HIV AND AIDS IN HESSE
Hesse was hit by the HIV-epidemic at a very early point in time.
AIDS was first diagnosed and described in Frankfurt in 1982. In the Frankfurt
area the infection obviously spread very early. The reasons underlying
this phenomenon are not known. And neither the presently known facts nor
the epidemiological data contribute to giving an explanation either. The
number of female AIDS-patients is slightly higher than the average rate
in Germany, also the rate of IVDU´s. With 67.9 % the homo- and/or
bisexual transmission risk in Hesse is higher than the average of 64.4
% in the Federal Republic of Germany. Consistent with the early spreading
of the disease is that more cases of death occurred in Hesse (66.5 % compared
to 63.0 % on a national level).
HIV-positive people in Hesse
The epidemiological data is based on HIV-infections which have to
be reported anonymously to the “Robert-Koch-Institut” (RKI) by laboratories
in Germany and on the number of reported AIDS cases, whereby the number
of AIDS cases is more accurate than the data related to the reported HIV-infections
as this is incomplete. Having taken into consideration the different procedures
concerning the way of registering HIV-infection, the RKI estimates that
nationwide 50,000 – 60,000 people have become HIV-infected since the beginning
of the epidemic. When deducting the 12,000 deceased patients, the number
of those HIV-infected will be between 38,000 and 48,000, with 5000 of them
suffering from full blown AIDS. As there is no information on the rate
of HIV-positive people in the different federal states of Germany, this
number can only be calculated approximately. When departing from an 11.9
% of reported AIDS cases nationwide, it can be assumed that a comparable
number of people must be HIV-infected. Thus, as there are no plausible
reasons for not calculating the number this way, it can be estimated that
presently in Hesse 4,500 up to 5,700 people are HIV-infected. Approximately
750 of them have full blown AIDS and at least the same number suffers from
diseases of the AIDS Related Complex which require regular medical treatment.
Thus, in Hesse a maximum of 5,700 patients needs ambulant medical care
and/or needs to be treated in hospitals. When basing the calculation on
the number of AIDS cases it can be estimated that 57 % of them live in
the Frankfurt area, i.e. 3,250 patients for which medical care must be
available.
Ambulant Care
The Regional Association of SHI-Accredited Physicians in Hesse (KVH)
has reported that at present in the state of Hesse 337 general practioners
offices (GPO´s) with different medical specialisations claim benefits
every quarter. Among them are 17 GPO´s which have specialised on
treating HIV-patients, some of these GPO`s - according to information provided
by the Frankfurt University Hospital – treat more than 500 patients. Theoretically,
if all HIV-patients were distributed equally and only treated by one doctor
for their infection, every GPO would have 17 HIV-patients. But the fact
is, that the ambulant care is mainly provided by the few GPO`s which are
specialised on treating HIV-patients, and only a small number of HIV- and
AIDS patients is treated by the other GPO`s. The GPO`s which claim benefits
for their services are not distributed equally in H+esse. Altogehter there
are 337 GPO´s in Hesse which claim benefits for treating HIV-patients;
17 of them are GPO´s specialised on the treatment of HIV-patients
( 10 of them in Frankfurt).
Number of AIDS-cases in Hesse
Thanks to prevention and information campaigns on HIV starting at
the very beginning of the epidemic, and compared to the situation worldwide
and in other European countries, the development concerning the spreading
of the HIV-infection has been relatively favorable. But still there is
a slow and staedy spreading of the desease. Of 18,700 AIDS cases registered
at the “Robert-Koch-Institut” (RKI) in Berlin on June 30, 2000 2,224 cases
had been in Hesse. So far 1,479 persons died, thus, the number of those
suffering from AIDS is approx. 745. As only 7.3 % of the population live
in Hesse but at the same time 11.9 of all German AIDS cases have occurred
in Hesse, among the large federal states it is among those with the highest
incidence.
With a cumulated incidence - i.e the number of all people who have
contracted AIDS since the beginning of the epidemic - of 1.64 AIDS cases
per 1000 inhabitants, the rate in Frankfurt is higher than in Berlin (West)
or Munich.
AIDS-Ambulant Medical Care
In the federal state of Hesse there are 5 outpatient clinics which
provide ambulant medical care for AIDS-patients, two of them at the university
hospitals in Giessen and Frankfurt, two authorized physicians in the areas
of Darmstadt and Kassel and one at a hospital in Wiesbaden.
In 1999 approx.2,900 HIV-patients were treated at the outpatient
clinic of the Frankfurt university hospital. About 45 % of these patients
lived in the city center of Frankfurt, another 5 % were from the surrounding
areas. Approx. 18 % came from the areas near Offenbach, Hanau or Aschaffenburg.
7% were from Darmstadt and 9 % from Wiesbaden. A total of 90 % of all those
treated resided in Hesse, the remaining patients came from other federal
states or from abroad.
Horst Herkommer
Source: Hessisches Sozialministerium, 2000
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