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Unit 34: HIV/AIDS, STI and Blood-borne Infections

Viviane Bremer
Barbara Gunsenheimer-Barmeyer, Klaus Jansen

The work of unit 34 includes obtaining comprehensive epidemiological data on HIV/AIDS, sexually transmitted infections (STIs), viral hepatitis and Creutzfeldt-Jakob disease in order to better understand the epidemiology of these infections. This data is used to formulate, adapt and evaluate prevention strategies and to develop recommendations for diagnostics and patient care.



Data on infections with HIV and syphilis as well as infections with gonococci with reduced susceptibility to azithromycin, cefixime and ceftriaxone are reported directly to the RKI in accordance with Section 7 (3) of the Infection Protection Act. With the amendment to the Infection Protection Act (IfSG) of 16 September 2022, all detections of Neisseria (N.) gonorrhoeae and Lymphogranuloma venereum must be reported. The RKI's electronic reporting and information system (DEMIS) is currently being expanded to include the electronic reporting of pathogen evidence in accordance with Section 7 (3) IfSG.

Reports on laboratory evidence and infections with hepatitis B, C and D as well as Mpox and Creutzfeldt-Jakob disease are transmitted to the RKI via health authorities and state health authorities, analysed and published in accordance with Section 6 and Section 7 (1) of the Infection Protection Act. In addition, unit 34 is responsible for analysing and evaluating data on infection markers (HIV, syphilis, hepatitis B and C, hepatitis E and West Nile fever) in blood donors in accordance with Section 22 of the Transfusion Act (TUNIT).

In addition to routine surveillance, unit 34 has collected longitudinal data on the clinical course and therapy of HIV infection in two multi-centre prospective HIV long-term observation studies for over 20 years. Together with unit 18, blood samples are collected from reporting laboratories, sequenced, genotyped and examined for transmitted resistance-associated mutations. Isolates of resistant gonococcal infections are collected, retested and sequenced as part of molecular surveillance in collaboration with the RKI's gonococcal consiliary laboratory.

In collaboration with other RKI units, blood donation samples are also used for supplementary surveillance tests, such as for repeated cross-sectional testing of SARS-CoV-2 antibodies during the coronavirus pandemic or for testing rare or newly emerging pathogens such as West Nile virus or Borna virus.

In addition, secondary healthcare data (e.g. data from health insurance companies, pharmacy invoices) is used to determine the number and type of HIV and hepatitis B and C treatments. In addition, the introduction of HIV pre-exposure prophylaxis (PrEP) as a statutory health insurance benefit was scientifically monitored and evaluated (EvE-PrEP). A national PrEP surveillance system (PrEP-Surv) is currently being set up to continuously record the utilisation of PrEP.

For the annual estimation of the incidence and prevalence of HIV in Germany, the HIV notification data is used together with the data from the long-term observational studies on HIV, pharmacy billing data and death notifications. This analysis is used to create the so-called HIV treatment cascade in order to document the progress towards the UNAIDS 95-95-95 targets for Germany.

Outbreak investigations

Outbreak investigations are carried out regularly in unit 34. Together with units 35 and ZBS 1, unit 34 coordinated the activities relating to the Mpox outbreak in 2022. This included setting up surveillance, communicating with various national and international stakeholders, coordinating risk communication and preparing various studies.


An important focus of unit 34 is the implementation of applied epidemiological studies, especially among vulnerable populations. Fig. 1 provides an overview of the populations that potentially have a higher risk of becoming infected with HIV, hepatitis B and C or STIs, as well as the ongoing or recently completed studies in these populations. Studies on so-called integrated biological and behavioural surveillance combine information on the prevalence of certain infectious diseases in a population with data on sexual behaviour.

Overview of the populations that potentially have a higher risk of becoming infected with HIV, hepatitis B and C or STIs, as well as the ongoing or recently completed studies in these populations, in German. Source: RKIFigure 1: Overview of the populations that potentially have a higher risk of becoming infected with HIV, hepatitis B and C or STIs, as well as the ongoing or recently completed studies in these populations (in German). Source: RKI

These studies can provide information on indicators required for national and international reporting that can be used to determine Germany’s progress regarding the elimination of AIDS, hepatitis B and C and STIs. Examples of the studies are the DRUCK 2.0 and DRUCK-Surv studies. The aim of DRUCK 2.0 was to develop a design that could be used to regularly record the prevalence of hepatitis B, C and HIV as well as associated risk and prevention behaviours in people who inject drugs. With DRUCK-Surv, this design is to be rolled out to sentinel cities in various federal states so that the situation can be assessed and adjustments made on a recurring basis in the future. This data will also be used to determine the HIV and HCV care cascade in people who inject drugs, identify gaps in care and report international indicators. Another important indicator of prevention among this group is the distribution of sterile drug paraphernalia, which is determined recurrently in the saferKONSUM study. In contrast, the TASG and EMIS 2023 studies are purely survey studies among trans and non-binary people or MSM.

In the area of blood donation, studies have been carried out on the sexual infection risks of blood donors, coupled with the development and evaluation of a standardised national donation questionnaire.

International projects on the monitoring of hepatitis B and C are underway with the European Centre for Disease Prevention and Control (ECDC) and with the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA).

WHO Collaborating Centre for viral hepatitis and HIV

Unit 34 was appointed WHO Collaborating Centre for viral hepatitis and HIV by the World Health Organization on 3 March 2021. As a WHO Collaborating Centre, the RKI, together with national and international partners, supports the WHO in the fight against viral hepatitis and the elimination of hepatitis B and C as well as the containment of HIV in the WHO European Region. As the WHO Collaborating Centre for viral hepatitis and HIV, the RKI has the following areas of responsibility:

  • Providing technical support to WHO to assist Member States in the methodological development, planning, implementation and analysis of epidemiological studies on hepatitis B and C and HIV in different populations
  • Supporting the WHO in the evaluation of monitoring, control and elimination of viral hepatitis B and C and HIV/AIDS in the countries of the WHO European Region


Date: 08.02.2024