Russia Says Its HIV Rates Are Falling. Experts Aren’t So Sure.

Four years ago, while hospitalized with Covid-19, St. Petersburg singer Ksenia Aleksandrova was unexpectedly diagnosed with HIV.

Known by her stage name Neksusha, the 23-year-old Aleksandrova has built a devoted online following, with around 90,000 subscribers on YouTube and more than 213,000 monthly listeners on Spotify. Despite the persistent stigma that surrounds HIV, she decided to publicly disclose her diagnosis in an effort to raise awareness about the illness.

“I’m not a drug user, I’m not a sex worker. It just happened, I’ve been in a monogamous relationship for a year and my partner is HIV-negative,” she told journalists at the time.

“I realized I was tired of staying silent. I have a platform and I want to use my story to help other people,” she said. Since then, Neksusha has openly discussed HIV, using her social media to educate her audience in Russia.

Neksusha is one of tens of thousands of people in Russia who live with HIV, the virus that causes AIDS. 

In 2026, Russia said that new infection rates had reached a historic low. But experts say the official statistics conceal a public health crisis that was already serious long before the full-scale invasion of Ukraine — and has only worsened amid the war and growing pressure on vulnerable groups.

Statistics 

Russia ranked fifth globally by the share of new HIV infections in 2021, accounting for 3.9% of all new cases worldwide, according to the United Nations Programme on HIV/AIDS. No updated global country ranking has been published for more recent years.

Assessing the current situation within Russia is also complicated because official sources report different figures. Nationwide data on HIV-related mortality are also no longer readily available after Russia stopped publishing a range of demographic statistics.

The Health Ministry said in June that Russia’s HIV incidence had halved since 2016 and placed the number of people with HIV at 931,000.

In 2016, the ministry reported 860,000 registered HIV cases, although experts suggested at the time that the real number could have been between 1.5 and 2 million.

Consumer protection watchdog Rospotrebnadzor put that figure at 1.23 million as of December 2025. Other estimates suggested 1.25 million HIV positive patients in 2025.

Experts say that Russia’s approach to testing may be obscuring the true scale of the epidemic.

“Russia has always been a country where a lot of HIV testing was carried out, but the problem is that investments in testing were often allocated incorrectly. A large number of people were tested through the general healthcare system — for example, patients before hospitalization and people visiting outpatient clinics,” said Yevgeny Pisemsky, editor-in-chief of the queer media outlet Parni Plus.

“To control the epidemic, it is critical to test precisely those groups where the risk of HIV transmission is higher: gay and bisexual men, transgender people, people who use drugs and sex workers,” Pisemsky told The Moscow Times. “These are exactly the groups that authorities are failing to work with properly.”

Official statistics on new HIV cases therefore cannot be fully trusted, he said.

“We simply do not know what is happening now among the groups where the epidemic typically spreads most actively and where, in a functioning public health system, prevention efforts should be focused,” he said.

Pressure on HIV organizations

Many organizations providing HIV prevention and support services to vulnerable groups have been pushed out of Russia or pressured by the authorities. Some were designated “foreign agents” due to Western funding, while others were simply banned.

Even before the full-scale war against Ukraine, “HIV had already become a political issue,” Pisemsky said. 

His HIV-focused organization Phoenix Plus had worked with people who use drugs and members of the LGBTQ+ community for 14 years before it was forced to close in 2020 after Russian authorities designated it a “foreign agent.”

Last year, Russia designated the Elton John AIDS Foundation, one of the world’s largest charities fighting HIV and AIDS, and the Eurasian Coalition on Health, Rights, Gender and Sexual Diversity as “undesirable organizations.” The designation prohibits other groups operating inside the country from working with them or engaging with their activities.

The crackdown on foreign initiatives and increased financial pressure have also forced Russian HIV organizations to scale back their work, said Maxim Malyshev, a former social work coordinator at the Andrey Rylkov Foundation, which helped people with drug dependence and worked on HIV prevention. 

“Many foundations and grassroots initiatives were funded through foreign grants — now it’s almost impossible to get them as many foreign organizations were banned in Russia. The only funding available to us is domestic,” which is very limited, Malyshev said.

The Andrey Rylkov Foundation closed in 2023 after being designated a “foreign agent.”

The SPID Center (AIDS Center) closed its Nizhny Novgorod branch in 2025 after failing to secure a presidential grant, but it continues to operate offices in Moscow and St. Petersburg.

The Shagi (Steps) fund, which has provided HIV prevention services and support to people living with HIV in Russia for more than 20 years, warned that it may be forced to shut down because of a lack of funding.

The state’s growing focus on “traditional values,” its ban on so-called childfree propaganda and crackdown on the LGBTQ+ community have created further obstacles to HIV prevention, experts say.

As discussions about sexuality are increasingly framed in terms of “morality,” “propaganda” and ideological control, promoting condom use and sex education among the wider population has become extremely difficult, they said.

Authorities are also pushing vulnerable groups such as LGBTQ+ people, sex workers and people who use drugs out of the public sphere, making working with them severely restricted and increasingly criminalized, Pisemsky said.

LGBTQ+ crackdown

Since the invasion of Ukraine, Russia has expanded its ban on what it calls "LGBT propaganda" and designated the so-called "international LGBT movement" as an extremist organization, banning its activities.

As a result, organizations in Russia can no longer openly work with LGBTQ+ communities — something that has made it significantly more difficult to conduct HIV prevention and outreach among one of the groups at highest risk of transmission, experts said.

“If you look at the statistics from the United States or EU countries, you can see that men who have sex with men remain one of the key populations in the HIV epidemic,” Pisemsky said.

“I see no reason to believe that the situation is fundamentally different in Russia’s major cities. Most likely, a significant share of new HIV cases there is also linked to sex between men, but Russian statistics either fail to capture this or do so very poorly,” Pisemsky told The Moscow Times.

Experts said LGBTQ+ people might be inclined to hide the route of HIV transmission or might avoid seeking help altogether.

“This is the most dangerous part — if a group cannot be named, it cannot be effectively reached or supported. You cannot launch a prevention campaign for gay and bisexual men, you cannot openly talk about  medicine for HIV prevention, condoms, regular testing, safer sex, the risks associated with dating apps, or the stigma and fear that keep people from seeking care at HIV/AIDS clinics,” Pisemsky said.

“Before the war, we were already talking about the high prevalence of HIV among gay men in major cities. Now we have fewer and fewer tools even to understand the real scale of the problem, let alone respond to it,” he added.

HIV and the war against Ukraine

While experts warned about the HIV situation in Russia long before the war against Ukraine, the full-scale invasion appears to cause it to deteriorate sharply.

Officially, people with HIV cannot join the Russian army.

But investigations revealed that HIV-positive soldiers are assigned to separate military units.

During the first year of the war alone, Defense Ministry figures showed a fortyfold increase in HIV detection among military personnel, the exiled outlet Vyorstka reported. By the end of 2023, the number of diagnoses was roughly 20 times higher than pre-war numbers.

Some men conceal their HIV-positive status to secure Defense Ministry contracts that promise large payments. In other cases, military enlistment offices are aware that recruits are HIV-positive but choose to ignore their diagnosis.

Malyshev said that the war also created major challenges for HIV treatment in Russia by limiting the range of treatment options and HIV medicines as well cutting into funding for HIV prevention.

“Many pharmaceutical companies have left the Russian market,” he said. 

While some Western HIV medicines remain available, Russia is increasingly seeking to manufacture treatments domestically or import generic drugs from countries like India, Malyshev said.

“The state is trying to purchase not newer, more advanced treatments, but rather the cheaper ones,” Malyshev said, adding that patients face more side effects as a result.

Pisemsky said the Russian state had created “almost all the conditions” for the HIV to continue spreading.

“Official figures may appear relatively manageable,” he said. “But in reality, we are seeing the breakdown of the very mechanisms that make it possible to control the epidemic: prevention, trust, work with key populations, independent HIV services and reliable statistics.”

This atmosphere has forced many HIV prevention activists to self-censor, Malyshev said.

Some anti-war HIV activists — like Malyshev, who was also diagnosed with HIV in 1997 — also left Russia after the start of the war.

“It is not normal that those working in HIV prevention in Russia have effectively been left without a voice,” Malyshev told The Moscow Times.

"The fact that I'm talking to you from Berlin is just kind of surreal."