After falling for several years, rates of HIV infection, particularly among young gay men, are rising again. Risky behavior is increasing as a new generation appears willing to close its eyes to the dangers of HIV/AIDS.
In the early 90s, aggresive HIV campaigns were the norm
At 20 years old, many young adults are busy getting their college degrees or beginning their work lives, often excited at the broad expanse of possibilities in front of them. However, for 20-year-old Andreas, a gay Berlin resident, a dark cloud has formed on his horizon; he found out recently he has been infected with HIV, the virus that causes AIDS.
Andreas, who asked that his real name not be used, is having difficulty coming to terms with a diagnosis that has changed his future irrevocably. While HIV is no longer the death sentence it once was, Andreas will have to begin a demanding drug regime to keep AIDS at bay -- and there are no guarantees. The disease still kills 600 people in Germany every year.
"There is too little information out there," he told DW-WORLD. "I never thought it could happen to me."
"New dynamic" to epidemic
For some time in the mid to late 1990s, researchers and health care professionals working in the areas of HIV/AIDS could take comfort in the statistics: the number of HIV infections was falling annually; the message of safer sex seemed to have gotten out.
But a report out by the Robert Koch Institute, a federal organization that researches disease control and prevention, warns that the epidemic of HIV in Germany could acquire a "new dynamic" since the number of infections since 2001 has been rising steadily.
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Three years ago, the institute reported 1,470 HIV infections in Germany; in 2002, that number rose to 1,716; last year, 1,958 people contracted the virus. That is a 33 percent rise in three years. The trend toward rising infection rates also affects heterosexuals, half of those infected were men who had sex with men.
Experts say the reason behind the rise in infections is an increase in unsafe sex and a swing in attitudes toward the dangers of AIDS.
Since 1987, the Koch Institute has carried out an annual survey about AIDS awareness in the general public. In 2003, the survey found that condom usage in general was falling. Among those surveyed who had multiple sexual partners in 2003, 78 percent used condoms, down five percent over two years. Manufacturers are even selling fewer condoms in Germany. Young people seem especially susceptible to letting their guard down in the heat of the moment.
"The general tendency among young people today is to not see fully the risks involved in risky sexual behavior," Rolf Gindorf, founder and past president of DGSS, a sexuality research center in Düsseldorf, told DW-WORLD.
"Older gay men, say around 40 and up, are aware of the danger because they came of age at a time when death rates were high and AIDS information was very visible and always on people's minds," he said. "But younger people today, they don't have that experience. Knowing that the disease can be treated tends to make them carefree when it comes to sex."
The result is a generation gap that has developed between older and younger gay men. Protected sex has become second nature to older gay men, but among today's youth, while they generally known the rules of safer sex, they often don't follow them in sexual situations, according to Birgit Krenz of Berlin AIDS Hilfe, an organization that provides counseling and care for people with the disease.
The results are becoming clear. In 2001, less than 1 percent of the HIV-infected people counseled at Berlin AIDS Hilfe were under the age of 20. By 2003, that number had risen to 5 percent.
After the deluge of AIDS information up until the late 1990s, according to Dr. Marita Völker-Albert of the Federal Center for Health Education (BZgA), there has been a strong decline over the past five years in public discussion of the disease.
"Priorities change, and issues like BSE or Sept. 11 have largely driven AIDS out of the media and the public mind," she told DW-WORLD. "It's harder to reach people now."
Public money made available for education has also fallen off. In 1987, when the BZgA began its AIDS awareness campaign, it had an annual budget of 50 million marks ($31.4 million). Today, the center's public awareness campaign has just over a third of that to spend -- €9 million ($11 million) a year.
Although he said he knew how to protect himself, Andreas still partially blames the lack of a strong public message and vigorous discussion about AIDS for his infection. "It didn't do much good for me to see some celebrity up there talking about wearing condoms or something," he said. "I needed something blatant that could shock me into making the right decisions. "