Statement by WHO and UNAIDS: Antiretroviral therapy and sexual transmission of HIV
4 February 2008 (ONUSIDA)
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Geneva, 1 February 2008 - Following the recent publication of an article on antiretroviral treatment and sexual transmission of HIV in the Swiss medical journal ‘Bulletin des médecins suisses’, UNAIDS and WHO reiterate the importance of a comprehensive approach to HIV prevention including correct and consistent use of condoms.
The article, published by Switzerland’s Federal AIDS Commission (La Commission fédérale pour les problèmes liés au Sida), states that seropositive individuals do not risk transmitting HIV to a seronegative partner under the following conditions: The seropositive partner has to have had undetectable HIV in the blood for at least 6 months, there must be strict adherence to his/her antiretroviral regimen, and he/she must be free of any other sexually transmitted infections. In the article the Commission states that although available medical and biological evidence does not rule out the possibility of HIV transmission they feel that there is nonetheless enough information to support its statement.
To prevent transmission of HIV, UNAIDS and WHO strongly recommend a comprehensive package of HIV prevention approaches, including correct and consistent use of condoms.
People living with HIV who are following an effective antiretroviral therapy regimen can achieve undetectable viral loads (the amount of virus in a body fluid such as blood, semen or vaginal secretions) at certain stages of their treatment. Research suggests that when the viral load is undetectable in blood the risk of HIV transmission is significantly reduced.
However, it has not been proven to completely eliminate the risk of transmitting the virus. More research is needed to determine the degree to which the viral load in blood predicts the risk of HIV transmission and to determine the association between the viral load in blood and the viral load in semen and vaginal secretions. Research also needs to consider other related factors that contribute to HIV transmission including comorbidity with other sexually transmitted diseases. UNAIDS and WHO will continue to follow the science of HIV transmission and the effect of antiretroviral treatment on the transmission of HIV.
UNAIDS and WHO underline the importance of effective and proven HIV prevention methods for all people irrespective of their HIV status. In 2005 UNAIDS published a policy position paper on HIV prevention to provide policy guidance on intensifying HIV prevention efforts.
A comprehensive HIV prevention package includes, but is not limited to, delaying sexual debut, mutual fidelity, reduction of the number of sexual partners, avoidance of penetration, safer sex including correct and consistent male and female condom use, and early and effective treatment for sexually transmitted infections.
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