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Confused about the swiss study
Dec 31, 2010

I discussed with my doctor about the swiss study which claims that in a monogamous serodiscordant and straight relationship with the infected partner on treatment and with an undetectable viral load the use of a condom is no more imperative. He agrees. I asked him about the possibilities of blips and differences between plasma and seminal fluids concerning viral load and he said that those changes and variations are likely not indicative for a significant trasmission risk since the copies detected are dead virus particles flowing around without the capability to infect a cell. He also said that those few cases which reported transmission with an undetectable viral load were related to poor and suboptimal adherence. What is the truth? Is unprotected sex with a single partner and under the rules of the swiss statement so extenuating low that condoms could be avoided at least for natural conception?

Response from Dr. Frascino

Hi,

I totally disagree with your doctor. I have discussed the "Swiss Study" repeatedly in this forum. My assessment has not changed. Unprotected sex between magnetic couples remains a risk for HIV transmission, even when the HIV plasma viral load has been suppressed to undetectable levels.

Regarding natural conception, certainly driving the HIV plasma vial load to undetectable levels significantly decreases (but does not completely eliminate) the risk of HIV transmission. Timing sex to the ovulatory cycle to decrease the number of exposures can further decrease the risk. I would suggest you review the information in the archives of this forum in the chapters on pregnancy and magnetic couples.

Good luck.

Dr. Bob



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