[AIDS prevention in Germany]

Bundeszentrale für gesundheitliche Aufklärung, Köln, BRD.

In 1987 the national AIDS prevention campaign "Gib AIDS keine Chance" (Don't give AIDS a chance) was started in Germany. After a very difficult and controversial political debate about a probably successful response to AIDS, in the end a political decision was made in favour of the implementation of a long term "social learning strategy". Thus, since then the Bundeszentrale für gesundheitliche Aufklärung (Federal Centre for Health Education, BZgA) has been running the campaign on behalf of the Federal Ministry of Health. The result of this prevention program is a low rate of infections. In Germany there were 2600 newly diagnosed infections in 2005: 59 % in homosexual men, 16 % by heterosexual contacts, 17 % in people from high prevalence countries and 7 % in i.v. drug users. In comparison to the international situation Germany has a relatively low HIV-prevalence even nowadays. However, Germany has also been confronted with an increasing number of newly diagnosed infections in the last few years. When the prevention program was started it was very important to build new structures for a successful implementation of the campaign. That meant for instance to build up an effective infrastructure for cooperation between the governmental and the nongovernmental sector, including organising the coordinated action among the partners at the federal, regional and local levels. Likewise, international networking was of great importance. A key element, relevant for the success of the campaign was the close cooperation at the federal level between the BZgA and the Deutsche AIDS Hilfe (German AIDS Help, DAH), to combine the highreach intervention in low-prevalence populations with intensive interventions for high prevalence groups. An effective national AIDS prevention campaign must reach the whole population; inform the public about the main risks of infection, about methods of protection and about what is not infectious. Moreover groups with a higher level of risk of infection must be addressed and motivated to adopt protective behaviour more intensely. The campaign thus must comprise closely related and mutually reinforcing elements: mass communication and individual communication measures, aimed at the public at large and at individual subgroups, national and international cooperation, especially the cooperation and task sharing with the DAH aimed at prevention in the epidemiologically most significant target groups, evaluation and quality assurance. The key element in this respect is the BZgA's annual representative survey of information levels, attitudes, motivation and behaviour in the more than 16- year-old population. In addition to the model of the special partnership between the BZgA and the DAH, a range of public-public partnerships, due to the German federalistic system, and public-private partnerships, which support public efforts, are necessary. It is shown that an increasing number of private partners are necessary to reinforce the program in a situation where Germany has to face new challenges. The new challenges are for instance high mobility in a globalizing society. In a world wide spreading epidemic no country will be excluded from the international development; the increase of other sexually transmitted diseases (STDs); a tendency to decreasing protective behaviour caused by the optimism that a definitive cure may soon be available. The conception of evaluation of the campaign comprises an annual monitoring of knowledge, attitude and behaviour in the whole population and in specific target groups. It includes pretests of specific prevention instruments and evaluation of different activities. An indicator system is developed to measure the results of the campaign. By continuous feedback of the evaluation results into the further development of the campaign the steering of the campaign at a high level of quality is ensured.

PMID: 17387442 [PubMed - indexed for MEDLINE]