“We can not do without effective HIV prevention methods”

“We can not do without effective HIV prevention methods”


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Thursday, 18.08.16, written by Cora Christine Döhn

There are around 83,400 people living with HIV or AIDS in Germany. The number of new infections is low by international standards. This is due to extensive HIV prevention in this country. Holger Wicht from the German AIDS Aid tells in an interview that prevention can even be improved, but the possibilities must remain unused so far.

What role does HIV prevention play in Germany?

Holger Wicht: German HIV prevention is very successful: Germany is one of the countries with the lowest infection numbers worldwide. There is a proven division of labor: The Federal Center for Health Education is providing information to the general public – the new “Liebesleben” campaign has just started. The German AIDS-Hilfe is responsible for the groups that are particularly affected by HIV, for example gay men. In order to keep up the successes and perhaps even lower the numbers , we must not let up on HIV prevention . And there are gaps to fill, for example with the nationwide establishment of drug consumption rooms and the issue of clean syringes for drug addicted people in custody .

How much money is spent annually in prevention?

Holger Wicht: The federal government provides around twelve million euros annually for the prevention of HIV and other sexually transmitted infections, of which five million go into the work of Deutsche AIDS-Hilfe. There are also funds from other sources, for example from the Länder and municipalities and from the Association of Private Health Insurance.

What costs are incurred in this country for the treatment of HIV-positive people?

Holger Wicht: The costs of HIV therapy can fluctuate greatly, On average, they amount to about 20,000 euros per year. About 60,000 people are currently receiving HIV medication.

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What costs are covered by health insurance?

Holger Wicht: The health insurance companies assume all necessary costs for diagnostics and medicines.

Are there differences between the reimbursement and the benefits of private and statutory health insurance?

Holger Wicht: No, no material, the benefits of the statutory health insurance cover everything that is necessary in the context of HIV therapy.

HIV prevention is not only at the societal level, but also more medically: there is a pill that, when taken regularly, reduces the risk of infection with HIV. What role does this so-called pre-exposure prophylaxis (PrEP) play in the fight against HIV / AIDS?

Holger Wicht: The PrEP will not play a role for the general public. The condom remains the simplest and most important means of protection against HIV. However, PrEP can prevent HIV infection anywhere where people are at particularly high risk and other protective options are not working properly . In Germany, for example, it comes into consideration for a relatively small group of gay men who, for various reasons, do not always manage to use condoms. We can finally offer these people another opportunity with PrEP. It is important to use!

Why is not she in the main afflicted group long since commonplace in Germany?

Holger Wicht: The PrEP is not yet approved in Europe, also is the drug Truvada, which can be used for this purpose, far too expensive – the monthly package costs more than 800 €. But that could change soon: Next year, the patent expires, then other companies can offer the drug cheaper . In addition, there will be more drugs in the next few years that can be used as PrEP. The goal must be that a low-cost drug is available. It must be accessible to anyone who can help them stay HIV-negative. The pharmaceutical industry must also contribute to this, for example through special prices for the use of HIV medicines for prevention .

Is there a possibility that PrEP in Germany will be prescribed by physicians in the future and health insurance will cover the costs? Are there any reasons against prescribing the drug?

Holger Wicht: Doctors can prescribe the PrEP without any problems as soon as it is approved. Whether the health insurance will pay for it, is currently open. We would welcome that. Otherwise, other financing models are needed. We can not afford to give up effective prevention methods!

In the US, PrEP is widely used. Who will be there for the costs?

Holger Wicht: In the US, the PrEP is submitted via the national health service and even advertised extensively. One hopes to be able to significantly reduce the number of infections. Partially already successful, for example in San Francisco. The pharmaceutical industry grants discounts on the use of the drug as PrEP.