Risk of HIV transmission through condomless sex in serodifferent gay couples with the HIV-positive partner taking suppressive antiretroviral therapy (PARTNER)

Risk of HIV transmission through condomless sex in serodifferent gay couples with the HIV-positive partner taking suppressive antiretroviral therapy (PARTNER): final results of a multicentre, prospective, observational study

The Lancet, Published Online May 2, 2019

Background

The level of evidence for HIV transmission risk through condomless sex in serodifferent gay couples with the HIV-positive partner taking virally suppressive antiretroviral therapy (ART) is limited compared with the evidence available for transmission risk in heterosexual couples. The aim of the second phase of the PARTNER study (PARTNER2) was to provide precise estimates of transmission risk in gay serodifferent partnerships.
Findings
Between Sept 15, 2010, and July 31, 2017, 972 gay couples were enrolled, of which 782 provided 1593 eligible couple-years of follow-up with a median follow-up of 2·0 years (IQR 1·1–3·5). At baseline, median age for HIV-positive partners was 40 years (IQR 33–46) and couples reported condomless sex for a median of 1·0 years (IQR 0·4–2·9). During eligible couple-years of follow-up, couples reported condomless anal sex a total of 76 088 times. 288 (37%) of 777 HIV-negative men reported condomless sex with other partners. 15 new HIV infections occurred during eligible couple-years of follow-up, but none were phylogenetically linked within-couple transmissions, resulting in an HIV transmission rate of zero (upper 95% CI 0·23 per 100 couple-years of follow-up).

Interpretation

Our results provide a similar level of evidence on viral suppression and HIV transmission risk for gay men to that previously generated for heterosexual couples and suggest that the risk of HIV transmission in gay couples through condomless sex when HIV viral load is suppressed is effectively zero. Our findings support the message of the U=U (undetectable equals untransmittable) campaign, and the benefits of early testing and treatment for HIV.

 

Healthcare providers should discuss U=U with all their HIV-positive patients

aidsmap/nam, 18/03/2019

Healthcare providers should inform all patients with HIV they cannot transmit HIV to a sexual partner when their viral load is undetectable, argue the authors of  a strongly worded comment in The Lancet HIV.

The authors note that despite overwhelming scientific data supporting the undetectable = untransmittable (U=U) message, significant numbers of healthcare providers do not educate their patients about U=U when telling them their viral load is undetectable.

 

 

 

Gaps And Policy Barriers To Engagement With The HIV Cascade Of Care

Identifying and Plugging the Leaks: Gaps And Policy Barriers To Engagement With The HIV Cascade Of Care

CTAC (Canadian Treatment Action Council), 2018

This project explored what issues impact engagement by people living with HIV with healthcare in Ontario. The goal was to identify policy issues that impact treatment access for people living with HIV, and to identify opportunities to make the healthcare system more accessible.

The HIV Cascade of Care is a useful description of the different steps that a person living with HIV will need to take in order to achieve an undetectable viral load and optimal health outcomes, from infection and diagnosis through to Antiretroviral Therapy (ART) initiation and viral suppression.

We know people drop out of the HIV Cascade of Care – e.g. why those starting treatment don’t stay on it. By seeking out policy barriers and developing solutions we can enable people to live long, healthy, and happy lives.

The project has five recommendations around barriers to engagement in the HIV Cascade of Care.

Download report here

 

New HIV Treatment factsheet series

NAPWHA, 20 Dec 2018

NAPWHA would like to thank ViiV Healthcare for an unrestricted grant to produce a new range of treatment messages.

These are ideal for someone who has been newly diagnosed, or who is unsure if they are receiving the best possible treatment for them.

Below are the first three of the series; these are downloadable in PDF format.

Please continue to check in with NAPWHA in 2019 for the next in the series.

  • Download factsheets

Clinical Education Forum Recording: Contraception Update

SHINE SA, November 2018

Clinicians:  SHINE SA is pleased to present the following Clinical Forum by Dr Amy Moten on the topic of Contraception.

This recording is available free of charge, and access is limited to three months only.

This forum covers emergency contraception and new formulations of the Pill.

3 Category 2 RACGP Points can be awarded on completion of the forum.

Recording length: 1 hour 18 minutes

Newly available: WHO HIV PrEP Implementation Tool Mobile App

World Health Organization, August 1, 2018

The WHO PrEP Implementation Tool App for Health Workers App is now available.

On-the-go access to the following modules from the WHO PrEP Implementation Tool:

  • Clinical: for clinicians, including physicians, nurses and clinical officers
  • Counsellors: for staff who counsel people as they consider or start taking PrEP, and support them in coping with side effects and adherence strategies
  • Pharmacists: for pharmacists and people working in pharmacies; to provide information on the medicines used in PrEP as well as storage conditions
  • Testing providers: for people who provide testing services at PrEP sites and laboratories
  • PrEP users: for people taking PrEP and people interested in taking PrEP to reduce their risk of acquiring HIV; to support them in their choice and use of PrEP.

For more information and to download app, click here 

You can also visit these two websites: