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.

 

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

 

How HIV Possibly Jumped From Monkey To Man

Asian Scientist, April 12, 2018

Scientists in Japan have discovered a protein that may have enabled the simian immunodeficiency virus (SIV) to be transmitted to humans. Their findings are published in Cell Host & Microbe. The human immunodeficiency virus (HIV) is believed to have evolved from a SIV that originated in chimpanzees.

New evidence supports HIV screening in young adulthood

Science Daily, December 19, 2017

A new study suggests that the most beneficial age for a one-time screening HIV test of the general population would be age 25.

The report — led by researchers at Massachusetts General Hospital  working with the U.S. Centers for Disease Control and Prevention (CDC) and the Massachusetts Department of Public Health — will be published in the Journal of Adolescent Health and has been issued online.

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.