Reg Domingo
While having an undetectable viral load may reduce the risk of transmitting HIV, it should not be used as an alternative to using condoms and lube, GLBT health agencies warn.
The Australian Federation of AIDS Organisations (AFAO), responding to claims made by Swiss AIDS experts, said: “People need to be aware that relying on ‘undetectable’ viral load is not a ‘safe sex’ strategy – it’s one that reduces the risk of transmission and it isn’t foolproof. The best way to protect yourself and your partner from HIV is through regular and consistent condom use.”
Switzerland’s Federal AIDS Commission released a report last week claiming that people with HIV do not risk transmitting the virus sexually provided they have had an undetectable viral load for at least six months, are adhering to a strict antiretroviral treatment and do not have a sexually transmitted disease (STI).
It was authored by four of Switzerland’s foremost AIDS experts and published in medical journal Bulletin of Swiss Medicine.
Don Baxter, Executive Director of AFAO, told SX that the claims were highly conditional and it doesn’t apply to all people with HIV on treatment.
“An undetectable viral load has not yet been proven to completely eliminate the risk of transmitting the virus. The use of viral load in prevention is not a substitute for safe sex,” he said.
Nick Corrigan, Director of Community Health at ACON, told SX that while a person with an undetectable viral load is unlikely to pass on HIV, “it is difficult to know your viral load at a particular point in time and to ensure it remains undetectable”.
He said that factors such as common infections, treatment issues and the high prevalence of STIs in the community can lead to fluctuations in a person’s viral load.
Corrigan added that being on successful antiretroviral treatments does not necessarily mean a person’s viral load will remain consistently undetectable.
Different treatment options and individual circumstances can also mean some people have detectable levels of the HIV virus in their semen when there is none in their blood, he said.
Corrigan also point out that the Swiss research is based on heterosexual couples and are not directly comparable to gay men.
“It is estimated that HIV is between 10 to 30 times easier to transmit during anal sex than vaginal sex. We therefore need to be more cautious than the Swiss experts have been,” he said.
The study prompted the World Health Organisation and UNAIDS to issue a joint response saying that they “strongly recommend a comprehensive package of HIV prevention approaches”.
These include “a reduction of the number of sexual partners, avoidance of penetration, safer sex including correct and consistent condom use and early and effective treatment for sexually transmitted infections”.
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