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:

Bei erfolgreicher HIV-Therapie ist HIV im Blut nicht mehr nachweisbar und dann beim Sex nicht mehr übertragbar. Dafür ist es wichtig, dass die HIV-Medikamente ohne Unterbrechung eingenommen werden und der Erfolg der Therapie regelmäßig ärztlich geprüft wird. „Schutz durch Therapie“ schützt nur vor HIV, nicht vor anderen Geschlechtskrankheiten oder einer Schwangerschaft.

HIV-negative Menschen können ein HIV-Medikament einnehmen, um sich vor einer Ansteckung mit HIV zu schützen. Man nennt das „Prä-Expositions-Prophylaxe“, kurz PrEP. Das bedeutet so viel wie „Vorsorge vor einem Kontakt mit HIV“. Die PrEP wird von dafür zugelassenen Ärzt*innen verschrieben. Die gesetzlichen Krankenkassen übernehmen dann die Kosten für die Medikamente und die nötigen Untersuchungen. Die privaten Krankenkassen haben eigene Regelungen. Auch ohne Krankenversicherung kannst du die PrEP erhalten. Informiere dich in der Aidshilfe oder dem Gesundheitsamt vor Ort, welche Ärzt*innen die PrEP verschreiben. Die PrEP schützt nur vor HIV, nicht vor anderen Geschlechtskrankheiten oder einer Schwangerschaft.

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