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Sexual and reproductive health services for people living with HIV/AIDS in Germany: are we up to the challenge?

  • Clinical and Epidemiological Study
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Abstract

Purpose

Germany is witnessing an increase in the number of new infections with human immunodeficiency virus (HIV). Enabling persons living with HIV (PLHIV) to adopt safer sex practices might contribute towards reducing the incidence of HIV infections. The aim of this study was to identify gaps in the sexual and reproductive health (SRH) services provided to PLHIV in Germany.

Methods

Within the framework of the European public health project Eurosupport 5, self-reported questionnaires were distributed to PLHIV and a survey of SRH-service providers was carried out. The completed questionnaires and survey results were analysed.

Results

Of the questionnaires distributed, 218 PLHIV (90 % men, 10 % women) returned a completed questionnaire. Of these, 74 % self-identified as men having sex with men (MSM) and 13 % as heterosexual men. MSM reported a median number of ten casual partners in the previous 6 months and unprotected sex in one-third of anal intercourses with casual partners, demonstrating that this group adopted more risky sexual behaviours than heterosexual PLHIV. Even though all PLHIV stated they would appreciate more support and service providers indicated that they provided a wide range of SRH services, SRH-relevant topics were rarely discussed between PLHIV and service providers. According to the patients’ perception, shortage of time, lack of initiative by service providers and their own difficulty to address SRH-related topics were the most relevant obstacles to receiving satisfactory support.

Conclusion

Many PLHIV consult their HIV-physician regularly for medical follow-up and also indicate that HIV-physicians should be the source of information concerning SRH counselling. HIV-physicians should take advantage of their key role in HIV care and strengthen their efforts to integrate SRH services in routine HIV care.

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References

  1. Schätzung der Prävalenz und Inzidenz von HIV-Infektionen in Deutschland, Stand Ende. Estimation of the prevalence and incidence of HIV-infections in Germany at the end of the year 2012. Epidemiol Bull. 2012;2012:47.

    Google Scholar 

  2. Bouhnik AD, Preau M, Lert F, Peretti-Watel P, Schiltz MA, Obadia Y, Spire B. Unsafe sex in regular partnerships among heterosexual persons living with HIV: evidence from a large representative sample of individuals attending outpatients services in France (ANRS-EN12-VESPA Study). AIDS. 2007;21:S57–62.

    Article  PubMed  Google Scholar 

  3. Crepaz N, Hart TA, Marks G. Highly active antiretroviral therapy and sexual risk behavior: a meta-analytic review. JAMA. 2004;292:224–36.

    Article  PubMed  CAS  Google Scholar 

  4. Elford J, Ibrahim F, Bukutu C, Anderson J. Sexual behaviour of people living with HIV in London: implications for HIV transmission. AIDS. 2007;21:S63–70.

    Article  PubMed  Google Scholar 

  5. Peretti-Watel P, Spire B, Schiltz MA, Bouhnik AD, Heard I, Lert F, Obadia Y. Vulnerability, unsafe sex and non-adherence to HAART: evidence from a large sample of French HIV/AIDS outpatients. Soc Sci Med. 2006;62:2420–33.

    Article  PubMed  CAS  Google Scholar 

  6. The Global Network of People Living with HIV/AIDS (GNP), Joint United Nations Programme on HIV/AIDS (UNAIDS). Positive health, dignity and prevention. Technical consultation report. 2009. GNP/UNAIDS, Amsterdam/Geneva

  7. del Rio C. New challenges in HIV care: prevention among HIV-infected patients. Top HIV Med. 2003;11:140–4.

    PubMed  Google Scholar 

  8. Crepaz N, Lyles CM, Wolitski RJ, Passin WF, Rama SM, Herbst JH, Purcell DW, Malow RM, Stall R. Do prevention interventions reduce HIV risk behaviours among people living with HIV? A meta-analytic review of controlled trials. AIDS. 2006;20:143–57.

    Article  PubMed  Google Scholar 

  9. Johnson WD, Diaz RM, Flanders WD, Goodman M, Hill AN, Holtgrave D, Malow R, McClellan WM. Behavioral interventions to reduce risk for sexual transmission of HIV among men who have sex with men. Cochrane Database Syst Rev. 2008;3:CD001230.

    PubMed  Google Scholar 

  10. Wingood GM, DiClemente RJ, Mikhail I, Lang DL, McCree DH, Davies SL, Hardin JW, Hook EW III, Saag M. A randomized controlled trial to reduce HIV transmission risk behaviors and sexually transmitted diseases among women living with HIV: the WiLLOW Program. J Acquir Immune Defic Syndr. 2004;37:S58–67.

    Article  PubMed  Google Scholar 

  11. Marcus U, Schmidt AJ, Hamouda O. KABASTI-Study. Rober-Koch-Institut. 2007. Available at: http://www.rki.de/DE/Content/InfAZ/S/STI/Studien/KABaSTI/Abschlussbericht%20KABaSTI.pdf?__blob=publicationFile. Accessed 7 Feb 2013.

  12. Nostlinger C, Niderost S, Woo R, Platteau T, Loos J, Colebunders R. Mirror, mirror on the wall: the face of HIV+ women in Europe today. AIDS Care. 2010;22:919–26.

    PubMed  CAS  Google Scholar 

  13. Vernazza P, Hirschel B, Bernasconi E, Flepp M. HIV-infizierte Menschen ohne andere STD sind unter wirksamer antiretroviraler Therapie sexuell nicht infektiös. HIV-infected people under antiretroviral therapy without other sexual transmitted diseases are sexually not infectious. Schweiz Ärztezeit. 2008;89:165–9.

    Google Scholar 

  14. Diagnostik und Behandlung HIV betroffener Paare mit Kinderwunsch. German-Austrian recommendations on the diagnostics and treatment of HIV discordant couples who wish to have children. 2011. Available at: http://www.daignet.de/site-content/hiv-therapie/leitlinien-1/Diagnostik%20und%20Behandlung%20HIV%20betroffener%20Paare%20mit%20Kinderwunsch%202011.pdf. Accessed 7 Feb 2013.

  15. German AIDS Society (DAIG). Two years discussion about the EKAF statement: an assessment. 2013. Available at:http://www.daignet.de/site-content/news-und-presse/newsmeldungen/newsarchiv/DAIG%20Stellungnahme%20zu%20EKAF%20Okt%202010.pdf. Accessed 30 Mar 2013.

  16. Cohen MS, Chen YQ, McCauley M, Gamble T, Hosseinipour MC, Kumarasamy N, Hakim J, Kumwenda J, Grinsztejn B, Pilotto JH, Godbole SV, Mehendale S, Chariyalertsak S, Santos BR, Mayer KH, Hoffman IF, Eshleman SH, Piwowar-Manning E, Wang L, Makhema J, et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Eng J Med. 2011;365:493–505.

    Article  CAS  Google Scholar 

  17. Marks G, Richardson JL, Crepaz N, Stoyanoff S, Milam J, Kemper C, Larsen RA, Bolan R, Weismuller P, Hollander H, McCutchan A. Are HIV care providers talking with patients about safer sex and disclosure?: a multi-clinic assessment. AIDS. 2002;16:1953–7.

    Article  PubMed  Google Scholar 

  18. Metsch LR, Pereyra M, del Rio C, Gardner L, Duffus WA, Dickinson G, Kerndt P, Anderson-Mahoney P, Strathdee SA, Greenberg AE. Delivery of HIV prevention counseling by physicians at HIV medical care settings in 4 US cities. Am J Public Health. 2004;94:1186–92.

    Article  PubMed  Google Scholar 

  19. Fakoya A, Lamba H, Mackie N, Nandwani R, Brown A, Bernard E, Gilling-Smith C, Lacey C, Sherr L, Claydon P, Wallage S, Gazzard B. British HIV Association, BASHH and FSRH guidelines for the management of the sexual and reproductive health of people living with HIV infection 2008. HIV Med. 2008;9:681–720.

    Article  PubMed  CAS  Google Scholar 

  20. Rietmeijer CA. Risk reduction counselling for prevention of sexually transmitted infections: how it works and how to make it work. Sex Transm Infect. 2007;83:2–9.

    Article  PubMed  CAS  Google Scholar 

  21. Marcus U, Schmidt AJ, Hamouda O. HIV serosorting among HIV-positive men who have sex with men is associated with increased self-reported incidence of bacterial sexually transmissible infections. Sex Health. 2011;8:184–93.

    Article  PubMed  Google Scholar 

  22. Jansen K, Brockmeyer NH, Hahn M, Kaul I, Fenske S, Rausch M, Kuhlmann B, Ulmer A, Lauenroth-Mai E, Harrer T, Hower M, Skaletz-Rorowski A, Michalik C. Epidemiological composition, clinical and treatment characteristics of the patient cohort of the German competence network for HIV/AIDS. Eur J Med Res. 2009;14:415–25.

    Article  PubMed  Google Scholar 

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Acknowledgments

This study was in part financially supported by the European Commission, SANCO/Public Health [Grant agreement No. 2004314], with additional supporting grants from UCB Pharma, Bristol-Myers Squibb and Tibotec (Janssen-Cilag). The European Commission is not responsible for any use that may be made of the information contained herein. The authors acknowledge the contributions of the members of the Eurosupport 5 Study Group and of the HCPs involved in the recruitment of participants and data collection. We are deeply indebted to all patients who participated in the study.

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Authors and Affiliations

  1. Sektion Klinische Infektiologie, Medizinische Klinik und Poliklinik IV, Klinikum der LMU, Pettenkoferstr. 8a, 80336, Munich, Germany

    M. C. Mueller, U. Seybold, R. Draenert & J. R. Bogner

  2. Department of Infectious Diseases and Tropical Medicine (DITM), University Hospital, Ludwig-Maximilians University, Munich, Germany

    C. Walentiny

  3. Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium

    C. Nöstlinger

  4. Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium

    T. Platteau

  5. Sensoa, Flemish Expertise Centre for Sexual Health, Antwerp, Belgium

    R. Borms

Authors
  1. M. C. Mueller
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  2. C. Walentiny
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  3. U. Seybold
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  4. C. Nöstlinger
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  5. T. Platteau
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  6. R. Borms
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  7. R. Draenert
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  8. J. R. Bogner
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Corresponding author

Correspondence to M. C. Mueller.

Additional information

M. C. Mueller and C. Walentiny contributed equally to this work.

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Mueller, M.C., Walentiny, C., Seybold, U. et al. Sexual and reproductive health services for people living with HIV/AIDS in Germany: are we up to the challenge?. Infection 41, 761–768 (2013). https://doi.org/10.1007/s15010-013-0499-7

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  • DOI: https://doi.org/10.1007/s15010-013-0499-7

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