Abstract
In contrast to global patterns, the HIV epidemic in the Russian Federation continues to expand. The epidemic remains largely concentrated among key populations and their sexual partners but has the potential of affecting the general population. We have focused our analysis on legislative, policy-related, structural, and cultural obstacles that the country faces in confronting its epidemic. The Russian Federation has the largest HIV epidemic in Europe. Recent epidemiological analyses have shown a decrease in the annual growth of new reported infections. However, stigma and discrimination, marginalization, legislative provisions, harsh policing, and the lack of relevant prevention programs remain compounding factors that limit access of at-risk populations to information, prevention, and care, including to treatment for a number of people who would know their serological status. The ability of the Russian Federation to address the challenges it faces in dealing with a concentrated epidemic, will determine the future of the epidemic in the country.
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