UNAIDS, WHO React To Swiss Claim About Antiretrovirals, HIV Transmission

Main Category: HIV / AIDS
Article Date: 05 Feb 2008 - 8:00 PDT

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UNAIDS and the World Health Organization last week responded to a claim by a Swiss state commission that HIV-positive people taking antiretroviral drugs cannot transmit the virus during sex under certain circumstances, AFP/Google.com reports. The organizations said that they "strongly recommend a comprehensive package of HIV prevention approaches, including correct and consistent use of condoms" (AFP/Google.com, 2/1).

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 that the HIV-positive partners are adhering to their treatment regimens, have suppressed HIV viral loads for at least six months and do not have any other sexually transmitted infections. 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 (Kaiser Daily HIV/AIDS Report, 1/31).

UNAIDS and WHO in a joint release said that HIV-positive people "who are following an effective antiretroviral therapy regimen can achieve undetectable viral loads" at certain points during treatment and that research "suggests that when the viral load is undetectable in blood, the risk of HIV transmission is significantly reduced." The organizations added that despite these findings, "it has not been proven" that suppressed viral loads "completely eliminate the risk of transmitting the virus. More research is needed to determine the degree to which the viral load in blood predicts the risk of HIV transmission and to determine the association between the viral load in blood and the viral load in semen and vaginal secretions." In addition, further research should "consider other related factors that contribute to HIV transmission," including coinfection with other STIs, UNAIDS and WHO said.

According to the groups, a comprehensive HIV prevention strategy also includes:

• Delaying first sexual activity;
  
  
• Fidelity;
  
  
• Decreased number of sexual partners;
  
  
• Avoiding penetration;
  
  
• Safer-sex practices, including the use of male and female condoms; and
  
  
• Early and effective STI treatment (UNAIDS/WHO release, 2/1).

The release is available online (.pdf).

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