Earlier this year, Russia’s HIV epidemic reached a tipping point: For the first time, the number of people living with HIV surpassed 1 million.

But as Vadim Pokrovsky, the head of Russia’s federal AIDS center, told Reuters, that number includes only people officially registered as having the virus. The real number could be as high as 1.5 million, or nearly 1 percent of the population of 143 million. He warned that the epidemic is in a transitional stage, moving from a concentrated epidemic to a generalized one. This means that it is moving into the general population where it can be spread by sexual networks.

In Russia, Pokrovsky said, about 55 percent to 60 percent of HIV cases are caused by drug use, and about 40 percent are linked to heterosexual sex.

Almost 1 percent of pregnant women in Russia have HIV, reports Canadian medial journal CMAJ, noting that the Kremlin has opposed preventive measures such as needle exchange and condom use.

A report from UNAIDS, according to Al Jazeera, noted that HIV continues to rise rapidly in only one region of the world: Eastern Europe and Central Asia (this is considered one region and comprises 23 countries, including Russia). Reporting on the growing crisis, “Talk to Al Jazeera” went to St. Petersburg and Moscow to interview several people living with HIV as well as the advocates fighting the epidemic. Watch that segment here.