In addition to white East German men who identified as gay or bisexual, the other group most affected by HIV/AIDS in the GDR consisted of students and guest workers from sub-Saharan Africa.31 In East Germany between 1986 and 1990, there were approximately 200 confirmed cases of HIV in citizens of African countries. Out of the dozen or so who got sick with AIDS during their stay, many died in East German hospitals.32 News of their deaths was urgently communicated to the highest levels of the government and the SED.33 Their encounters with the East German state, moreover, were in many ways shaped by the ways in which East German efforts to combat AIDS were initially framed as an aspect of socialist solidarity with Africa and with the rest of the state-socialist world.34 In the mid- to late 1980s, East German health officials made a concerted effort to help establish and (they hoped) ultimately lead a Warsaw Pact–based collective effort geared toward AIDS research and prevention. Socialist countries fighting the epidemic together would mean, according to Soviet and East German representatives, a strong stance against AIDS-related discrimination.35 It also meant that Warsaw Pact countries would be able to lobby together at the WHO for funds to be diverted to AIDS prevention and other programs that were “in the interest of health care in socialist countries and our friends in the developing world.”36

These were (potentially) meaningful symbolic gestures of socialist solidarity with the “third world,” but there were practical gestures as well. In some instances, local officials and school administrators sent letters up the SED chain of command seeking assurances that foreign students who had tested positive for HIV would be allowed to remain in the country and receive medical care.37 Correspondence that took place prior to 1987 about for- eign students and workers who had tested positive for HIV was concerned mostly with the logistics of providing treatment. When a Zambian student of agricultural sciences at a regional college in Gera tested positive in 1985 for what were then called LAV/HTLV-III anti- bodies, for example, the Minister for Health filed a report that mentioned neither the indi- vidual’s immigration status nor any ongoing contact between the ministry and the Zambian embassy about the student’s condition. Instead, the student was referred to the Central AIDS Consultation Center at Charité Hospital in Berlin for further assessment and, potentially, long-term care.38 Likewise, around the same time, the Ministry of Health issued instructions regarding the care of foreign AIDS patients in which the ministry’s (official) priorities included making specialized medical care available as efficiently as possible, guarding patient privacy, and being sensitive to cultural differences. Any decisions about a patient’s repatriation, the document stated, would need to be made in consultation with Ministry of Health representatives and with doctors and administrators at the hospital where the patient was being treated.39

AIDS in East Germany

Infection with HIV is rare in the German Democratic Republic, with only 48 known carriers and seven cases of AIDS. These figures were given to British health care workers on a recent seven day visit to the country organised by the London-Berlin (GDR) Commiittee.

Two main factors seem to have limited the transmission of the virus. Firstly, there are very few intravenous drug users. The penalties for dealing in drugs are high and there is careful scrutiny of border traffic. The authorities state that “there are almost no intravenous drug users,” although other drug misuse occurs. Secondly, in East Germany imported blood products have not been used to treat patients with haemophilia. Of 1300 haemophiliacs tested, only five were positive for the virus, and they had been treated abroad.

The homosexual community is substantial in East Berlin. The old law relating to homosexuality was abolished in 1957, and since then homosexuality has been perfectly legal. At an early stage members of the National AIDS Committee, including the director, Professor Jurgen Grosser, resolved to make contact with homosexuals. It became apparent that homosexual men from West Berlin were seeking ‘“clean” partners in the East, and so the risks of unprotected intercourse with these men were carefully explained. So far the AIDS epidemic seems not to have affected homosexual men in East Germany to any great extent.

Compulsory AIDS tests are carried out on three main groups of people—namely, donors of blood, semen, or transplanted organs; foreign students; and prisoners.

Nine people positive for the virus have been identified. among 1-5 million blood donors, and 500000 tests have been per- formed for other indications. Compulsory screening has not reduced the number of people coming forward to donate blood.

‘There are significant numbers of foreign students pursuing higher training in East Germany and compulsory tests and certifica- tion are required for stays of longer than three months.

Currently the prison authorities do not supply condoms for the use of prisoners, and we were not provided with data on the prevalence of homosexuality or seropositivity among the prison population.

Public awareness of the AIDS problem seems high, and our impression was that a vigorous and thoughtful education campaign had been mounted as the result of careful preparation.

—N J COOLING, Fulbourn Hospital, Cambridge CB1 SEF

source: AIDS in East Germany (BMJ. 1988 Nov 26)