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03/06/2014

No HIV Transmission with Condomless Sex when HIV+ Partners are Virologically Suppressed: CROI 2014


In 2008 Switzerland’s Federal AIDS Commission stated that HIV-positive persons who were adherent to antiretroviral therapy, with undetectable viral loads and free of STIs could have condomless sex with their HIV negative partners without risk of transmission, however no large studies have prospectively evaluated the risk of condomless sex among discordant couples, in particular among MSM couples. In a latebreaker presentation, Dr. Alison Rodger (University College London) presented interim results from the PARTNER Study group, on the risk of HIV transmission between serodiscordant couples when partners receive suppressive therapy. The study is a multicenter study of serodiscordant couples in 14 European countries and 75 sites. Couples were included in this analysis if they admitted to condomless sex, the positive partner was on suppressive ART (HIV RNA < 200 copies) and the negative partner had not taken PEP or PrEP. Among HIV negative MSM, 34% had sex with other partners and there was a high rate of sexually transmitted infections (16%). An analysis of 767 couples (including 282 MSM couples) who contributed 894 couple years followup and more than 45,000 condomless sex acts, showed zero phylogentically-linked HIV transmissions (95% CI, 0-0.4/100 couple-years of follow-up). Although this study confirms that treatment as prevention works, the investigators advised that due to the small sample size it is possible that 10-year transmission risk could be as high as 10%.

References:
1. Vernazza P, Hirschel B, Bernasconi E, Flepp M. Les personnes séropositives ne souffrant d’aucune autre MST et suivant un traitement antirétroviral efficace ne transmettent pas le VIH par voie sexuelle [In French]. Bull Med Suisses. 2008(05):165-169. Available from: http://www.saez.ch
2. Rodger A, Bruun T, Cambiano V, Vernazza P, Estrada V, Van Lunzen J, Collins S, Geretti AM, Phillips A, Lundgren J, for the PARTNER Study Group. HIV Transmission Risk Through Condomless Sex If HIV+ Partner On Suppressive ART: PARTNER Study. Abstract 153LB, CROI 2014, Boston, MA, March 3-6, 2014.


Source: Reporting for PRN News: Anita Radix, MD