"Stigma, unfortunately, doesn't go away."
The head of a district in Bashkortostan declared a "critical situation" with HIV infection in his area. We found out what's going on there and whether it's really that dire.

Author: Katerina Mayakovskaya*
* 18+ THIS MATERIAL (INFORMATION) WAS PRODUCED, DISTRIBUTED AND (OR) SENT BY FOREIGN AGENT EKATERINA ALEKSEEVNA MAYAKOVSKAYA OR CONCERNING THE ACTIVITIES OF A FOREIGN AGENT EKATERINA ALEKSEEVNA MAYAKOVSKAYA.
One of Bashkortostan's municipalities recently made national news: several media outlets reported that the republic's Abzelilovsky District was experiencing a "critical situation" with the immunodeficiency virus. All cited post The speech of the district head, Airat Aminev, was uncharacteristically emotional: Aminev called on the district residents to “think about the numbers,” “think about their loved ones,” and “not be indifferent.”
Kommersant publication led to Another quote from the head: "Among the last batch of contract soldiers, men who decided to go off to perform military labor, the HIV detection rate was 15%—a terrifying figure." Apparently, the post on Aminev's page was subsequently edited—the reference to "contract soldiers" no longer appears in it.
NeMoskva spoke with experts and examined statistics, trying to understand what's so special about the district and why it's in crisis. However, it turns out the situation isn't all that dramatic. Moreover, experts believe that such harsh language from officials isn't helpful, but rather detrimental, complicating prevention and outreach to vulnerable groups.
● The Abzelilovsky District of Bashkortostan has landed on the federal agenda due to an emotional post by the district's head about the "critical situation" with HIV. High rates have been recorded in the area for several years. However, previously, these reports were presented without alarmist tone.
● At the same time, experts believe that the district head's statements do not reflect the reality. HIV prevalence in the Abzelilovsky district does not exceed the Russian average, mortality has been relatively low over the decades, and the incidence rate is steadily declining.
● Experts note that panicked statements from officials are not helpful; on the contrary, they are harmful, further stigmatizing people living with HIV. This does not contribute to education or prevention. Incidentally, the district head did not mention any truly effective methods of protection.
● What's needed is "systematic, calm, and persistent public awareness efforts," collaboration between agencies, and communication with key groups. And an individual approach. Each region has its own specific HIV transmission patterns, so there's no one-size-fits-all solution.
How the situation changed
On the rise in human immunodeficiency virus cases in the Abzelilovsky district of Bashkortostan сообщалось Back in the summer of 2019, the rate was 77 cases per 100 residents, significantly higher than the Russian average. Moreover, the majority of new cases were among pensioners and those approaching retirement age—those aged 50–60. All media outlets reporting on the issue noted that the primary causes of infection were sexually transmitted, and that the rise in cases was due to "unemployment, drunkenness, and a dissolute lifestyle."
However, at the same time, the head of the HIV prevention center at Rospotrebnadzor, Vadim Pokrovsky noted, that we should actually be talking about an increase in detection rates, not incidence. "If we've diagnosed someone, we don't know when they became infected. Therefore, when more people are being detected, it could be because we're testing certain groups that weren't tested before," Pokrovsky explained.
One way or another, for many years the Abzelilovsky district has occasionally appeared in the news as an area with a high level of infection with the immunodeficiency virus. 2020-m и 2021-m The chief physician of the Republican Center for the Prevention and Control of AIDS stated his position. Similar reports were also in 2022, in in 2024-mand summer of 2025However, all of them did not go beyond citing official statistics and were not accompanied by alarmist statements.
Is everything really bad?
How critical is the situation in the Abzelilovsky District? A medical professional was asked. Specialistworking with HIV-positive patients in Bashkortostan. He believes that Airat Aminev, took office In August 2025, he simply reacted emotionally to the figures, which were a "big revelation" for him. After all, district heads are responsible, among other things, for the spread of infectious diseases and for preventive measures.
The HIV prevalence in the Abzelilovsky District is no higher than the national average. And for Bashkortostan as a whole, it's even slightly lower. If I remember correctly, monitoring has been underway there since 1990. Over the past 35 years, about 200 people have died from the infection in the Abzelilovsky District—that's not a huge number. And given modern medications, which, thankfully, are freely available, the death toll has been reduced significantly in recent years.

The Trans-Urals, where the Abzelilovsky District is located, faces its own challenges, the expert comments. For example, there are active migration processes due to shift workers. Bashkortostan, in general, also faces problems. For example, last August, federal media outlets wrote about refusals to test for viral load and immune status in a number of regions of Russia, including in the Republic.
"Sometimes things go wrong, of course. There are people everywhere, and people make mistakes. There are also logistical issues. But the AIDS Center and non-profit organizations really work closely with the patient community and try to respond quickly to problems," says the healthcare worker.
How to understand statistics correctly
In news reports from various years mentioning the Abzelilovsky District, the "incidence" indicator—the number of patients newly diagnosed with the immunodeficiency virus per 100 people—is most often cited. A medical specialist interviewed by NeMoskva, in turn, refers to the "prevalence"—the number of HIV patients per 100 people. The former figure is indeed high in the district, while the latter is close to the Russian average.
Alexey Lakhov, author of the online project Drugmap.ru about Russia's drug scene, explains how to interpret the statistics. Overall, he agrees with the Bashkortostan health worker: there is no "apocalypse" in the Abzelilovsky District. Moreover, there are areas in the republic with higher infection rates.
"Perhaps the problem is that incidence and prevalence are conflated. Prevalence is a cumulative history, and it doesn't make the Abzelilovsky District look like a 'black spot' on the map. Incidence is a different matter. Looking at the last year, the numbers are truly 'scary': about 81 per 100, compared to around 30-40 across Russia and Bashkortostan. But when we look at the dynamics, the picture changes: 2020—126,6; 2021—117,2; 2022—98; now—around 81... In other words, incidence is falling, not rising," Lakhov notes.
Why is an incidence rate of 81 per 100 so alarming? The interviewee points out that the original post contained information about contract soldiers, among whom the HIV-positive rate was 15%—a controversial topic in itself. Furthermore, with a population of 45 people per district, each new case further inflates the rate, and even 10-15 new cases can make a significant difference, potentially making it appear on paper to be a "critical situation."
What's missing from the rhetoric about HIV
LGBTQ+ activist and author of the media project "Parni PLUS" Yaroslav Rasputin, in an interview with NeMoskva, ironically called Airat Aminev's post "very progressive":
Compared to the typical "arguments" in Russia, Aminev is actually quite charming. No "people with diminished social responsibility," no complaints about promiscuity, no "enemy image." So I wouldn't rush to accuse him of alarmism. It's too bad he doesn't suggest anything other than getting tested. So he says, "The disease could be in the house next door"—so what, what difference does it make? What should follow is advice on how to protect yourself. And here's another plus for Aminev, because in Moscow they'd end it all with the phrase, "And don't you dare have sex outside of marriage"—he doesn't even say that.
However, Rasputin emphasizes, the bad thing is that the chapter does not mention any truly effective methods of protection: condoms for sex, clean needles for drugs, prophylactic pills PrEP:
"In Russia in 2025–2026, all this is taboo and unconventional. Hopefully, doctors mentioned this during the month-long testing period—I hope Aminev remembers to report on the results," Rasputin comments.
Like Lakhov, he notes that the infection rates cited in the publication can be considered "good" compared to the national average.
Rita Loginova, a journalist and host of the HIV podcast "Only Pluses," agrees that emotional statements should be followed by "systematic, calm, and persistent work to inform the public."
"[The post] doesn't mention anything about HIV transmission methods, condoms, pre- and post-exposure prophylaxis, and there's no mention of a regional HIV hotline—or does one even exist? For the situation to improve, we need educational and media programs aimed at people of all ages. We need HIV hotlines that operate year-round, not just on December 1st," Loginova comments.
For people already living with HIV, it is important to ensure access to treatment, the interviewee continues: after all, a person taking ART therapy and having achieved an undetectable viral load, cannot transmit the virus to others.
Features of the spread of HIV in Bashkortostan
In Bashkortostan, the infection's spread path had its own unique characteristics from the very beginning, notes our interviewee, who works with HIV-positive patients. The republic's Muslim status, which leads to more conservative sexual norms, played a significant role. At the same time, Bashkortostan's location also played a role: drugs were trafficked from Kazakhstan through the region in the 90s.
The combination of these two factors led to HIV spreading much more rapidly among injection drug users. But then the situation changed: some of those who had previously used drugs began to start families and lead normal lives, but the virus followed them.
"People don't get tested until something goes wrong or something breaks," the expert says. "For many years, they might not even know they have the disease and live with a 'dormant' virus without serious harm to their health. Every year, the proportion of infections through regular heterosexual intercourse increases. Today, it accounts for almost 90% of infections."
However, the belief that HIV is a disease specific to certain groups and stigmatized remains widespread in Bashkortostan. This complicates both prevention and treatment efforts.

"Stigma, unfortunately, doesn't go away. Many people believe that if they don't behave a certain way, it's just not their thing." And when someone is diagnosed with HIV, self-flagellation sets in. People consider themselves "bad." And Zemfira's song, "You have AIDS, which means we'll die," has become a constant theme for many. Although dying isn't necessarily a necessity. I know people with HIV who live better lives than people with diabetes thanks to modern medications.
What really works?
Our interviewee is confident that the understanding that HIV prevention is not the sole responsibility of the Ministry of Health is working. Results are significantly better wherever there is collaboration between agencies. For example, the assistance of the Ministry of Education would be invaluable—to ensure that HIV awareness is raised not only among the public. December 1 or May 19Or the involvement of the Ministry of Labor in the process, which makes it possible to reach out to workforces—and this is important, given the main route and age groups of the virus's spread in recent years.
Speaking about effective practices, the healthcare professional cites the example of the Chechen Republic, where HIV testing is mandatory for marriage. The interviewee believes that some civil registry offices in Ufa could implement a similar initiative on an experimental basis—but without coercion and with the right incentives.
The expert also mentions the Tyumen region, believing that Bashkortostan could follow its example.
"Tyumen receives a large number of people from other regions, resulting in high population turnover. This is similar to the situation in Bashkortostan. Despite this turnover, the Tyumen region has been able to do a truly good job of preventing HIV. One of my favorite examples is testing through feldsher-midwife stations, which they implemented with the participation of the Ministry of Health, the AIDS Center, and public organizations. Thanks to this, anyone anywhere in the Tyumen region, seeking any medical care, can immediately find out their HIV status. I wish we had something like this," he says.
However, no single technology or plan can be blindly extrapolated to all of Russia. The HIV spread pattern varies not only across countries, but also across regions within a single country. It is influenced by religion and beliefs, geographic location, population mobility, the region's economic structure, and other factors. Therefore, the approach to prevention can only be individualized. Perhaps the only common thread is the tone: calm conversation rather than panicked comments about a "critical threat."
"HIV is present in the district, it's present in all populated areas, the prevalence is comparable to the Russian average. The incidence rate is still higher than average, but it's declining year after year," Alexander Lakhov explains, describing how he would report on the situation in the Abzelilovsky district. "This means we need to specifically strengthen prevention, testing, [ensure] access to treatment, and work with key populations. Instead of stigmatizing the district and people living with HIV with loud statements."
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