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.

 

 

 

80% of new HIV cases transmitted by undiagnosed or untreated people

Healio, March 18, 2019

In 2016, more than 80% of new HIV infections in the United States were transmitted by individuals who either did not know they were infected with HIV or had been diagnosed but were not receiving care, according to data released on the first day of the National HIV Prevention Conference in Atlanta.

Understanding U=U for women living with HIV

ICASO, September 2018

Since its announcement, Undetectable equals Untransmittable (U=U) has
become a call to action to assert that when someone living with HIV has an
undetectable viral load they cannot transmit HIV. Additionally, the U=U message
is evolving to challenge notions of HIV infectivity, vulnerability and stigma.

The science behind the U=U message provides the evidence that we can reduce the anxiety related to the sexual transmission of the HIV virus with confidence.

To contribute to getting this message out, ICASO produced a Community Brief on U=U. This community brief explains why it is so important to understand what ‘U=U’ means for women. The brief documents the experiences and needs of individual women living with HIV from all over the world. Important questions still remain that need to be answered to make the U=U message relevant, understandable and more meaningful to women in their diversity.

  • Download the community brief in English here

FACTS NOT FEAR: a free forum on undetectable viral load

SAMESH is pleased to invite you – community members, clinicians, sector workers, anyone who may be interested – to their community forum, FACTS NOT FEAR: A forum on undetectable viral load.

 Join our panel of experts and community members to discuss the latest science about undetectable viral load and its role in preventing onward transmission of HIV, and to hear personal perspectives from People Living With HIV on how their experience of intimacy and relationships has been transformed.  There will be presentations and opportunities for questions and answers.

Panel members include:

Professor Mark Boyd

  • Chair of Medicine, Lyell McEwin Hospital, University of Adelaide
  • Principal Research Fellow, SAHMRI
  • Visiting Professorial Fellow, Kirby Institute UNSW Australia
  • President, Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM)
  • Co-Editor-in-Chief, AIDS Research and Therapy

 Dr Carole Khaw

  • Consultant Sexual Health Physician, Clinic 275, SASSHS, Infectious Diseases Unit, Royal Adelaide Hospital
  • Clinical Senior Lecturer, School of Medicine, University of Adelaide

 Specially invited Community members

  • Speaking of their personal experiences

Free Event

6.PM – 7.30 PM, Thursday 28 September 2017,  57 Hyde ST, Adelaide

~ Light refreshments provided: a selection of cheeses, wine and juices ~

 

The Evidence for U=U: Why Negligible Risk Is Zero Risk

August 10, 2017

Over the last year, hundreds of HIV organisations have joined a new campaign to endorse the statement that HIV transmission does not occur when viral load is undetectable on ART.

And while the dramatic impact of ART on reducing HIV transmission has been known for a long time, it is new to say ART stops transmission completely.