New HIV Infections in Germany: Breaking Down the Numbers
In a recent preliminary report from the Robert Koch Institute (RKI), an estimated 1900 individuals in Germany contracted HIV last year. The RKI acknowledged that the figures are yet to be finalized due to ongoing data collection. For 2021, the experts predict a slightly lower number of new HIV infections, approximating 1800.
The report suggests a significant decrease in new HIV infections among men who have sex with men (MSM) since 2007, initially dropping substantially. However, the decrease has plateaued in the last three years, leaving the numbers around 1000. Interestingly, there has been no fall in HIV infections among heterosexuals or drug users. Instead, these groups have seen a modest increase in infections, partly due to their lesser concentration in major cities and resulting poorer availability of testing facilities outside urban areas.
The RKI attributes the increase among drug users to the rising popularity of drugs outside the opiate group for which there is no substitution treatment, consequently reducing contact with medical services and testing. This late detection of HIV infections enables the formation of local infection clusters, observed more frequently nowadays.
The World Health Organization (WHO) aims to eradicate HIV and AIDS by 2030, but the RKI considers this goal challenging given the lack of a highly effective vaccine. Marginalized and stigmatized communities, who are disproportionately affected by HIV, often do not receive adequate testing and treatment services. In Germany, immigrants without legal residency and those without health insurance are particularly affected.
Internationally, while Germany registers fewer new cases compared to other nations, HIV infections are on the rise in some countries, notably Eastern Europe. Particularly in Russia, heterosexual contacts have led to an emerging epidemic. The RKI attributes this to poor HIV prevention efforts among drug users in the region.
Inefficient PrEP policies, unequal access to prevention services, human rights violations, funding uncertainty, stigma and discrimination, and inconsistent policy implementation within and across countries are some of the challenges impeding the WHO's goal to eliminate HIV and AIDS by 2030.
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While meaningful comparisons across countries are not available in the provided source, a study on PrEP implementation and cost-effectiveness in 20 EU countries does show that specific policies can influence the success of HIV prevention efforts. For instance, the CDC and Belgian (BEL) policies were found to be the most effective in reducing HIV infections and deaths due to their higher PrEP coverage. Labour market integration programs and harm reduction interventions can further aid drug users and vulnerable populations, respectively.
