HIV treatment and transmission: an update
We have known for some time that being on treatment with an undetectable viral load makes it extremely unlikely you will pass on HIV. Treatment as Prevention (TasP) continues to be a hot topic, with exciting new research findings and a new It Starts with Me campaign both putting it centre stage.
The PARTNER study is a large observational piece of research taking place in 14 European countries. It aims to understand the impact that treatment has on reducing the chances of HIV being passed on. The researchers have recruited serodiscordant couples (where one partner is HIV positive and the other is HIV negative) in which the HIV positive partner is taking HIV treatment. Of particular interest is that all of the couples reported using condoms inconsistently, or not at all, and that approximately half of the participants are men who have sex with men.
Although the study is still ongoing, early analysis of data from almost 800 couples - who reported just under 45,000 acts of penetrative sex - found that there had been no transmissions from a partner with an undetectable viral load. This applies to both anal and vaginal sex.
The researchers are collecting more data, and recruiting more gay couples, so that they can provide precise estimates of the transmission risks during different sexual acts. The final results are due in 2017
For more detailed information check out this briefing from HIV Prevention England, which contains an overview of all the available research on TasP.
It Starts with Me
In 2012, there were around 21,900 people living with undiagnosed HIV in the UK. As this group of people are not acccessing treatment, alongside the significant risk to their own health, they are unknowingly a source for new transmissions. As many as eight out of 10 infections among gay men come from guys who are living with undiagnosed HIV.
Furthermore, research also shows that as many as half of all new transmissions occur soon after someone first contracts HIV. This is because recently acquired HIV produces an initial peak in viral load - making the person extremely infectious. Testing alone will not identify those with newly acquired HIV as most people don’t regularly test. Even if they did, the antibodies which many tests look for may not be produced in sufficient quantities to be detected for up to three months. Condoms remain a really important way to prevent new infections when people don’t know they are positive and are at their most infectious.
The new part of the campaign challenges people’s preconceptions by asking which out of two people is more likely to pass on HIV. The high-risk scenario is not the person who knows they are HIV positive and on treatment, but the person who thinks they are still negative - and may even have tested recently.
An interactive leaflet, advertising online and in magazines and two new videos (for gay men and Africans) help to get this important message across. People can then use the FitsMe tool on the It Starts With Me website to help them find the best condom for them and order a free sample pack.