AIDS expert Brockmeyer: "We have to take prevention much more seriously"

By 2030 the AIDS epidemic should be overcome – that's the goal of the United Nations. Already today 15 million patients have access to anti-retroviral drugs, which is something to celebrate on this World AIDS Day.

DW: Worldwide there are about 36.5 million people infected with HIV. Now almost half of them have access to anti-retroviral therapies. Those drugs enable patients to grow old with HIV. The World Health Organization is hopeful that more and more people can get access to such drugs and that the AIDS epidemic can be brought under control by 2030. Germany is already on the right path, even though there are 85,000 people with HIV.

Professor Brockmeyer, how many more people get infected every year in Germany?

Deutschland Norbert Brockmeyer Leiter des Zentrums für Sexuelle Gesundheit und Medizin in Bochum

Norbert Brockmeyer says that with information and proper medication we can win the battle against HIV/AIDS

Norbert Brockmeyer: In 2016, there was a decline in new infections which stood at around 3,200. The situation has stabilized, in fact newly diagnosed cases are even less, now. However, we are seeing a slight increase among heterosexual people. But this could still be in the margins of statistical variability.

The overall trend concerning HIV infections is very good. One reason for that is the very good therapeutic options we now have. In Germany, a lot of patients are being successfully treated with the result that they are not infecting others anymore.

Culture | 16.11.2017

What does that mean for the psyche of those patients?

It means a lot for their psychological health. If they are not infectious anymore, it is like a liberation. Some have described it like this: "Since I know that I am not infectious anymore, I have become another person. I can behave and move around like everyone else and don't have to hide anymore or be afraid of infecting someone." This is a huge success and strengthens those who are HIV positive.

Which other positive changes have you noticed in recent years?

There are wonderful perspectives we have now – which were unthinkable 10 years ago: The possibility that the patients can have a life expectancy like anybody else. It is great that we have achieved that. But we still have to take prevention much more seriously. Here in Bochum – at the Centre for Sexual Health and Medicine – we have developed a system in the last six months, which enables HIV-positive people [that often change sexual partners] to anonymously inform sexual partners about the need to get tested.

And you have developed a risk test. How does that work?

With the risk test people can check several things: With whom did I have sexual contact? What are my sexual preferences? And then they can get advice about what to do about prevention and other aspects. It also deals with the question of whether someone should get tested and which possibilities there are to get tested and receive therapy. And finally, there is the question of "pre-exposure prophylaxis" (PrEP).

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For people, who do not like to go to a doctor, we offer a self testing kit. People who have received a consultation in our center can then test themselves at home by taking some blood from their finger and sending it to a lab.

Practically, it is a possibility to test yourself at home. For people who are inhibited and cannot go to a doctor this opens up new possibilities. This is another offer for people to get themselves tested – for people who really need it.

What kind of prevention measures can people take? 

Besides condoms people with a high risk of getting infected with HIV do have additional options. For people who do not manage to use condoms, because it leads to erectile dysfunction or they have allergies, there is the PrEP medication. This means, that people, who do not have HIV take two kinds of substances, which were originally developed for HIV therapy. Then, they are protected against an infection. While health insurance companies in Germany do not pay for the medication, the price has gone down dramatically. Currently you can get it for roughly €50.


Prize-winning: '120 BPM'

The drama "120 BPM" is the latest film to take on the illness. Directed by Robin Campillo, the movie tells the love story of two young AIDS activists. It won the Grand Prix jury prize at Cannes in spring and opened in Germany just ahead of World AIDS Day.


An early work: 'Longtime Companion' (1989)

Above all, French and American productions took up the subject of HIV and AIDS early on. "Longtime Companion" by Norman René is considered the very first to have described the disease as it tells the stories of eight gay middle-class men who are friends in the early 80s. That's when the illness first appeared and began ravishing the community, the impact of which is at the heart of the film.


Autobiographical: 'Savage Nights' (1992)

The French director and lead actor in "Savage Nights," Cyrill Collard, likewise takes up the topic of repression of AIDS when he brought his autobiographically influenced novel of the same name to life. In the film version, Collard plays a bisexual who does not take his life or that of his partners into consideration. He died in 1993, just one year after its release.


Oscar-decorated: 'Philadelphia' (1993)

Jonathan Demme's film "Philadelphia" was the first major Hollywood production that brought AIDS to the big screen for a wide audience. In it, Tom Hanks plays a lawyer who is let go from his job due to his illness. He takes his former employer to court in a melodramatic and sentimental film that is very effectively staged. With the Oscar-winning film, AIDS was finally recognized by Hollywood.


Semi-documentary: 'And the Band Played On' (1993)

Whereas "Philadelphia" was a true Hollywood production, "And the Band Played On," released that same year, took a quieter, nearly documentary approach to the AIDS epidemic. Starring Matthew Modine as the young AIDS researcher Dr. Don Francis, the film by Roger Spottiswoode attempted to tell the tale of those infected by including numerous stories.


Controversial: 'Kids' (1995)

Two years later, director Larry Clark put out the teenage drama "Kids," a fictional narrative with a documentary feel. The director highlighted the youth culture in New York in the mid-90s, where sex is on the minds of young boys and girls alike while AIDS lurks in the background. The scenes are drastic and with actors not yet of age, the film created quite a controversy after its release.


Melodramatic: 'All About My Mother' (1999)

What appears to be a standard Pedro Almodóvar film, "All About My Mother," released by the Spanish director in 1999, takes on the lives, loves and sorrows of a handful of protagonists. Set in Madrid and Barcelona, the melodrama addresses gender roles and society's prejudices, with AIDS playing a central role in the film.


Looking back: 'The Witnesses' (2007)

"The Witnesses" is French director André Téchiné's look back to the 1980s, when the AIDS crisis first came into focus. The movie follows several characters as it shows the disease and its impact on their lives at all stages. The movie was celebrated at the Berlinale for its handling of the AIDS epidemic but wasn't able to make the leap into German theaters, despite stars like Emmanuelle Béart.


A global perspective: 'Same Same But Different' (2009)

Germany has likewise tackled AIDS as a film subject. Rosa von Praunheim was the first, with his typically anarchistic approach in "A Virus Knows No Morals" in 1986. In 2009, director Detlef Buck took a more worldly view on the global crisis, with "Same Same But Different," which follows the love story between a young German man (David Kross, seen above) and a Cambodia prostitute.


An actor's film: 'Dallas Buyers Club' (2014)

"Dallas Buyers Club" by Canadian director Jean-Marc Vallée was widely acclaimed upon its release three years ago. Matthew McConaughey (r.) and Jared Leto are brilliant as two people living with HIV in the 1980s, who are trying to get their hands on the AIDS medications that could prolong their lives. Both actors won nods from the Academy for their roles.

In the past, these substances cost anywhere from €500 to €800. What happened?

We are talking about medicine that was originally called Truvada. The patent for it has run out. Since then, five or six companies started producing it as a generic drug. That led to an initial decrease in the price to about half the original. In addition there were PrEP campaigns which drove the price down even farther. This is a huge success. It also shows that with tough negotiations it is possible to drive down the costs for life-saving therapies and medications.

What are the main preconditions to further reduce the number of new infections?

Most important is informing people about how to protect themselves, and about how to talk to their sexual partners about the issue. Many people are afraid to even address the issue. Sexuality is still a big taboo. Those with HIV are stigmatized. You don't talk about it. Therefore, the question is: How can I talk to my partner about HIV and other sexually transmittable infections – in a way that sex is actually still possible?

Professor Norbert Brockmeyer is the director of the Centre for Sexual Health and Medicine at the University Clinic of Bochum.