WHY , FOR HIV
UNdetectable = UNtransmittable
By Roger Pebody
In recent months , an increasing number of national and international scientists , advocates and organizations have issued statements about undetectable viral loads , HIV treatment and HIV transmission .
The most prominent comes from Prevention Access Campaign , the U . S . -based activist group that coined the “ Undetectable = Untransmittable ” slogan . They spell out what this means : People living with HIV [ on antiretroviral treatment ] with an undetectable viral load in their blood have a negligible risk of sexual transmission of HIV . They clarify that “ negligible ” means “ so small or unimportant as to be not worth considering ; insignificant .”
Their statement continues : " Depending on the drugs employed it may take as long as six months for the viral load to become undetectable . Continued and reliable HIV suppression requires selection of appropriate agents and excellent adherence to treatment . HIV viral suppression should be monitored to assure both personal health and public health benefits ."
Prevention Access Campaign ’ s statement has been endorsed by some of the leading scientists working on this issue . They include Myron Cohen , M . D ., of the University of North Carolina ( the HPTN 052 study ); Jens Lundgren , M . D ., of the University of Copenhagen ( the PARTNER study ); and Pietro Vernazza , M . D ., of St . Gallen Hospital ( the “ Swiss Statement ”).
The statement has also been endorsed by over 150 organizations . In the United States , endorsers include AIDS United , GMHC , Housing Works , Human Rights Campaign , Latino Commission on AIDS , National Black Justice Coalition , the Positive Women ’ s Network - USA , the San Francisco AIDS Foundation and Southern AIDS Coalition . The International AIDS Society and a large number of organizations in Europe , Australia , Canada and South Africa have also given their support . Similar language has been used by some of the world ’ s most prominent HIV scientists .
In a statement on World AIDS Day 2016 , Anthony S . Fauci , M . D ., director of the National Institute of Allergy and Infectious Diseases ( NIAID ) and Carl W . Dieffenbach , Ph . D ., director , Division of AIDS , NIAID , said :
“
Studies have proven that when an individual living with HIV is on antiretroviral therapy and the virus is durably suppressed , the risk that he or she will sexually transmit the virus is negligible .
The PARTNER Study
Some people might wonder whether such cases exist but simply haven ' t been noticed by doctors . To make sure that wasn ' t the case , scientists set up the PARTNER study . The aim was to observe and carefully measure the real life risk of HIV transmission in couples that weren ' t using condoms .
The researchers specifically sought out couples in which one partner was taking HIV treatment and the other partner did not have HIV . Moreover , they only enrolled couples who were already having sex without condoms .
They collected data on 888 couples who had sex without condoms ( or pre-exposure prophylaxis [ PrEP ]) when viral load was undetectable ( below 200 copies / mL ). There were 58,000 unprotected penetrative sex acts , around one-third in gay couples and two-thirds in heterosexual couples .
And how many people acquired HIV from their partners ?
Zero . Not one HIV-negative partner contracted HIV from a positive partner . No transmissions took place within these couples . What ' s more , all of the factors that someone might reasonably suggest could make
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