Monday , January 25 2021

Fighting HIV: An Anti-Pandemic Pandemic

IN.Less sex in times of a pandemic? This seems to be a side effect of Covid-19, and it’s not just because many brothels are closed. Some fear that 2020 might be the year fewer babies were born and conceived in Germany, as many people have lost their desire for intimacy in times of contactless. On the other hand, it’s positive that the number of sexually transmitted diseases has declined due to Corona. For example, in the case of syphilis, which, unlike other sexually transmitted diseases in Germany, is notifiable, the Berlin Robert Koch Institute (RKI) reported a decline in the first half of the year compared to the same period last year from around 3,400 to 3,200.

Peter-Philipp Schmitt

It cannot yet be said if HIV numbers will also decline in 2020, also because infections can often occur years ago before they were detected. However, according to the RKI, in 2019 slightly more newly detected infections were detected than in previous years – namely 2,600. This is about 100 cases more than in 2018. The trend is over: since 2015, with around 3,700 new diagnoses, the number of new HIV infections diagnosed in Germany has been declining year by year, following an almost continuous increase since 2011, when the number was 2,661.

There are no drastic declines in Germany

Overall, the Robert Koch Institute assumes that around 90,700 HIV-positive people were living in Germany at the end of 2019, of which around 10,800 were unaware they were infected. The virus is mainly transmitted by people whose infection has not yet been diagnosed. It is estimated that 3,100 people, despite knowing the diagnosis of HIV, are not treated with antiretroviral drugs. For all others (a good 96 percent), treatment is almost always successful, so they are no longer contagious. According to the RKI, the question about the impact of HIV prevention with drugs cannot yet be clearly answered. The drastic decline in HIV infections among homosexual and bisexual men, as reported in San Francisco and London, “has not yet been seen across Germany.”

For the main affected group of homosexual and bisexual men, the number of new infections has fallen further in recent years, from 2,200 in 2013 to 1,600 today. On the other hand, low-level increases are seen in heterosexual transmission (around 650 cases) and through the use of drugs with syringes (360).

380 AIDS-related deaths

The serious problem remains that about a third of diagnoses are still only made when the affected person already has advanced immunodeficiency, in 15% of cases even with AIDS. That’s another reason why there were 380 AIDS-related deaths last year. Sven Warminsky, of Deutsche Aidshilfe’s board of directors, describes the stagnation in late diagnosis as “tragic” and calls for further efforts, for example by training doctors who often do not see HIV as the cause of the disease.

Even if it is not yet clear how many HIV diagnoses will be diagnosed this year, it is already becoming clear that, due to the corona, far fewer tests will be performed. One of the reasons: health services are overburdened and therefore do not offer tests for HIV and other sexually transmitted diseases.

Less testing in the world thanks to Corona

Corona also has an international impact on the fight against HIV and AIDS, as shown by the United Nations AIDS report on World AIDS Day today. There are fewer tests, for example, in Uganda, HIV testing fell by 40 percent in April alone, and several African countries also report that some infected people can no longer receive treatment. On this basis, UN-AIDS assumes there could be 123,000 to 293,000 additional HIV infections and 69,000 to 148,000 AIDS-related deaths due to the coronavirus.

Even before the outbreak of the corona pandemic, it was not possible to achieve the goals set by the global community, which are “90-90-90” for short. By the end of this year, the UN AIDS organization wanted to ensure that at least 90 percent of all HIV-positive people would know they were infected, and 90 percent should receive treatment so 90 percent could no longer transmit the virus because they cannot, thanks to their medications, are contagious. But of the 38 million people infected with HIV in the world, twelve million still lacked access to antiretroviral therapy in June. In the last year alone, the number of people infected with HIV has increased by 1.7 million, three times more than the United Nations AIDS target. 150,000 children became infected with HIV in 2019 alone, almost eight times more than expected for UN AIDS.

One of the main reasons for the failure: in 2019, only $ 18.6 billion was available to fight HIV and AIDS, not $ 26.2 billion as requested by the United Nations.

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