One week ahead of a national AIDS prevention conference in Berlin, German health minister Ulla Schmidt presented a mixed picture regarding the spread of AIDS in Germany. Speaking at a press conference, she said that as in previous years, overall AIDS-related statistics remained stable last year, with about 43 thousand AIDS patients, around 600 AIDS deaths and a rate of about 2000 new infections.

Yet in spite of the fact that these statistics haven’t changed much over the past two decades, Schmidt also said the latest figures gave cause for concern.

"There are worrying signs in the statistics indicating that prevention among young people below 30 years of age is diminishing," she explained. "The use of condoms in risky situations is dramatically lower than in previous years and there is a widening gap in the knowledge about AIDS." She also referred to a particular lack of understanding of AIDS among people from immigrant backgrounds.

Raising consciousness

Bernhard Bieniek is spokesman of a national advisory panel, created at the outset of the AIDS pandemic in the 1980s, which coordinates national efforts at grass-roots and government levels. He agrees with Schmidt's assessment.

"Young people especially have the impression that it's not their problem anymore," he told Deutsche Welle. "Very often they don't know anybody who has HIV and they have never seen anyone who was sick and died of the disease. So we have to find young people who are willing to get involved and find new ways to communicate."

He points out that in the past two decades, Germany has been able to keep the spread of AIDS in check because the rate of new infections has remained largely stable and stresses that the country's success in the fight against AIDS was primarily due to political courage and a strong anti-discriminatory approach.

"We were lucky with the government we had in the 1980s – a conservative government – which had the courage to work with gay movements and find ways to make people at risk understand," he says, adding that "in Catholic countries such as Spain and Italy HIV infection is still increasing and that is partly due to the ignorance of politics."

An unbearable burden

Meanwhile, Germany's premier aid organization for HIV/AIDS patients says the government's health care reforms have created an extra, sometimes unbearable, burden for those infected with the virus.

As its annual conference got underway on Thursday, Deutsche Aidshilfe, an umbrella group of around 130 local German HIV/AIDS groups, said the government's health-care reforms forced more and more infected people into poverty. According to Rainer Jarchow, managing board member with Deutsche Aidshilfe, the changes were carried through at the expense of the chronically sick, handicapped and poor.

Although public health funds still pay for the costs of AIDS therapy, including some prescription drugs, since the reforms were implemented in January the funds don't cover over-the-counter drugs anymore. Yet, this medication is necessary to ease the side effects of combination therapy, which causes aches and pains, nausea, diarrhea and vomiting, Jarchow said.

"Those who only receive welfare benefits or a small pension are frequently unable to cover the costs of medication," Jarchow said.

Government action necessary

Deutsche Aidshilfe called on the government to either lower the value added tax or add the costs of the over-the-counter drugs HIV/AIDS patients use to payment exemptions. At the moment, the health-care regulations ensure that patients pay no more than 1 percent of their income for prescription drugs.

AIDS patients, in particular, frequently live from low salaries or welfare benefits because their illness prevents them from holding down a regular job.

Deutsche Aidshilfe also said that the reforms -- which require people to proffer a €10 ($12) co-payment during each quarter that they visit a doctor -- led some to avoid getting medical help even though they need it. The organization estimated that someone being treated for HIV/AIDS who lives off the standard €300 monthly welfare benefit has to pay €30 just for over-the-counter drugs, as well as quarterly co-payments.

Prevention strategies tailored for the needs of young people will be a major issue at next week's meeting between German anti-AIDS activists and the government in Berlin. Another key issue will be the AIDS catastrophe unfolding right at Germany’s doorsteps in Eastern Europe where the pandemic is spreading faster than anywhere else in the world. Experts believe that the EU's eastward enlargement could abruptly end Germans' complacency and their belief that they are safe from AIDS.