OBJECTIVES: Several governmental anti-HIV programs are implemented in Russia, however as of 2020 only 74.5 % of the infected people knew their status and only 67.4 % of them received antiretroviral therapy. The aim of this study is to forecast future social and economic burden of HIV-infection in Russia in various scenarios of centralized financing of anti-HIV activities.

METHODS: We assessed impact of the national HIV policy on demographic and social indicators in "no change" scenario of maintaining costs for HIV control at the level of 2020 and in cases of increase in expenditures by 25, 50 % and 60% with keeping the current structure of costs, and "intensive" scenario with increased nominal expenditures and shifting costs to the purchases of newer third-generation antiretroviral therapy regimens. Social burden was defined as excess mortality and decrease in life expectancy at birth, fertility, natural population growth and population size. Economic burden included medical costs for screening, diagnosis and treatment of HIV; direct non-medical costs for disability benefits, and indirect costs in form of GDP loss due to premature mortality and disability.

RESULTS: Current financial strategy will result in HIV mortality growth to 25 thousand per annum, the economic burden during 2022 – 2035 will exceed US$ 87.9 billion. Increasing anti-HIV expenditures will reduce both social and economic burden, as growth in direct medical costs on therapy procurement could be offset by decrease in GDP loss due decrease in disability and mortality cases from HIV. The most efficient scenario implies annual expenditures increase by US$194 million. This could reduce mortality by 144 thousand cases. Economic burden will be reduced by US$43.5 billion compared with “no change” scenario.

CONCLUSIONS: Current level of expenditures on anti-HIV activities will not allow to reach 90-90-90 goal.