Jens Spahn cleared the way, the Federal Council agreed – since October HIV tests can be freely sold in Germany as well. Experts believe that a small test set that can now be bought for 20 to 50 euros in pharmacies, drugstores or the Internet is a major step in the fight against HIV and AIDS. After all, it is likely that many people who have previously been removed from the test at a doctor or health department will succeed.
It's important to know your HIV status because otherwise the HIV virus can be unintentionally transmitted. And this is a precondition for timely therapy. As with almost all diseases, success largely depends on the time of diagnosis: according to the Robert Koch Institute, only slightly less than a third of the first HIV diagnoses in 2016 have been diagnosed with advanced immune deficiency. Although initiated therapy may prevent the replication of HI virus, it can not eliminate any physical damage that has already occurred.
That is why "Know Your Status" is the motto of this year's World AIDS Day on December 1st. With their unequivocal appeal, the United Nations reaffirms its 90-90-90 target, which will have at least 90 percent of HIV status by 2020, 90 percent have access to treatment, and 90 percent no longer shows viral loads needed.
Only the tester learns the result
Germany can be well addressed. However, the new infection rate, with about 3800 first annual diagnoses, is consistently low according to international standards. But between the coast and the Alps there are about 12,700 people who do not know anything about their HIV infection. The strongest economic energy in Europe is still far from the 90-90-90 goal.
Of course, local AIDS organizations want the introduction of an HIV test to bring it closer to the goal. The director of the German Foundation for AIDS, Kristel Degener, sees this as an important addition to the existing possibilities. "The home test takes the advantage for the first time that only the end of the test gets the result. You stay in your home and you do not have to go to a health department or counseling center," she said. "The test threshold is therefore lower."
Well, she also reveals that the self-testers do not stay alone. On the packaging of test equipment contact information is printed by advisory centers to which users can contact. In addition, the Federal Ministry of Health and the Paul Ehrlich Institute put online help on the network, explaining important issues and presenting the products: www.pei.de/hiv-selbsttests.
However, the Foundation's director does not believe that the new option should now be a panacea in the fight against HIV / AIDS. "Knowingly deal with your own health and behave indifferently to your partner, Know Your Status is indispensable," emphasizes Degener. HIV test is the first important step. "But you also need to be notified accordingly," she says. "Knowledge that seems natural to one target group must always be repeated or renewed in the other." One of the key issues in the fight against HIV / AIDS is that messages such as "Know Your Status" or "I Will Do it", and you? "In many social groups that actually have good listening reasons.
Even with many doctors, the inhibition threshold is great
This includes, for example, people who are more likely to detect HIV infection and therefore feel that they are not approaching preventive campaigns or new test offerings. But how, for example, a housewife, a family man or a retired person pass to an HIV test if they do not suspect their own infection?
Best of the doctors. Family doctors, dermatologists and dentists are those who should actually advise their patients on a particular clinical image for testing. However, the inhibition threshold is also high among many doctors, especially if the diagnosis of HIV is difficult to match the patient's profile. For this reason, the Private Health Insurance Association (PKV) has been making a series of "Talk about Sex" training a few years ago. Physicians train in their communicative skills on this sensitive subject and gain the necessary professional knowledge. "Without their help, we will not be able to diagnose 12,700 people who are unconsciously HIV positive," says Degener, explaining the role of brokerage mediator. However, some people are barely available through this channel: they are people who can hardly access the healthcare system anyway. This includes a particular community of men who have sex with men (MSM) as well as people with a migrant background. Refugees often come from countries where sex and sexually transmitted diseases are not discussed. Consequently, knowledge of the "topic tab" is extremely skinny.
It is important to be sensitive to culture
Victor Trofimov can sing the song. He recently moved from Berlin to Potsdam AIDS Aid and now runs the project "Take Care of Yourself! HIV / AIDS and STI for Refugees in the State of Brandenburg". The project was established in 2015 to present newcomers on HIV / AIDS and STIs. Specially trained consultants go to temporary housing centers in Brandenburg, offer workshops there and distribute leaflets in various languages. Supports multipliers who have a migration background and can translate the message in a culturally sensitive way. They talk about the disease itself, the paths of transmission, the possibilities of prevention, the HIV test and treatment options.
Being sensitive to culture is the most important thing, says Trofimov. Sexuality is a taboo, especially in Muslim countries, and many are difficult to open the subject. Men and women from the countries concerned are therefore separated from the beginning of the workshops. "You have to find the right way to tackle the topic, otherwise we will not reach people," says a social worker.
But this is a precondition for reducing new HIV infections among migrants. According to Trofimov, most of them are stuck in Germany – out of ignorance. The figures from Aids-Hilfe Potsdama indirectly reflect the problem: in the meantime, every other person receiving advice is an asylum seeker.
Refugees should have the same opportunities to protect themselves
The situation is similar to Berlin Aids-Hilfe. Here, 20 years ago, people began offering bans on migrants with HIV / AIDS. The "BeKAM" group consists of a hard core of about 50 to 60 people; In addition, every time new asylum seekers are present. During a meeting at the "Ulrichs" café in Berlin-Aids-Hilfe, a volunteer is exchanged with coffee and croissant due to illness and health, the desire for children and work or the question of staying. There is also a content program in multiple languages. New members get the first important information, the old can deepen their knowledge. Regardless of their diversity, the groups work together harmoniously and solidly, "says Volker Mertens of the German Support Foundation, which has been providing financial support to the project for many years." We do this because we consider the low thresholds for migrants with HIV infections to be extremely meaningful ".
With the "BeKAM" group, the Foundation sponsors many other projects aimed at people with migratory history, including the Brandenbur project "Take Care of Yourself!". Money – more precisely, 100 000 euros a year – comes back from private health insurance. "We want immigrants to have equal opportunities to protect themselves and their partners," says Kristel Degener. "And since most of them stay in Germany, targeted project support is a good long-term investment."
Victor Trofimov is considering how to put HIV Home Test into a refugee workshop. There is no experience yet. Maybe she'll wait until she finds the real movie.