Therapy for hiv-positive people: no fear of aids

As an HIV-infected person, sex without a condom? Unimaginable! What hardly anyone knows: medication is the safest safer sex method for positive people.

Nice and colorful and even nicer if you leave it out? Image: dpa

"It may be that the cure for AIDS was on that plane," says Travor Stratton on Australian television. The Canadian has lived with HIV for more than 20 years, and has been an activist and consultant on the subject since 1999. On Friday, news of a setback in the fight against AIDS reached him as well.

The MH17 plane, which crashed Thursday over Ukraine, was not carrying about a hundred researchers and health experts on their way to the World AIDS Conference in Melbourne, as initially reported. But several experts were likely killed in the crash. It is confirmed that the former president of the International AIDS Foundation, Joep Lange, is among the dead. "You can only guess what expertise was on that plane," Stratton says.

The conference, which is expected to draw nearly 18,000 researchers, preventionists and activists to Melbourne, Australia, starting Sunday, was meant to be another step toward a world without AIDS. The experts had set themselves the motto "Increase the pace".

The researchers’ fight against the virus has been a success story over the past decades. While there is still no cure for HIV, with no vaccine in sight, for HIV-positive people who have access to medication, this therapy has dramatically changed life with the disease.

In the eighties, the fear of AIDS was pervasive. Today, HIV-positive people on therapy live as long as non-infected people and don’t infect anyone without a condom. Read whether the battle has been won in the wochenende of July 19/20, 2014. In addition: You don’t always have to be happy, says philosopher Wilhelm Schmid. And: The wind farm operator Prokon is bankrupt. Who is the man behind the company? At the kiosk, eKiosk or right away in a practical weekend subscription.

Various active ingredients work together to stop the virus from multiplying in the cell and thus ensure that the number of pathogens in the blood drops. If everything goes well, HIV is no longer detectable in the blood after a few weeks. HIV-positive patients have to swallow tablets forever and may have to live with side effects such as digestive problems, headaches and nausea. But if they start therapy early enough, they will live to the same age as people who are negative.

What remains of 30 years of education?

And the tablets have another consequence – a second revolution for those affected: Once an HIV-infected person is on treatment and the viruses are no longer detectable in his blood for six months, he can practically no longer infect anyone – even when having sex without a condom. The study that proved this was hailed by Science magazine as the scientific breakthrough of the year. 1,750 couples from different continents, one partner of each being HIV-positive, took part. The result: consistent therapy provides 96 percent protection against infection. Condoms provide 95 percent protection.

"There is no longer any doubt about the protection provided by therapy," says Armin Schafberger, medical officer of the German Aids Federation today. When a Swiss expert commission made the same fact public in 2008, as the first AIDS expert panel to do so, Schafberger’s colleague Rero Jeger of the Zurich Aids-Hilfe still ruled differently: The kind of clarification was fatal, "it would have been better not to have published this discovery widely," he said.

In the cover story of the sonntaz of July 19/20, 2014, authors Jorg Schmid and Luise Strothmann explore the question of what such scientific findings mean for dealing with HIV. Schmid and Strothmann meet three gay men in Berlin who grew up in different times – and therefore have very different answers to the question of how much one should still fear HIV.

Marco Erling, 33, whose name is actually different, made a conscious decision to have sex without a condom when he was 17. And he took the risk of contracting HIV – a treatable, chronic disease, in his opinion. "I grew up in a different time. The old images of AIDS were almost no longer present."

Wolfgang Kohl, 53, a social worker and director of an assisted living facility for people with AIDS or HIV, still has those same disturbing images in his head. The time when he was at at least one funeral every week is over. But it left its mark on him: he would never have sex without a condom. After all, you can never be sure if your partner is taking it regularly. "It’s just easier to pass a condom over."

Many prevention workers fear that news of the non-infectiousness of HIV-positive people could mean that all that remains of 30 years of AIDS education is the phrase: You don’t need condoms. But some also see a debate about this as an opportunity: "It is important to communicate openly about the protective effect of the drugs," says a 2013 position paper by the Aids-Hilfe. "This counteracts misinformation, allays fears, prevents rejection of people with HIV, and promotes communication about safer sex."

It’s a balancing act: how much differentiation can the debate take when a quarter of young people don’t use a condom the first time they have sex? What do you think? Do we fear AIDS too much or too little? Is carelessness dangerous? Do you find condoms annoying or normal hygiene articles for a carefree everyday life? And: What should AIDS preventionists advise in such a case?

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