December 1st is the annual World AIDS Day. Since 1988, this day has served as a reminder of the AIDS pandemic and to raise awareness of the HI virus and HIV prevention. But what is HIV actually all about? Is the disease still relevant? Can straight people also get infected? And what is the best way to protect yourself from infection? I, Michael, Product Manager at Junglück, get to the bottom of these and many other questions about HIV & AIDS in this blog post for World AIDS Day. In addition to some fact checks on HIV and current figures, I also discuss my personal relationship to HIV as an openly gay man and explain why World AIDS Day is not a thing of the past. 

HIV & AIDS - What is what?

HIV stands for "human immunodeficiency virus". HIV is therefore the pathogen and not the disease itself. However, if an HIV infection remains untreated, it can lead to AIDS, the actual disease, in the long term. AIDS stands for "acquired immune deficiency syndrome". AIDS is characterized by a permanently weakened immune system. As a result, other pathogens that our immune system would otherwise fight off can develop freely and even common illnesses such as a cold or flu can be fatal.

What does HIV do in our bodies?

The HI virus attacks our immune system by infiltrating the so-called 'T helper cells' and using them as a host. The T helper cells are part of the body's own defense system and are also known as "killer cells", as their task is to eliminate pathogens. They are also a kind of task force of the immune system, i.e. they tell the other cells what to do.

HIV attacks these helper cells of all things and thus paralyzes the command center of our immune defence. If pathogens then enter the body, the immune system can no longer keep things in order. In the worst case scenario, the body is no longer able to fight off pathogens. 

Particularly insidious: AIDS has a particularly long incubation period of 1-3 years. This means that it can take several years for the typical immunodeficiency symptoms of AIDS to appear after an HIV infection. As a result, the disease itself remains undetected for a long time. 

History of the AIDS pandemic - a 'gay disease'?

Today we know: Anyone, regardless of age, gender and sexual orientation, can be infected with HIV. For a long time, however, AIDS was considered a "gay disease" - a rumor and prejudice that persists to this day. Especially in the 1980s, when the disease first came to the attention of the public, it was mainly gay and bisexual men and trans women who contracted AIDS. For a long time, it was not clear exactly why this was the case and why the disease apparently only claimed victims in the gay community. It was only with the advent of HIV tests that it became clear that women and heterosexual men could also be infected. 

The panic and helplessness in the queer community was omnipresent, while the world public was hardly interested in it and AIDS was even interpreted by religious people 'as a just punishment for the sin of homosexuality'. Apart from the disease itself, people also had to fear the social consequences of an infection; many infected people lost their jobs or were excluded from public life because it was not known how the disease was transmitted. The AIDS wards in hospitals fell into disrepair because many medical staff refused to get too close to AIDS patients. During this time, the virus also claimed many celebrity victims such as Freddie Mercury, Rock Hudson, Klaus Nomi and Leigh Bowery, to name but a few. 

Even today, the AIDS crisis is still experienced as particularly painful, especially in the gay community. The sex lives of an entire generation of gay and bisexual men were dominated by the fear of infection. Many contemporary witnesses abstained from sex for years, while the number of burials and farewells to loved ones increased dramatically. There was simply a lack of education, research and destigmatization, which unfortunately came far too late. But the AIDS pandemic has also burned itself into the collective consciousness of society in general. I still clearly remember, for example, how my parents' biggest worry when I came out was that I might one day contract HIV myself. Or how often the disease haunted our curriculum as a spectre. I also vividly remember my first HIV test and how irrational my fear of a positive test result was. I had only just had my first time with my first boyfriend - and it was protected. 

And even today, I am still very moved when HIV and AIDS are discussed in the media, even though I have no direct personal connection to it. I am HIV-negative, don't know anyone personally who has died of AIDS and was still far too young in the 1990s to be aware of what was happening back then. Nevertheless, as an openly gay man, the topic touches me deeply. I recently saw a series about the AIDS crisis. Someone had just lost someone and a friend asked for help on how the person could deal with their grief. The two of them went to a small hill that was full of flat river stones. She put a stone in the person's hand and said that each of the stones had been laid down by someone who had lost a loved one to the virus. That was the end of my evening. That's why it's so important for me to raise awareness about HIV & AIDS today, because even today there are still many prejudices. But why is that the case? 

Transmission

In order to understand why the AIDS pandemic has hit the gay community in particular so hard, it is necessary to address the question of how HIV is transmitted Tone. As already mentioned, we now know that HIV has nothing to do with sexual orientation or gender, but much more with sexual practices. Men who have sex with men (MSM) are in fact particularly at risk, as the risk of infection is much higher with unprotected anal intercourse than with unprotected vaginal intercourse. This is because the tissue of the vagina is much more resistant than the intestinal mucosa. After all, it also serves as the birth canal of our species. The intestinal mucosa, on the other hand, is much more sensitive and small blood vessels can quickly be damaged during anal intercourse, making blood-to-sperm contact possible during unprotected sex. HIV is therefore transmitted through blood and other infectious bodily fluids such as semen and vaginal secretions. Transmission via saliva (e.g. when kissing) is not possible. The most common transmission routes are therefore unprotected sexual intercourse and the shared use of syringes for drug use.

How can I contact Protect?

The safer sex rules should be followed to prevent HIV. This means that unprotected sexual intercourse should be avoided and condoms or femidoms should be used. Risk groups can also take a drug to prevent HIV infection, known as PrEP ("pre-exposure prophylaxis"). This protects against HIV as well as condoms if used correctly, but offers no protection against other STIs. Prevention measures can also prevent infection when using drugs by using sterile needles (see SaferUse). 

Know your status!

If you have frequently changing sexual partners, you should also take an HIV test regularly. But even if you live monogamously or only have sex rarely, a test can't hurt to know where you stand. For the test, blood is taken from you and tested for HIV in a laboratory. You can either take the test free of charge at HIV-focused medical practices, at the municipal AIDS service organizations and health centers or for a fee at your GP. 

Status quo - HIV and AIDS today

Very important: A positive test result no longer means the end of the world. If HIV is detected early enough, it can be treated very well and with just 1-2 tablets a day it is possible to lead a long and healthy life. If the therapy works well and you take the medication conscientiously, your viral load can even fall below the detection limit. This means that the virus can no longer be detected in an HIV test and you are no longer infectious to others. This makes it all the more important that this safety, this knowledge, is also disseminated in order to continue to counter the stigma surrounding HIV and AIDS Treat.

Overall, AIDS is on the decline, at least in the western world. Research into a vaccine is already underway. So one thing is clear: a lot has happened since the 80s and 90s and I am very glad that my generation is no longer affected to the same extent. Within the community, but also in many other parts of society, more and more educational work is taking place. Campaigns like World Aids Day are extremely important to raise awareness and educate people. And not just in the LGBTQIA+ community, but also among heterosexuals. HIV and AIDS is something that concerns every sexually active person. 

For more information and education about HIV, AIDS & SaferSex, please visit the website of the German AIDS service organization (www.aidshilfe.de).

Your Michael

 

 

Sources

German AIDS service organization: HIV / Aids. URL: https://www.aidshilfe.de/hiv-aids (Retrieved on 29.11.2021).

German AIDS service organization: HIV-PrEP. URL: https://www.aidshilfe.de/hiv-prep (Retrieved on 25.11.2021).

Robert Koch Institute: HIV/AIDS: Key data and trends for Germany and the federal states. URL: https://www.rki.de/DE/Content/InfAZ/H/HIVAIDS/Eckdaten/Eckdaten.html (Retrieved on 25.11.2021).

Robert Koch Institute: 1981 to 1990: AIDS - the political dimension in the 1980s. URL: https://www.rki.de/DE/Content/Institut/Geschichte/Bildband_Salon/1981-1990.html (Retrieved on 25.11.2021).

Wikipedia: AIDS. URL: https://de.wikipedia.org/wiki/AIDS (Retrieved on 29.11.2021)

World Aids Day: What is World AIDS Day?. URL: https://www.worldaidsday.org/about/ (Retrieved on 24.11.2021).