Back HIV Prevention Treatment as Prevention 1. HIV Undetectable = Uninfectious

1. HIV Undetectable = Uninfectious


Evidence continues to accumulate showing that HIV-positive people on effective combination antiretroviral therapy (ART) with a consistently undetectable viral load have a very low -- perhaps as low as zero -- risk of transmitting the virus.

Back in 2008 the Swiss AIDS Commission released the "Swiss Statement" declaring that an HIV-positive person on potent ART "is not sexually infectious" as long as they maintain an undetectable viral load and do not have concurrent sexually transmitted infections (STIs).

More recent evidence supports that conclusion. HPTN 052, a large randomized study of antiretroviral treatment-as-prevention, found that HIV-positive partners who started ART immediately had a 96% lower risk of transmitting HIV to their negative partners than those who waited until their CD4 count fell below 250 cells/mm3.

The latest data from the PARTNER study, reported at the International AIDS Conference this summer and published in the July 12 New England Journal of Medicine, saw no documented cases of within-couple HIV transmission among nearly 900 heterosexual and gay male serodiscordant couples who engaged in more than 58,000 sex acts.

Nevertheless, due to the small risk that HIV might not stay undetectable -- as well as concern about other STIs -- some experts recommend that HIV-positive people on effective ART should continue to use condoms. And many people with HIV still considerably overestimate their chances of infecting someone.

NEXT: 2. Quicker, Simpler, and Better Antiretroviral Therapy