Key facts about HIV and AIDS

HIV is a virus that attacks the body’s defences (the immune system) and can lead to AIDS, if left untreated. AIDS weakens the immune system so much, that it can barely fight off diseases, resulting in severe infections and even cancer. HIV treatment (ART = anti-retroviral therapy) can be used to prevent AIDS. 

HIV is one of the most difficult germs to pass on to others. The virus cannot be passed on during everyday activities, at work, or during sports. There is only a risk of an HIV infection, if body fluids containing large volumes of the virus enter the body:

  • HIV is most commonly transmitted by means of vaginal and anal intercourse, when protective measures are not used (e.g. condom/femidom, PrEP, treatment as prevention – TasP). 
  • In the case of drug users, there is a very high risk of infection when users share needles used for injecting drugs.
  • During pregnancy, childbirth and breastfeeding, HIV can be transmitted to the child, if the mother does not take HIV medication.

HIV drugs (called ‘anti-retroviral drugs’) stop the HIV virus from reproducing in the body and prevent AIDS. If HIV treatment is started on time, patients have a good chance of reaching the normal life expectancy and should largely be free of any symptoms/complaints. If a person has AIDS, HIV drugs can be used to reverse the symptoms and the immune system can recover. 

Successful HIV treatment also means that the virus can no longer be transmitted during sex. People with HIV can, when under regular treatment, become parents without having to fear passing the virus on to their partner(s) and/or babies; it is also possible to have a vaginal delivery and to breastfeed.

Yet, the medication cannot eliminate HIV from the body, and thus must be taken for life.

An HIV test can be performed to find out if a person has become infected with HIV. You can get tested and have a medical consultation, both anonymously, (in some cases for a small fee) at one of the Aidshilfe (AIDS service organization; see Information, advice, and support), at a prevention project/checkpoint, or at the local health authorities (usually free of charge). You can also obtain HIV self-tests from the pharmacy, which means you can test yourself for HIV at home. 

Medical practices and outpatient clinics offer HIV tests too. Yet, these tests usually are carried out under your name and the results are recorded in your patient records: this can lead to social and legal disadvantages (e.g. if you want to enter into private health insurance).

Methods for protecting yourself against HIV and AIDS

In addition to using CONDOMS or FEMIDOMS (see What do I need for work?), there are other methods that can protect you against HIV transmission during sex:

If HIV is treated successfully, then the HIV virus can no longer be detected in the blood and can no longer be passed on during sex. It is important for HIV drugs to be taken without any interruptions (i.e. no skipped doses) and for a doctor to regularly check that the treatment continues to be effective. “Protection through treatment” can only protect you from HIV, and offers no protection against other sexually-transmitted diseases, or pregnancy.

 

 

 

HIV-negative people can take HIV medications to protect themselves from potential infection with HIV. This is called “pre-exposure prophylaxis”, or ‘PrEP’ for short. This basically means “prevention prior to exposure to HIV”. PrEP can be prescribed by specially-approved doctors.

Statutory health insurance companies then cover the costs for the drugs and for any necessary investigations. Private health insurance companies each have their own regulations. You can even get PrEP if you do not have health insurance. You can find out which doctors can prescribe PrEP from an Aidshilfe (AIDS service organization) or your Gesundheitsamt (local health authority).

PrEP can only protect you from HIV, and does not offer any protection against other sexually-transmitted diseases, or pregnancy.

Why should sex workers take PrEP?

Many sex workers look after their (sexual) health, but the same may not necessarily be true for clients. 

You can use PrEP in combination with condoms/femidoms, and protect yourself in situations such as the following:

  • The condom/femidom breaks or slips.
  • You are under pressure to offer your services without using a condom/femidom.
  • A client removes the condom/femidom without your knowledge/consent.

PrEP is suitable for cis, trans* and non-binary people, and can also be taken while on hormone therapy. You can find more information and advice on PrEP from AIDS service organizations (Aidshilfen), HIV specialist practices, and from the local health authorities (Gesundheitsämter).1

1 Based on the leaflet “PrEP & Sex Work + Infos for trans, inter and non-binary folks” by Trans*sexworks