Although inroads are being made in the control of TB, Russia's rising HIV/AIDS epidemic threatens to undo all of the success that's been experienced thus far. Doctors at the Tomsk TB Dispensary, the main TB hospital in Tomsk, say that two percent of TB patients are also HIV positive. Treatment of these patients is more complicated due to the weakened state of their immune systems. Learn more about HIV prevention efforts in Tomsk and

The Russian Federation registered its first case of HIV in 1985. The disease became an epidemic in 1995 when severe outbreaks of HIV were registered among groups of injecting drug users (IDUs) in several regions. By May 2005 the number of officially registered HIV cases exceeded 318,000; however some experts estimate that the actual number of people living with HIV/AIDS (PLWHA) is several times higher. The Joint United Nations Programme on HIV/AIDS (UNAIDS) has estimated that more than 860,000 people are living with AIDS in Russia. Estimates from other sources vary from 420,000 to 1.4 million.

The epidemic has hit all of Russia's regions with the ten most developed and populated regions accounting for approximately 70 percent of all cases. In Russia, HIV/AIDS is a disease of the rich. The majority of infections occur among young people, who contract the disease as a result of injecting drug use. In the late 1990s many young people associated heroin use with prestige and glamour, but there was very little information available in Russia at that time about HIV and the ways in which it is transmitted.

Russia's rigid drug policy further aided the spread of the disease: methadone programs are forbidden in Russia, forcing those who want to kick their habit to quit cold-turkey -- not an appealing option to most. Also, severe penalties were often levied on those who were caught with syringes, which meant addicts were forced to exchange the few available needles among themselves. The wide availability of cheap raw opium (khanka), which must be diluted – often with human blood – to remove impurities, further contributed to the spread of the disease.