World AIDS Conference: Interview with local co-chair Prof. Christoph Spinner
“The virus does not care about borders”
The World AIDS Conference (AIDS 2024) will be held in Munich from July 22 to 26. For five days, experts from science, politics, affected groups, and counseling organizations will gather to discuss HIV. Prof. Christoph Spinner, an infectious disease specialist at the Technical University of Munich’s Klinikum rechts der Isar, serves as the local co-chair. In this interview, he explains why the conference remains essential after more than 40 years of AIDS and highlights some of the latest encouraging research findings.
Prof. Spinner, the first AIDS cases were identified in the early 1980s. In 2024, more than 10,000 experts are expected to attend the 25th World AIDS Conference in Munich. Do we still need such a large event?
Absolutely! Germany is a low-incidence country regarding HIV, with about 96,400 people affected and around 2,200 new infections per year. The situation is very different in other parts of the world. Many African countries, as well as Eastern European and Asian countries, are particularly affected. For instance, the number of new infections in Eastern Europe and Asia increased by 72% between 2010 and 2019.
The situation in Eastern Europe will be the subject of several presentations at the conference. How did such a drastic worsening of the situation occur?
It is largely due to the increasing criminalization of transmission routes such as drug use, and sex work. People at high risk of HIV exposure or those already living with HIV often lack access to appropriate information, prevention, and treatment, or are simply stigmatized. This allows HIV to spread unchecked, resulting in rising infection rates, as currently reported from Eastern Europe.
Can medication help those affected?
HIV is now easily treatable, and the acquired immunodeficiency syndrome can be effectively prevented. With modern medication, affected individuals can have a potentially normal life expectancy and cannot transmit the virus. Thanks to international programs, these medications are also available in resource-poor countries. However, access to treatment remains significantly restricted in many parts of the world, and there is a lack of knowledge and awareness about HIV and AIDS among both those responsible and those affected, which facilitates the spread of the disease. The HIV virus doesn't care about borders or societies.
How can we improve the situation?
It is crucial to engage political leaders. Fortunately, many politicians recognize the importance of the issue – Chancellor Olaf Scholz will attend the AIDS 2024 opening ceremony, for example. There are also supporters in Eastern Europe fighting against HIV and AIDS, as exemplified by Poland. Miłosz Parczewski, President of the Polish AIDS Research Society, is one of the keynote speakers at the conference.
What role does the issue of exclusion play in Germany?
In Germany too, and especially in Bavaria, dealing with HIV has not always been easy. In the 1980s, people with HIV were ostracized. Some politicians even tried to push risk groups and those affected to the margins of society. It took a great deal of political commitment at the federal level for common sense to prevail. Ultimately, the fight was against the disease and not those affected - with education, access to diagnostics and treatment and effective prevention.
So, all is well in Germany?
The number of new infections in Germany has been significantly reduced. However, they have recently risen slightly again, especially among drug users and heterosexuals. There is still no time to rest on our laurels. Those affected are still stigmatized in everyday life, by other people and sometimes even in doctors' offices. My colleague Prof. Jochen Schneider has just made a short film with the Munich University of Television and Film to raise awareness of this issue.
Will HIV be curable in the foreseeable future?
There have been a handful of cases in recent years where the virus was no longer detectable in infected individuals. So far, this has only been achieved through stem cell transplants. Unfortunately, this approach is not scalable due to many side effects.
That sounds discouraging. Are there developments in other areas that could benefit a larger number of people?
Pre-exposure prophylaxis, which involves the preventive use of antiviral medication, is now an effective prevention strategy for risk groups. Combining prophylaxis, more frequent HIV testing, and universal treatment access has significantly reduced new infections in many areas, such as in London, where the number of new infections dropped by 80% in just two years.
The prophylactic drugs are tablets taken daily?
Exactly. This method only works reliably if the medication is taken consistently. Unfortunately, studies show that adherence is lower in some regions, particularly in Africa, despite the high risk of infection. Recently, however, depot preparations have become available, eliminating the need for daily intake. Current studies show nearly 100% protection against new infections, which is very promising. Groundbreaking news from these studies will be presented at the AIDS 2024 conference.
You treat patients yourself at the Interdisciplinary HIV Center (IZAR) at Klinikum rechts der Isar. How has treatment changed in your view?
Generally speaking, AIDS used to be a death sentence. It no longer has to be. Modern antiviral therapy is highly effective, allows the immune system to recover, and is also very well tolerated. Today, one tablet taken once a day is usually sufficient. In the early days, it often required a handful of tablets up to three times a day with significantly poorer tolerability. This has also changed our consultation experience: in addition to HIV, non-infectious comorbidities are often the focus. Maintaining general health is at least as important as managing HIV itself.
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The World AIDS Conference will take place from July 22 to 26 at the Munich Exhibition Center. The conference will be chaired by Prof. Sharon Lewin, President of the World AIDS Society (IAS). Prof. Christoph Spinner represents the Munich location as co-chair, while Andriy Klepikov, Managing Director of Alliance for Public Health, one of the largest NGOs in the fields of HIV and tuberculosis in Ukraine, represents the Eastern Europe region as the third co-chair. The city of Munich won the competition to host the conference in February 2023 with the support of research institutions and specialist organizations.
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In addition to the scientific conference, there will also be the 20th "Global Village" at the Messe München exhibition center, where the topic of AIDS will be addressed in many events for the public. Around the conference, there will be numerous other events on the topic in Munich, such as a benefit concert by the Munich Chamber Orchestra in cooperation with the Bavarian State Opera on Wednesday, July 24, 2024 in the Prinzregententheater.
Technical University of Munich
Corporate Communications Center
- Paul Hellmich
- paul.hellmich@tum.de
- presse@tum.de
- Teamwebsite
Contacts to this article:
Prof. Dr. Christoph Spinner, MBA
Technical University of Munich
Klinikum rechts der Isar
Klinik und Poliklinik für Innere Medizin II
IZAR@mri.tum.de
