A Sydney-based study of 119 gay men in serodiscordant relationships of six months or longer found that 37 -- or 31 percent -- reported engaging in unprotected anal sex. Of those, 70 percent engaged in condomless sex only after the HIV-positive partner had received a favorable blood test showing an undetectable viral load as a result of highly active antiretroviral therapy.

Most HIV-positive Australians are prescribed HAART, and they usually take blood tests every three months. About 80 percent of those on HAART are able to achieve the undetectable viral load that allows them to live longer and be less infectious to others.

"It's certainly not a foolproof strategy and it's not one that we're advocating," said Susan Kippax, director of the National Center in HIV Social Research. "On the other hand, it's not a strategy that people should go 'shock, horror' about," Kippax said. "What some men have worked out are strategies for reducing, but not eliminating, the risk and although that is a cause of some concern, in some ways it's certainly a better response than thinking: Oh God, I can't [have sex] anymore."

"It's not anything like a wholesale abandonment of condom use and it's actually quite a rational ... strategy," said Kippax. "If you give people enough knowledge, they'll fashion strategies that both reduce risk and are something they can manage."

Researchers were most concerned with 11 cases -- 9 percent of the sample -- in which couples had unprotected sex despite the HIV-positive partner having a detectable level of virus in his blood.

The research, "Undetectable Viral Load Is Associated With Sexual Risk Taking in HIV Serodiscordant Gay Couples in Sydney," was conducted by University of New South Wales in collaboration with the National Center in HIV Epidemiology and Clinical Research and published in AIDS (2005;19(2):179-184).

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