDS as the cause of death.