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Medical News

Both Drugs and Condoms Needed to Stop HIV: Study

July 25, 2008

People with HIV on effective antiretroviral therapy should not stop using condoms on the assumption their infection is not sexually transmissible, a new study reports. In fact, HIV infections could quadruple if those responding well to antiretrovirals stopped using condoms, said Australian researchers.

Their findings rebut a report earlier this year, made by the Swiss Federal Commission for HIV/AIDS, which suggested that HIV-infected people who have attained undetectable viral loads through successful antiretroviral therapy are sexually non-infectious.

Even if the risk of HIV transmission for a single sexual contact is fairly small, it is not zero, and the risk from exposure becomes substantial over large numbers of sexual contacts, the Australian study found. The researchers' risk assessment was based on mathematical models of 10,000 serodiscordant couples having 100 unprotected sexual contacts per year over a decade.

"The expected number of HIV infections would be 215 for female-to-male transmissions, 425 for male-to-female transmission, and 3,524 for male-to-male transmission, corresponding to an increase in incidence of four times compared with incidence under current rates of condom use," said the study, which was conducted by a team at Sydney's National Center in HIV Epidemiology and Clinical Research.

"When the viral load goes down in the blood due to antiretrovirals, it might not go down in the semen or vaginal and anal fluids," said Australasian Society for HIV Medicine President Jonathan Anderson, who was not involved in the research. "Antiretrovirals can complement consistent condom use, but replacing condom use with medications may end in disaster."

The report, "Relation Between HIV Viral Load and Infectiousness: A Model-Based Analysis," was published in The Lancet (2008;372:314-320).

Back to other news for July 2008

Adapted from:
07.24.2008; Tan Ee Lyn

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This article was provided by CDC National Prevention Information Network. It is a part of the publication CDC HIV/Hepatitis/STD/TB Prevention News Update.
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