HIV, antiretroviral treatment, and HIV sexual transmission: what’s new?
28 October 2008
In the first of a series of HIV good practice updates Ade Fakoya, senior adviser on HIV and health services in the Alliance secretariat’s HIV Best Practice Unit, captures the latest thinking around HIV, antiretroviral treatment and the sexual transmission of HIV. Below he summarises some of the key issues explored in the full article.
Many factors affect the risk of HIV transmission from one individual to another. These include structural, social and biological aspects of both the individual and the virus. One of the most important factors is the level of circulating virus in the blood or other body fluids including semen, vaginal secretions and, in mother to child transmission, breast milk.
Reducing the viral load in a person living with HIV by antiretroviral treatment greatly reduces the risk of HIV transmission. In studies of couples where one partner is positive and the other negative no transmissions have been reported when viral loads are below a certain level.
For individuals, understanding the issues of HIV transmission while on antiretroviral treatment will allow them to make decisions about their sexual relationships with long term partners, including the use of protection and decisions about conception. There are several important caveats when advising HIV positive individuals about the risk of sexual transmission while on long term suppressive antiretroviral treatment. These need to be dealt with at individual level and require clear unambiguous messages about risk.
At a population level the possibility exists that increasing the number of people who are aware of their HIV status and are on antiretroviral treatment may help reduce the number of new cases of HIV (incidence). Although we cannot treat our way out of the HIV epidemic, identifying and treating people living with HIV is of benefit in itself and for the prevention effect. Although it still needs to be understood that this is useful as one tool in the prevention portfolio.
There is an urgent need to scale up comprehensive country and population specific HIV prevention in order to properly address the 2.5 million new infections which occur every year.
Read the full article
We want your input!
If you have a particular area that you think would be of interest to cover in a future technical update, please send an email to Jane Coombes jcoombes@aidsalliance.org.
