Präventionsstrategien zur Eindämmung der HIV-Epidemie

Erfolge, Probleme und Perspektiven
Leitthema: HIV: Prävention und Aufklärung


Nach der Erstbeschreibung des Krankheitsbildes AIDS und der Entdeckung von HIV Anfang der 1980er-Jahre entwickelte sich eine heftige Debatte darüber, mit welchen Mitteln eine Ausbreitung von HIV verhindert werden könnte. In allen westlichen Industriestaaten setzte sich schließlich eine Präventionsstrategie durch, deren wesentliche Pfeiler Aufklärung zu Übertragungswegen, die Werbung für Kondomgebrauch und schadensminimierende Ansätze bei Drogengebrauchern waren. Der relative Erfolg dieser Strategie in den westlichen Industriestaaten, in denen eine Ausbreitung der Epidemie in der Bevölkerung weitgehend verhindert werden konnte, schien ihr Recht zu geben. In den meisten Entwicklungsländern und in den Nachfolgestaaten der ehemaligen Sowjetunion blieben die Präventionserfolge dagegen deutlich bescheidener. Die Gründe dafür sind wahrscheinlich vielfältig. Seit dem Jahrtausendwechsel mehren sich in den westlichen Industriestaaten die Anzeichen dafür, dass zumindest in einer Hauptbetroffenengruppe, den homosexuellen Männern, Risikoverhalten und HIV-Neudiagnosen wieder ansteigen. Dieses mitunter auch als Krise oder gar Versagen der bisherigen Präventionsstrategie bezeichnete Phänomen wird häufig mit der verbesserten Behandelbarkeit der HIV-Infektion in Verbindung gebracht, wobei aber umstritten ist, wie und warum diese das Risikoverhalten beeinflusst und wie Präventionsstrategien verändert oder angepasst werden müssen.


HIV-Prävention Kondome HIV-Serodiskordanz Barebacking Prävention durch antiretrovirale Therapie 

Prevention strategies to control the HIV epidemic. Successes, problems, and perspectives


After the recognition of AIDS as a new disease entity and isolation of HIV as the causative agent in the early 1980s, a controversial debate about adequate measures to reduce the spread of HIV developed. In all developed countries a strategy based on education about modes of HIV transmission, condom promotion and harm reduction approaches to intravenous drug use finally succeeded and became instrumental for the relative containment of HIV within most at risk populations. However, in most developing countries as well as in the countries of Eastern Europe, the success of HIV pre vention remained limited for various reasons. In addition, for several years now, in the western developed countries sexual risk behaviour, newly diagnosed HIV infections, and the incidence of various other sexually transmitted infections seem to re-increase, especially among men who have sex with men (MSM). These increases coincide with a dramatic improvement of therapeutic options for the treatment of HIV infection. The relationship between improvement of therapy and changes in sexual risk behaviour has to be further defined. It is hypothesized that HIV serosorting as a predominant risk management strategy among MSM results in an accumulation of health risks in the HIV-positive MSM population. In addition to and beyond established condom promotion, additional biomedical approaches to reduce transmissibility and susceptibility for HIV will be necessary to regain control of the spread of HIV in highly sexually active populations.


HIV prevention Condom HIV serodiscordance Barebacking Antiretroviral treatment as preventive tool 


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Copyright information

© Springer Medizin Verlag 2007

Authors and Affiliations

  1. 1.Robert Koch-InstitutBerlinBRD
  2. 2.Robert Koch-InstitutBerlinBRD

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