Integrated Strategy for HIV, Hepatitis B and C and Other Sexually Transmitted Infections

In 2016 the German Federal Ministry of Health in co-operation with the Federal Ministry of Economic Cooperation and Development published the new »Integrated Strategy for HIV, Hepatitis B and C and other sexually transmitted infections«. With its »demand-oriented«, »integrated« and »cross-sectoral« core concepts, the Strategy forms the framework for the sustainable, successful containment of HIV, Hepatitis B and C and other sexually transmitted infections (STI). This approach is innovative by linking HIV to Hepatitis B and C and other STIs and thus making use of synergies – synergies which are the essential element of LIEBESLEBEN.

Principles and goals of the Strategy

The Strategy acknowledges that STIs are often associated with shame and stigma. Those concerned are frequently marginalized and made the subject of discrimination. It is important to create an open and tolerant atmosphere within society to counter shame and discrimination – this is a precondition for effective prevention. It is equally important for all stakeholders to work together to implement the Strategy – not only the Federal Ministry of Health with its expert bodies but also the states, the public health offices, voluntary organizations and the medical profession among others.

The Strategy aims to

create an enabling environment which promotes the acceptance of sexual orientations and different lifestyles, which does not make different sexual practices taboo, which promotes communication about sexuality and sexually transmitted infections, and which does not marginalize the people concerned;
further expanding needs-orientated services for populations affected and at risk, taking various factors and conditions into account that affect vulnerabilities and risk exposure, and considering the wide variations in regional prevalence;
developing integrated services which address the different infections and make available co-ordinated prevention, testing and care services in order to prevent transmission and co-infections, and to recognize and treat infections early. Vital importance is attached to testing, which closes the gap between prevention and care;
promoting networking and cross-sectoral cooperation in order to reach people in their individual circumstances and to facilitate co-ordinated, high-quality, integrated prevention, testing and care services;
generating and expanding strategic information and data as the basis for the planning and implementation of prevention, testing and treatment interventions.

The safeguarding of sexual rights and the acceptance of diversity, as well as the self-determination of the individual and personal responsibility to respect and protect oneself and others, are central principles of the Strategy. The inclusion of self-help bodies, empowerment and participation are pivotal to the success that has been achieved to date, and shape the principles applied in the implementation of the Strategy. The Strategy focuses on imparting knowledge and expanding skills in order to set the stage for people to deal with sexually transmitted infections responsibly, and to encourage them to take up the prevention and healthcare services offered.

Data from research and surveillance provide the basis for planning and refining evidence-based prevention and treatment services, and for adjusting the measures in line with changing behaviour. Together with its partner countries, Germany is striving to achieve the goal that has been set by the international community in the 2030 Agenda for Sustainable Development, namely to ensure healthy lives and to promote well-being for all at all ages. It was agreed as a part of this goal to end the epidemics of AIDS and tuberculosis by 2030, as well as to combat hepatitis and ensure universal access to services and information relating to sexual and reproductive health and rights. In order to reach these goals, and not to endanger the successes that have been achieved, greater efforts and a holistic approach will be needed in the years to come on the part of all concerned.

The Strategy aims to sustainably contain HIV, Hepatitis B and C, syphilis, gonorrhoea, chlamydia, HPV and other sexually transmitted infections. This can improve the overall health of the population by preventing serious related diseases such as AIDS, cancer or cirrhosis of the liver. Undesired childlessness and miscarriages are averted and diseases among newborns prevented. In addition to positive individual and societal effects, preventing infections, as well as early diagnoses, might also contribute to a reduction in healthcare expenditure.