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
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.
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).
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.
By David Rhodes, Senior Lecturer, School of Education, Edith Cowan University
How children are taught about sex, relationships and sexuality at school is shaping up to be a political hot potato in Australia (again).
It’s already been slated to be an issue in the Victorian state elections later this year. That’s just a short time from being on the agenda during the same-sex marriage debate.
Now a radical shift in how children in England are taught about sex, relationships and sexuality promises to be the biggest reform of its kind in nearly 20 years. Here’s what Australia can learn from the new English system.
An increase in the number of notifications of hepatitis A has been reported in New South Wales amongst men who have sex with men (MSM). It is suspected that these infections are associated with a recent outbreak overseas amongst MSM in Europe and the Americas.
Key prevention messages:
Vaccination is the most effective form of prevention against hepatitis A infection. To receive the vaccine, contact your health care provider to arrange an appointment.
Follow good personal hygiene practices, especially thorough hand washing and safe sexual practices.
People with hepatitis A are excluded from work for 7 days after the onset of jaundice (if present) or 2 weeks from the onset of illness.
A factsheet and 2 videos of different lengths have been developed.
Dr Alison Ward, Senior Consultant Sexual Health Physician, Head of Unit, STD Services, Clinic 275 (RAH), discusses the importance of vaccination against Hepatitis A for men who have sex with men (MSM) (3:08 Minutes)
Dr Alison Ward, Senior Consultant Sexual Health Physician, Head of Unit, STD Services, Clinic 275 (RAH), discusses the importance of vaccination against Hepatitis A for men who have sex with men (MSM) (47 seconds)
The stillbirth rate among women living with HIV in the UK and Ireland from 2007 to 2015 was more than twice that of the general population, Graziella Favarato, presenting on behalf of the National Study of HIV in Pregnancy and Childhood (NSHPC), told participants at the 9th International AIDS Society Conference on HIV Science (IAS 2017) in Paris last week.
Most women originated from a sub-Saharan African country, accounting for 0.9% of stillbirths (71/7752) while stillbirth among women from Europe or westernised countries accounted for 0.4% (8/2004).
The annual number of new cases of HIV increased by at least 8% in 2015 in the European region, and by 60% in the last decade. A continued increase in new diagnoses in Russia was responsible for most of the increase.
In 2015, 64% of European-region new cases were in Russia.
The UK still reported by far the largest number of new cases of HIV of any country in western Europe.