Growing Russian influence in eastern Europe is driving a worsening HIV epidemic, health leaders have warned. In eastern Europe and central Asia, new diagnoses of HIV have risen 20% since 2010, while Aids-related deaths have gone up 34% – the fastest rates of growth globally. Most new infections in the region are among “key populations”, including people who inject drugs, sex workers and gay men, and their sexual partners. Efforts to improve treatment and prevent infections are being hampered by Russian-linked propaganda against targets including opioid replacement therapy services, which reduce the risk of HIV infection among people using drugs, and the LGBTQ+ community.