Since the study HPTN 052, we conclude that having an undetectable viral load HIV greatly reduces the risk of HIV transmission. But how safe is sex without a condom, if one partner has an undetectable viral load?
The PARTNER study is a European study to great extent with the aim of examining the transmission of HIV among seronegative (men who have sex with men) heterosexual or MSM couples who do not regularly use condoms expressly or take pre-exposure prophylaxis (PrEP or post-exposure prophylaxis (PEP, the English Post Exposition Profilaxy). The positive partner had to have a HIV viral load count was lower than 200 copies / ml at baseline.
Seven hundred and seventy-six couples are currently enrolled, with data already contributed some 900 couples / year and an estimated 44.400 sexual acts. About 30% of sex acts were reported to have been without condom use. There was no HIV transmission events between the partners in the study, both heterosexual and homosexual. The authors were cautious in their conclusions, but said the higher estimate of risk for HIV (ie the 95% confidence interval) was 0,45% per annum and for anal sex 1% per year. The researchers speculate that these rates translate into a maximum of 5% chance of transmission over a period of 10 years.
While it is important to remember that sex without a condom still carries with it the risk of other sexually transmitted infections, the findings of this study are profoundly important. The PARTNER study confirms the simple fact that HIV treatment is prevention. In the real world, where condom use is imperfect, HIV positive people in treatment can prevent transmission of HIV to their partners of the same sex or different sexes.
Partner data also have important implications for counseling sorodivergentes partners who desire pregnancy, especially in places where assisted pregnancy or sperm washing may not be available. There is also the possible legal implications for legal systems that criminalize sex between discordant people, an issue that was pioneered by Swiss government statements. Along with HPTN 052, this study gives further support to treatment as an essential component of HIV prevention programs.
Josep M. Llibre, MD, and Benjamin Young, MD, Ph.D.
Copyright © 2014 Remedy Health Media, LLC. All rights reserved.
This article was provided by TheBodyPRO.com.
It is a part of the publication The 21ª Conference on Retroviruses and Opportunistic Infections (CROI 2014).
Note from the editor of Seropositive Web Site: Note that the text is clear and this posture, the treatment posture as prevention is not 100% safe (like everything else in medicine) and that, in my opinion, based on my personal experience over of twenty years, the proposal is good as a way to increase security. That is, the ideal is that there is sexual intercourse, but that it is safe, with the use of condoms, leaving treatment as prevention as a second zone of defense, in warlike terms, because that is what it is, of a war between a virus and the human race; I myself have published several texts on the problem itself, such as this text, this text and even more this show excellent results, it is necessary to take into account that even among the most "caxias" in the treatment, which includes me , adherence may not be complete, and in some cases there may be migration from one organism to another of a virus that is modified and resistant to PrEP and PEP. In this case, there would be transmission to a subject who may be unaware of the fact that he is being infected by a resistant virus, and what is worse, he can transmit to another person and this to another and to another and another and so on and so forth. , in the end, we would have a completely "new" epidemic with a virus resistant to the truvada and, by table, to other antiretrovirals (read, in another window, in another site on cross-resistance.
Translated and adapted to Portuguese in Brazil by Claudio Souza with support Babel revised by M. *. M.