AIDS experts: Unprotected sex OK for some with HIV

GENEVA - Swiss AIDS experts said Thursday that some people with HIV who are on stable treatment can safely have unprotected sex with non-infected partners.

The Swiss National AIDS Commission said patients who meet strict conditions, including successful antiretroviral treatment to suppress the virus and who do not have any other sexually transmitted diseases, do not pose a danger to others.

The proposal, published this week in the Bulletin of Swiss Medicine, astonished leading AIDS researchers in Europe and North America who have long argued that safe sex with a condom is the single most effective way of preventing the spread of the disease — apart from abstinence.

"Not only is (the Swiss proposal) dangerous, it's misleading and it is not considering the implications of the biological facts involved with HIV transmission," said Jay Levy, director of the Laboratory for Tumor and AIDS Virus Research at the University of California in San Francisco.

Decision up to HIV-negative partner
The Swiss scientists took as their starting point a 1999 study by the U.S. Centers for Disease Control and Prevention, which showed that transmission depends strongly on the viral load in the blood.

The Swiss said other studies had also found that patients on regular anti-AIDS treatment did not pass on the virus, and that HIV could not be detected in their genital fluids.

"The most compelling evidence is the absence of any documented transmission from a patient on antiretroviral therapy," said Pietro Vernazza, head of infectious diseases at the cantonal hospital of St.Gallen in eastern Switzerland and one of the authors of the report. [ full story ]

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If you were HIV- would you have unprotected sex with an HIV+ partner that said they were on the treatment and not able to transmit the disease?

Do you think this information will give "permission" to some on the treatment not to disclose their status to others, thinking they can't transmit the disease?

no
and won't even with rubbers

Quote:

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"The most compelling evidence is the absence of any documented transmission from a patient on antiretroviral therapy,"

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some conclusion...the lack of evidence is evidence ... :dolt:

Here is an update and reaction that I just got from my friends at the CA-DPH:

Some HIV/AIDS advocacy groups and scientists on Wednesday reacted with concern to a claim by a Swiss state commission that HIV-positive people taking antiretroviral drugs cannot transmit the virus during sex if they are adhering to their treatment regimens and have suppressed HIV viral loads for at least six months, AFP/Yahoo! News reports.

The Swiss AIDS Commission on Wednesday in a report based on four studies said that couples with one HIV-positive partner do not need to use condoms to prevent HIV transmission provided the above conditions are met and the HIV-positive partner does not have any other sexually transmitted infections. One of the studies -- published in the Swiss Bulletin of Medicine -- was conducted in Spain between 1990 and 2003 among 393 heterosexual couples with an HIV-positive person. The study found that none of the HIV-negative partners contracted the virus from an HIV-positive person taking antiretrovirals. Another study conducted in Brazil found that out of 93 couples, 43 with an HIV-positive partner, six people became HIV-positive. All six of the new HIV cases in the Brazil study were attributed to the HIV-positive partners not following their treatment regimens, AFP/Yahoo! News reports. The two other studies -- one conducted in Uganda and the other conducted among pregnant women -- had similar results, Bernard Hirschel, co-author of the Swiss report and an HIV/AIDS specialist at University Hospital in Geneva, said.

Reaction
Several HIV/AIDS advocacy groups and scientists expressed concern following the release of the report, noting that the research was focused on heterosexual couples and vaginal intercourse rather than anal sex, according to AFP/Yahoo! News. Roger Peabody of the Terrence Higgins Trust in London said the "real thing" missing from the report was information about "anal sex and getting a new" STI. "We don't feel the scientific evidence is conclusive, and there are some key issues that are not covered" in the report, Peabody said.

The French HIV/AIDS advocacy group Act Up said that only a small number of HIV-positive people would be affected by the findings and added that 40% of HIV-positive people taking antiretrovirals still carry the virus despite treatment adherence. France's National AIDS Council said the findings are not conclusive enough to apply to all HIV-positive people who follow their treatment regimens.

Ten years ago when the AIDS cocktail was announce, the SF AIDS Foundation said, "It's not time to open the champagne, but you can at least buy the bottle."

This study is encouraging, but I still wouldn't unwrap the cork. Maybe you can dust off that vintage bottle, but leave it in the cellar...

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If you were HIV- would you have unprotected sex with an HIV+ partner that said they were on the treatment and not able to transmit the disease?



No, I would not. I would err on the side of caution.




Do you think this information will give "permission" to some on the treatment not to disclose their status to others, thinking they can't transmit the disease?



Of course it will. it will give "permission" in the minds of a few delusional characters that are aching to find a reason not to disclose their status to new or casual sex partners.



I believe in honest and open discourse between partners, and always treating an unknown or other-than-monogamous partner as having some STD risk. I believe I am negative because I use condoms. I have had situations where I have been asked if I would prefer to not wear one but I do respectfully decline. I am sure many would just go for it and plunge in unwrapped, and this story could make both negative and positive guys consider a risky practice because they "read it was OK if you are on your meds"

Scary.

Open and honest discourse really is key, but it's a two-way street.

I've talked to several guys (including one of our former models) who are poz but still are awkward about bringing it up to a new potential partner, sometimes waiting until the last minute -- with predictably bad responses -- before disclosing. The guys I've talked to have all said they would be perfectly OK talking about it if the other person asked or brought it up, but it was difficult for them, either because they were concerned about being judged, or because they were concerned about their intentions being misread.

On the other hand, I know of at least one model whose new "friend" got him very drunk and topped him bareback, saying he was "clean"... and when the model found the antiretroviral meds in the bathroom the next morning, he confronted him, but the "friend" still denied it. The model became positive as a result of that encounter.

Both parties need to take responsibility to initiate conversation more than 2 minutes before clothes are ripped off and action is starting. When I went through HIV testing counseling training 20 years ago, we had a whole pitch that we gave to people coming in for testing on how to approach the subject, how to ask the important questions (# of partners, # of bareback experiences, etc) in a respectful and low-key way.

I wonder how much of that education is still happening in the testing results room, and how much today's youth even think of HIV as a serious concern?