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.

 

 

 

Australia will never be HIV-free if access to prevention requires a medicare card

The Conversation, January 23, 2019 12.21pm AEDT

by Nicholas Medland, Sexual health physician and senior researcher, UNSW

Australia aims to “virtually eliminate” HIV transmission by 2022, according to the health minister’s new national HIV strategy. This ambitious goal has been made possible by biomedical HIV prevention, a new and highly effective way of preventing HIV using medications.

But new inequalities are emerging between those who can and can’t access these medications because of their Medicare eligibility. These inequalities may undermine the success of HIV elimination in Australia and threaten Australia’s international reputation as a safe place to study, work and live.

Read more of Australia will never be HIV-free if access to prevention requires a medicare card

 

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

Post Exposure Prophylaxis (PEP) for HIV: An overview for Health Professionals

SHINE SA, October 2018

Access to PEP after an eligible exposure to HIV is a medical emergency. Your response to patients presenting for PEP can support them in preventing a life-long infection with HIV.

A brief, online training module has been created to support health professionals to:

• Increase your understanding of PEP as an emergency presentation and vital HIV prevention measure
• Assist you in providing patients with optimal care and support when seeking PEP in the emergency setting

This course is designed for Medical Officers and Registered Nurses in hospital emergency departments and targeted primary care clinical and rural sites that hold PEP starter packs in South Australia.

  • To register for the free PEP training module, please email us here with your name, position and workplace.

SA Health has contributed funds towards this program.

HIV PrEP update & HIV prescriber update in Adelaide

ASHM, October 2018

HIV PrEP Update for GPs and Practice Nurses

This training will provide GPs, Nurses, and Health Professionals working in primary care an update on strategies available for the prevention of HIV transmission, focusing on prevention particularly pre-exposure prophylaxis (PrEP).

– Date Tuesday, 23 October 2018
– Venue Mercure Grosvenor, 125 North Terrace, Adelaide SA 5000
– Time 6:15pm – 9:30 pm (Registration from 6:15pm, webinar broadcasts from 6:45pm)

At the end of this update, participants will be able to;
– Describe HIV epidemiology in Australia and the different HIV prevention
strategies
– Explain the role of HIV treatment and management
–  Provide patient education on the effectiveness and appropriate use of
PrEP/PEP
– Identify the prescribing pathways of PrEP within your local jurisdiction

This evening educational session will be presented by Dr Charlotte Bell, Sexual
Health Physician – Royal Adelaide Hospital.

This course is also available as a webinar, please contact Emma Williams here
for webinar registration

Register for this course at:
http://www.ashm.org.au/training/
Registrations close: Friday, 19 October 2018

Download flyer here: HIV PrEP Update_23Oct2018


HIV s100 Prescriber Dinner Update: 2018 IAS Conference Report Back and
Complex HIV Case Discussion

ASHM would like to invite HIV s100 Prescribers and medical practitioners in South Australia to attend this dinner training.

– Date Wednesday, 24 October 2018
– Venue Mercure Grosvenor, 125 North Terrace, Adelaide SA 5000
– Time 6:15pm – 9:30 pm (Registration starts 6:15pm, Webinar from 6:50pm)
– Cost FREE, Dinner and refreshments will be provided on site

This dinner workshop will bring attendees an overview of the content showcased at the
2018 International AIDS Conference held in Amsterdam, as well as a number of complex HIV cases to discuss. The first session is a conference report back
session. Professor Mark Boyd will provide an update on the latest studies, important
developments and best research methods in the ongoing battle against HIV, AIDS and
related infectious diseases from the IAS Conference 2018.

The second session will be an interactive panel discussion, focussing on the
management of complex HIV cases. Panellists include Professor Mark Boyd, Dr Russell Waddell (Consultant Sexual Health Physician and Clinical Director STD Services, Royal Adelaide Hospital) and Dr Andrew Beckwith (Senior Consultant Psychiatrist, Director of Training, HIV/Hep C Liaison Psychiatrist, CALHN Mental Health). The session will be hosted by Dr Samuel Elliott (Principal General Practitioner, Riverside Family Medical Practice).

This course is also available as a webinar, please contact Emma Williams here
for webinar registration

Register for this course at:
http://www.ashm.org.au/training/
Registrations close: Friday, 19 October 2018

Download flyer here: HIV Prescriber Update_24Oct2018