Number of new HIV infections declines in Germany, but many still unknowingly positive

Before World AIDS day on December 1st, statistics about new cases of infection in Germany have been published. After years in which figures remained stable, positive and negative trends have been noted.

Number of new HIV infections declines in Germany, but many still unknowingly positive
HIV ribbons. Photo: DPA

Fewer people in Germany were infected with the HIV virus last year, after a period of stagnation. The number of new cases of infection in 2017 was estimated to be 2,700, the Robert Koch Institute (RKI) stated in a report published on Thursday. Current calculations estimate that in the years 2014 to 2016, 2,900 cases were discovered each year.

“Thanks to successful preventative work and the good treatment options, Germany is one of the countries with the lowest rates of new HIV infection in Europe,” explained federal health minister Jens Spahn of the CDU, also a current candidate to become party leader.

He announced the intention to reduce the rate of new infections further and referred, as an example, to HIV self-tests, which are now available.

The RKI views the expansion of trial offers for target groups as a reason for the decline, in particular, for gay and bisexual men, among whom the number of new infections reduced from 2,300 in 2013 to 1,700 last year.

It added that the willingness to get tested has therefore “probably” increased, as dating app users are increasingly displaying information regarding their HIV status and their most recent test date.

HIV self tests are now available in Germany. Photo: DPA

Furthermore, an earlier starting date for treatment of HIV positive people in Germany has shown to be successful, according to the RKI. The reports states that 92 percent of people affected were undergoing treatment last year.

According to the RKI, a total of around 86,000 people in the country were living with HIV at the end of 2017. Despite the general decline, there are other trends to be noted. The estimated number of people in Germany who are infected, but don’t actually know it, has grown slightly. It has grown from approximately 10,800 cases at the end of 2011, to roughly 11,400 at the end of 2017. However, the figure has declined among gay and bisexual men.

Among heterosexuals, in contrast, a slow increase in new cases of infection can be seen. According to the RKI, this group often lacks awareness of their HIV risk, and so they get tested less frequently. Among women, the majority of HIV diagnoses are first discovered during routine pregnancy screenings.

Additionally, there are an estimated 6,000 people in Germany who have been diagnosed with HIV, but who are not receiving treatment. These could be people without documents or without health insurance.

According to the report, several thousand people are already taking medication for the prevention of HIV infection. The so-called Prä-Expositionsprophylaxe (PrEP) has been authorised in the EU since 2016 and has been available at an affordable price in Germany since autumn 2017.

HIV is mostly contracted through sex. When left untreated, the virus damages the body’s immune system and consequently often results in death. Nowadays with medication, the development of the immunodeficiency illness, AIDS, can be prevented. With successful therapy, the viral load in the bodies of HIV positive people can sink so far that, according to the RKI, “no more transmission” of the disease can be noted.

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What we could all learn from the German attitude to sickness

British people might like to tell themselves that the empire was built on a stiff upper lip. But Germany’s attitude of giving things time to heal seems much more appropriate to the modern workplace, writes Floraidh Clement.

What we could all learn from the German attitude to sickness
Photo: DPA

To put it most Britishly, my colleague has been “through the wars” recently.

After an unfortunate scooter incident, she’s due urgent knee surgery, with an estimated six to eight week recovery period. Given her recent promotion in an understaffed department, her predicament is not good news for our company.

Naturally, she fretted over taking such a long time away from work. I empathised. I wouldn’t feel so great about needing to take so much time off, either.

But what we didn’t feel the need to mutually fret about was how our bosses would take the news. We knew they would understand. Their reactions to such a lengthy, untimely absence didn’t even warrant a conversation.

Truly, one of the most pleasant culture shocks since arriving in Germany was this empathetic approach to sickness in the workplace. Not only are employees encouraged to go home if they are unwell, but they are actually given sufficient time to recover if necessary. Under Germany’s healthcare system, employee’s salary will continue to be paid in full for up to six weeks (Entgeltfortzahlung), and after that, 70% of their salary (Krankengeld). This means that in the already stressful situation of prolonged sickness, money woes won’t enter the equation.

As previously chronicled in this column, my new doctor in Berlin handed me a two week sick note unsettlingly early into my probation period. At such a crucial stage in my new venture, I wasn’t sure what was really making me feel worse: the illness itself, or the crippling guilt and fear that my bosses would be mentally harbouring reservations, concerned that their new hire was a slacking hypochondriac.

Given that my illness was depression, it made for an unsettling period of self-doubt – would they understand that I was genuinely incapacitated?

When I broke the news to my boss, I couldn’t believe what I was hearing: only to come back when I was absolutely better. She was genuinely kind, reassuring, and sympathetic, making it clear that her concern rested genuinely with my wellbeing, and not my ability to rush back to work as soon as possible.  

“I want you working at 100% and nothing less!” she said.

To this day, I still believe her compassionate approach was one of the key factors which aided my recovery.

This set a startling contrast to what I’d experienced working on home soil. For example, like many students, I balanced academia with part-time work in retail. Some weekends, I would take to the tills while snivelling, shaking and coughing, too fearful that my boss might think I was just another hungover student to dream of phoning in sick.

I had watched the adult role models around me adopt the same typically British, “stiff upper lip” attitude throughout my life, too. Taking a sick day was reserved only for illnesses which were legitimised by a doctor’s note. You either manned up, or maybe you just weren’t that determined a worker.

My refreshing experience isn’t unique to the young, progressive company I currently work for. Many friends and colleagues have shared similar stories of being sent home at the hint of the sniffle, or received tactful messages suggesting afternoons be taken off after spending just a bit too long in the office toilet.

One British friend recently shared how her boss reacted when she began to show signs of burnout, following a stressful period at work and at home.

“It was obvious I wasn’t doing well. I didn’t feel good about mentioning that I was losing sleep and couldn’t concentrate” she mentioned.

“But he told me to take holiday if that’s what I needed – even if it had to be last minute. He encouraged me to fly back to the UK to be with my family, but also to seek medical advice if concentration was really becoming an issue, just in case it might be anything more serious”

Understanding and aware of the repercussions of stress on the mental health? Memories of being coaxed into work with flu suddenly seemed far away for both of us. It also turns out that burnout is taken seriously by doctors in Germany, which challenges the more British notion of sickness only counting if you’re entirely bedridden.

Whether this attitude is motivated by genuine humility or just hyper-awareness of germs, the stark contrast in approaches to sickness in the workplace was an unexpected but pleasant surprise after moving. It subverts one of the greatest myths in British working life: that coming to work sick is the virtue of a grafter. Seriously – with one of the largest, most robust economies in the world, Germany clearly suffers no great ills for allowing its workers adequate time to recover from sickness.