Around 38 million people worldwide live with HIV, in Germany around 90,000. Serious illnesses caused by HIV are called AIDS. There is now medication that prevents the outbreak of the illness. This article will give you an overview about prevention, diagnosis, and treatment options.

At a glance

  • The HIV virus infects cells in the immune system that fight off pathogens. It is found in body fluids and is often sexually transmitted.
  • AIDS means that people with an immune system severely weakened by HIV get sick from otherwise harmless infections.
  • Medication prevents the HIV virus from replicating and causing an outbreak of AIDS. Medication known as pre-exposure prophylaxis (PrEP) should be offered to people with an increased risk of HIV.
  • Those affected undergoing successful treatment are regarded as non-infectious. In Germany, this is about 95 percent of all people treated for HIV.
  • People with HIV have a similar life expectancy to people without HIV.
  • Condoms, femidoms (female condoms) and dental dams during sex and PrEP reduce the risk of infection.

Note: The information in this article cannot and should not replace a medical consultation and must not be used for self-diagnosis or treatment.

HIV: piles of brightly-colored condoms.

What is HIV and what is AIDS?

HIV is short for human immunodeficiency virus. The virus infects cells responsible for resisting pathogens. Because the virus thereby weakens the immune system, it is known as immunodeficiency virus. Having a weakened immune system means that people get sick from illnesses that would otherwise be harmless, but from which they can no longer protect themselves. When this state is reached, doctors talk of AIDS. This stands for “Acquired Immune Deficiency Syndrome”.

Important: AIDS is not the same thing as HIV. People only talk of AIDS when an untreated HIV infection leads to other serious illnesses, often pneumonia or tumor disease, but also other illnesses.

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What are the signs of an HIV infection?

People with HIV show different symptoms depending on what stage of the infection they are at. Six days to six weeks, but usually two to three weeks after being infected, some of those infected show flu-like symptoms, which can be mild:

  • high temperature (fever)
  • headaches
  • muscle and limb pain
  • rash
  • sore throat
  • swollen lymph nodes
  • generally feeling weak and sick
  • sometimes diarrhea
  • in rare cases signs of meningitis

These symptoms are present in many illnesses and are not necessarily signs of an HIV infection.

After the first symptoms of an HIV infection, often months or years go by without any further symptoms. Only when a large number of immune cells are damaged do different illnesses occur because pathogens can no longer be fought against. These include for example fungal infections, skin disorders, pneumonia, toxoplasmosis, cytomegaly and some types of cancer.

How do people get infected with HIV?

In Germany it is still mainly men who have sex with men who get infected. But the risk of getting infected is in itself nothing to do with sex or sexual orientation. A person’s sex life is the decisive factor.

The HIV virus is mainly found in body fluids with which people come into contact during sex. They are:

  • sperm
  • vaginal fluid
  • menstrual blood
  • fluid on the lining of the intestine

If these fluids get into the mucous membranes or open wounds, the virus can be transmitted.

People who share needles or injection sets to inject drugs, for example, are at very high risk. The risk of infection decreases sharply when they use sterile needles instead and they are the only ones to use the accessories.

During pregnancy, it is possible for the virus to be transmitted shortly before, but especially during birth. Successfully treating the mother reduces the risk for the child from 20 to 25 percent to below one percent. After the birth the infection can be transmitted to the child through breast-feeding. Here, too, antiretroviral therapy, i.e. a treatment targeted against the virus, offers protection.

Important: It is more difficult for the HIV virus to be transmitted than other viruses or bacteria. It is not transmitted through close skin contact or through the air.

The following are not contagious:

  • coughing
  • sneezing
  • hugging
  • cuddling
  • snuggling
  • caressing
  • petting
  • kissing, including French kisses
  • insect bites
  • everyday situations such as going to the cinema together, exercise or work

Oral sex is also considered to be relatively safe in terms of HIV transmission, but not in terms of other sexually transmitted infections, abbreviated as STI.

The risk of getting infected with the HIV virus in Germany through a blood transfusion is now less than one out of three million transfusions and therefore extremely low.

Do you have any further questions about the HIV infection and AIDS? You can find answers to frequently asked questions on the Robert Koch Institute website.

How common is HIV?

The HIV virus exists the world over. But the infection rates vary considerably. Today, it is mainly regions in Africa, Asia, South and Central America and Eastern Europe that are affected. The number of infections and deaths is falling worldwide. The Joint United Nations Programme on HIV/AIDS counted three million newly infected people in 2000.

In 2017 this number dropped to 1.8 million. The number of people who died of AIDS dropped from one and a half to one million in the same period. In Germany, HIV infections must be reported. In 2019, about 3,105 people were newly infected and about 88,400 people in Germany lived with HIV.

How can an HIV infection be prevented?

The HI virus is sexually transmitted in 90% of cases. Condoms, for example, provide protection from this. They also provide protection from other sexually transmitted infections such as chlamydia and hepatitis B.

Women who don’t want to leave it to their partners to ensure protection can use femidoms. These are a type of condom that is bigger that women can insert into their vagina.

Das HI-Virus wird zu 90 Prozent sexuell übertragen. Davor schützen Kondome.

Oral sex can now also be enjoyed with protection. Thin latex sheets, dental dams, which also protect against other sexually transmitted infections help with this. Condoms are also important as additional protection.

There is no vaccination against an infection with HI viruses.

But there is the option for people to protect themselves with medication. This method is called pre-exposure prophylaxis, or PrEP for short. It stops the HI virus from replicating and provides over 95 percent protection against an HIV infection. Medical practitioners also call this “Therapy as Prevention”, or abbreviated TasP.

It should be noted however that PrEP protects against HIV, but not against other sexually transmitted infections. 

Would you like to know more about how you can protect yourself against HIV with pre-exposure prophylaxis? You can find out more on the Deutsche Aidshilfe website.

Would you like to assess your risk of getting an HIV infection and other sexually transmitted infections (STI)? WIR – Walk In Ruhr Center for Sexual Health and Medicine offers an anonymous online STI risk test.

What tests are performed for an HIV infection?

If a doctor suspects an HIV infection, they take a blood sample. To diagnose the infection, the sample is sent to the laboratory for analysis.

There , first of all the presence of certain antibodies is determined. This test is done to see whether the patients’ immune system has had contact with HIV viruses and has already formed antibodies against it. The body needs time for this – on average, the antibodies can be detected at the earliest three weeks after the HIV infection. A negative antibody test doesn’t therefore necessarily mean that someone isn’t infected. Since a positive antibody test doesn’t necessarily mean there is an HIV infection either, this must be verified by doing another test.

Self-tests for an HIV infection have been available in pharmacies since 2018. The Paul Ehrlich Institute provides information about what tests are available and how safe they are.

How is an HIV infection treated?

For an HIV infection to be cured the virus would have to be removed from the body completely. Because the HIV virus inserts itself into the human genome, this is not yet possible. This means that an infection with HIV cannot be cured from a medical point of view. But it can be very effectively treated. Treatment in this case means keeping the virus inactive and by doing so preventing AIDS. There are many ways of achieving this.

Highly effective drugs mean HIV-positive people can lead a normal life in almost all respects. Their life expectancy is similar to that of people without an HIV infection.

Protection from high-risk contact

The above-mentioned pre-exposure prophylaxis (PrEP) is meant for people who have an increased risk of HIV infection. Taking a tablet daily offers protection of over 95 percent. The costs are covered by the health insurance providers.

Important: Women and men benefit equally from the pre-exposure prophylaxis to protect themselves from HIV high-risk contacts.

Protection after high-risk contact

Post-exposure prophylaxis (PEP) can be administered within 72 hours after an infection. But the earlier a person begins – preferably within the first 24 hours – the more reliable the protective effect.

The PEP is used in emergencies and reduces the likelihood of getting infected with the HIV virus, for example with needlestick injuries or if a condom breaks. Affected persons take medication for four weeks which prevents the spreading of the HI virus in the body.

Treatment for proven HIV infection

Highly effective drugs mean people with HIV can lead a normal life in almost all respects. They have a similar life expectancy to people without HIV and are not infectious. They are not restricted in their professional life or their leisure. They can express their sexuality and have children naturally without any risk.

The HIV treatment is also called antiretroviral treatment. People with an HIV infection also daily take medication containing several active ingredients combined. They stop HIV viruses from replicating: the number of infected cells drops drastically resulting in the infection not spreading and the disease not breaking out. If the medication is taken regularly and for at least half a year, it is almost impossible to infect others.

The antiretroviral treatment does not remove the HIV virus from the body completely. The infection cannot be cured from a medical point of view. People must therefore take this medication their whole lives.

What does life with HIV look like?

If an HIV infection is treated, it is like living with many other chronic diseases. People who have HIV can experience normal day-to-day life. They are not ill more often than other people without HIV and they achieve as much as them. Nevertheless they often face discrimination or rejection. The World AIDS Day was initiated to raise awareness of this and call on all people to show solidarity. It has been taking place on 1st December since 1988.

Go to the World Aids Day website.

Would you like to find out more about the history of the HIV virus? You can read more on the website of the Federal Center for Health Education.

Points of contact for HIV and AIDS

Liebesleben (Love Life) is the website from the Federal Office for Health Education (BZgA). This is where you can get information about love, sex and protection.

You can find general information and advice about HIV and AIDS on the Deutsche Aidshilfe website.

You can also get information about HIV and AIDS from the German AIDS Foundation.

The WIR – Walk in Ruhr Center for Sexual Health and Medicine also provides interesting and useful information about HIV and other sexually transmitted infections.

Reviewed by the German STI Society (Deutsche STI-Gesellschaft e.V.).

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