Life with HIV

"I plan ahead for the next two to three years," Manny said. "That's realistic - prospects are different from what they used to be."

Manny, who was diagnosed with HIV 20 years ago at the age of 23, said he used to be afraid he would not live to see his 30th birthday. "I lived completely in the here and now," he said. "I was naïve and blindly in love."

"I was in a relationship with an HIV-positive guy," he said. "After my doctor handed me the diagnosis, I blocked it out at first." Six months later, after he and his partner had split up, he began to wonder about his own future.

Today, Manny cares for the elderly and is the face of a nationwide poster campaign in Germany for World Aids Day. He is also cautiously optimistic.

A race against time

An estimated 78,000 people in Germany today live with the human immunodeficiency virus (HIV). In 2011, 3,310 people were registered as newly infected. The virus weakens the immune system: HIV-positive people can contract about 30 different diseases that can lead to AIDS. As a rule, people speak of AIDS when a person infected with the HIV virus has contracted two of these diseases.

"Twenty years ago, there was hardly any medical treatment for an HIV infection," Ulrich Heide of the Bonn AIDS Foundation told DW.

The one active agent available was not very effective and did not prolong a patient's life by much, he said. In fact, the average survival rate of people suffering from AIDS was between 22 and 24 months. Then, in 1996, combination compounds that slowed down the spread of the virus finally hit the market.

Manny said he remembers he was lucky that his immune system was strong at the beginning. "I started my first therapy about five or six years after the infection was diagnosed," Manny said. At the time, he had to take three pills three times a day. He had to take them at the exact same time every day, and was not allowed to eat an hour beforehand. Today, Manny said, he takes two pills every morning.

Meanwhile, some anti-HIV medication has developed a resistance, Heide said. The virus strain becomes immune to certain drugs, and no longer works for some patients.

"It's a race between developing therapies and the formation of viral resistance," Heide said, adding that patients in Germany have the chance to be treated successfully and live with the disease while in many other countries, the diagnosis remains a certain death sentence.

A lease on life

The majority of people infected with HIV in Germany live normal lives, two out of three hold jobs or trainee positions. But: "Only few can openly admit to their disease at their workplace," Heide said.

The strain of keeping his heath a secret was too much for Manny. He decided to tell his employer about the infection. Meanwhile, all his colleagues and even some of the elderly people he cares for know about it, too. "One of the residents said how much he admires my courage and my dedication, and how glad he is that I am his caretaker," Manny said. "That makes me happy."

People know about HIV/AIDS, but those infected are often still stigmatized and ostracized. Compared with many other nations, Germany is well-educated about the disease. Due to education programs Germany has been running for 25 years, the rate of infection is lower than in the Netherlands or Switzerland, according to Heide.

A survey 15 years ago showed more than 30 percent of people felt AIDS could threaten their lives. Today, few people would say that and Heide said he fears that could result in a slackening of protective measures. "We might have bigger problems in the future," he said.

Give it some thought

These days, Manny is a busy man - as an ambassador to the campaign for this year's World Aids Day, he visits many events and speaks to many people. "I would tell someone who has just learned about his infection that it is not the end but that he can live with it and should not withdraw," Manny said.

He also has a message for the public: "You don't need to be afraid of us. There are ways to transmit the disease, and shaking hands isn't one of them. We are not dangerous; we are just people."