Top NYC HIV Official: 'Negligible Risk' of Transmission With Undetectable Viral Load

Demetre Daskalakis, M.D., M.P.H.
Demetre Daskalakis, M.D., M.P.H.
Estella Yu

HIV /AIDS experts from the U.S., Australia, Denmark and Switzerland--including Dr. Demetre Daskalakis, Assistant Commissioner for the Bureau of HIV/AIDS at the New York City Health Department -- endorsed a consensus statement concluding "negligible risk" of HIV transmission from a person with HIV who is on antiretroviral therapy (ART) and has had a consistently undetectable viral load for six months and beyond. Dr. Daskalakis is the first U.S. public health official to endorse this consensus statement, which is the first of its kind to bring together leading researchers, HIV activists and communications experts to share their conclusions from the groundbreaking evidence with the public.

A person with HIV becomes "undetectable" when ART suppresses the virus to a level so low in their blood that it cannot be detected by measurements. New Yorkers living with HIV have made great and rapid strides in viral suppression with the most recent surveillance data indicating that 72% have achieved viral load suppression.

"Several strong lines of evidence indicate that consistent viral suppression is truly HIV prevention. Given these empiric findings, New Yorkers living with HIV who take their antiretrovirals consistently and have suppressed viral loads should be confident that their risk of HIV transmission is negligible," said Dr. Daskalakis.

"Being sure about your own health by taking HIV medications means playing and staying sure for your entire community. The challenge is to sustain viral suppression by maintaining a relationship with an HIV healthcare provider who can support continued and consistent antiretroviral adherence."

Dr. Myron Cohen, chief of the Division of Infectious Diseases at UNC School of Medicine and the Principal Investigator of HPTN 052 the first landmark clinical study on the subject said, "I'm pleased that Dr. Daskalakis and the NYC Health Department joined the consensus on the dual benefits of early treatment to protect the health of people with HIV and prevent HIV transmission to their sexual partners. We hope that bringing the leading experts together will clear up mixed messages about the subject".

In addition to Dr. Daskalakis and Dr. Cohen, the consensus statement was endorsed by principal investigators and experts from each of the leading studies that examined this issue included Dr. Jens Lundgren (PARTNER study; University of Copenhagen, Denmark), Dr. Andrew Grulich (Opposites Attract study; University of New South Wales, Australia); and Dr. Pietro Vernazza (PARTNER study; Swiss statement; Cantonal Hospital, St. Gallen, Switzerland).

Only an estimated 30% of people with HIV in the U.S. are undetectable, and the majority of people with HIV and their medical providers are not yet aware of the extent to which ART prevents HIV transmission to their partners. This points to the need for much greater awareness about the prevention benefits of ART and improved access to HIV testing, treatment and care.

Understanding that people with HIV who are undetectable cannot transmit HIV to their partners will help reduce decades of HIV-related stigma and discrimination and encourage people with HIV to initiate and adhere to a successful ART regimen.

The consensus statement is a part of a health equity initiative of the Prevention Access Campaign, an NGO lead by a founding task force of prominent HIV activists, researchers and media experts.

Editor's Note: JD Davids of is on the founding task force of Prevention Access Campaign.