Background: The rapid advance of the HIV epidemic into Russia and countries of the former Soviet Union (CIS) has become a serious problem. In 2002 an estimated 1 million people were living with HIV/AIDS in the CIS region. As of September 2003, there were more than approximately 250,000 verified cases of HIV infection in the Russian Federation. According to unofficial data HIV affects about 1% of Russian population in 2003.

Methods: Analysis of official epidemiological data and results of researches concerning incidence and prevalence of HIV among different gender, age and risk groups in St. Petersburg, Russia.

Results: In St. Petersburg more than 28,000 HIV-infected persons were registered as of September 2003. Reflecting nationwide trend, there has been a dramatic increase in the incidence of HIV infection in last four years. In St. Petersburg, the incidence of HIV increased from 2.3 per 100,000 in 1998 to 215.6 per 100,000 in 2001. The disease is particularly prevalent among young people. In 2001, the incidence of HIV among persons less than 20 years was 287.3 per 100,000 and 854.3 per 100,000 for persons 20 to 29 years of age. There has also been a dramatic increase in the number of HIV-infected pregnant women in St. Petersburg in last years. The incidence of HIV among pregnant women increased from 0.009 per 1000 in 1998 to 3.6 per 1000 in 2001. In 2001 there were 74 cases of HIV-infected pregnant women, while 543 cases were reported during 2002.  The primary route of HIV transmission is intravenous drug use. More than 80% of HIV infected persons have a history of intravenous drug use. Another consequence of the intravenous drug use has been a significant increase in the prevalence of hepatitis C infection. HIV/HCV co-infection is common, particularly in injection drug users, with estimates of 79-93% of HIV infected individuals HCV co-infected.

Conclusions: Based on these statistics, the majority of HIV-infected individuals in St. Petersburg are young HCV co-infected injection drug users. We anticipate the further spread of HIV infection, and eventually, an increase in the number of cases of end-stage liver diseases. In addition to the significant impact on the health of the Russian population, the HIV and HCV epidemics will have negative economic consequences.

Keywords: Epidemiology; co-morbidity; Russia