TOGLIATTI, Russia (Cox News Service News Service) -- This industrial metropolis on the banks of the Volga River, once known as the Soviet "steel city," is home to Russia's largest car producing plant, where workers enjoy high wages and a better standard of living than most other parts of post-communist Russia.

But with one of the highest HIV infection rates in Russia, doctors and managers of the AvtoVAZ plant are worried that their current and future workforce is dying of AIDS.

The automaker currently employs 120,000 at its factory, pumping out hundreds of thousands of the popular Lada sedans each year.

Officially, 300 of its workers are registered as HIV positive.

Unofficially, that figure is five times higher and rapidly increasing through intravenous drug use and sexual contact, health experts say.

If nothing is done to slow the spread of the virus in Togliatti, AvtoVAZ will short of as many as 15,000 workers in 10 years as HIV/AIDS patients succumb to the disease, said Dr. Vladimir Shatokhin, the head doctor at AvtoVAZ.

"The statistics alone, even the official ones, make it obvious that we can no longer turn our backs to the problem," Shatokhin said. "Unfortunately, the state doesn't realize the whole of the problem. We are in a serious crisis."

Russia's AIDS epidemic is now the largest in all of Europe, according to the latest United Nations' AIDS agency figures. The government has registered just over 318,000 HIV patients in the country, but estimates by the Russian Federal AIDS Center, the U.S.

Centers for Disease Control and Prevention in Atlanta and other international organizations place that figure between 450,000 and 1.4 million.

About 70 percent of those infected are within Russia's working age population of 15-39. Experts warn that the disease's impact is threatening to wipe out a significant portion of Russia's work force, and harm the country's economy if more attention isn't given to treatment and preventive measures.

Russia is not the only country facing the potential economic impact of the AIDS epidemic. UNAIDS estimates that there are 40.3 million people living with HIV in the world, with 4.9 million new HIV infections in 2005 alone. The United Nations has designated Dec. 1 as World AIDS Day, each year seeking a renewed commitment from the international community to fight the disease.

China's top health official this week warned that the country risks social instability and a possible economic downturn if its number of HIV-infected people grow above 1.5 million.

China officially has 840,000 people infected with HIV and 80,000 with AIDS.

UNAIDS has said the true figure is likely higher, and that up to 10 million could be infected by 2010 without more aggressive prevention.

The impact on Africa, which has the highest rates of HIV and AIDS patients, is staggering at 25.8 million infected men, women and children. Countries in sub-Sahara Africa, with insufficient health care and education programs to combat the disease, will record a projected 3.2 million new HIV infections this year.

Without more intervention to halt the spread of HIV, Russia's gross national product will drop by 4 percent by the end of the decade, and by more than 10.5 percent by 2020, a World Bank study projected this year.

Russia's crisis is compounded by its already declining population. Alcoholism, smoking-related illnesses, heart disease and emigration reduce the numbers every day.

The United Nations estimates that Russia's population, now about 143 million, will drop to 112 million by 2050.

Moscow, St. Petersburg and the Siberian city of Irkutsk also have skyrocketing HIV infection rates. But it is here in Togliatti, some 700 miles southeast of Moscow, that the AIDS epidemic is taking its toll on the future of the Russia's economy, experts said.

Doctors at AvtoVAZ have started an AIDS awareness program for the company's autoworkers. More than half of the city's 750,000 residents either work for or are related to workers at AvtoVAZ.

With workers earning a higher salary than most Russians, Togliatti became a natural target for drug dealers and prostitution -- spreading HIV through the sharing of needles and unprotected sex.

"Togliatti is a druggie city. We had to get out of there to survive because all of our friends were coming over to shoot up and we couldn't get away from it," said Tatiana, 22, who was infected three years ago by her former boyfriend, a drug user.

Though she and her husband have been part of an anonymous HIV/AIDS support group in the nearby city of Samara for more than a year, Tatiana keeps her HIV status hidden, she said. She declined to give her last name out of fear that someone might recognize her.

Changing the population's perceptions of HIV/AIDS has not been easy.

"The risk perception of the general population is very poor," said Dr. Alexander Muravets, director of the Samara office of Population Services International, which works with the local government to create education programs on HIV/AIDS. The program receives funding from U.S. Agency for International Development.

A recent study by the organization of men and women under 30 in Samara province, where Togliatti is located, showed that 73 percent did not see HIV/AIDS as a personal threat.

"Many still believe, sadly, that if they are not gay, using drugs or a sex worker, than they aren't at risk," Muravets said.

Copyright 2005 The New York Times News Service. All rights reserved.