Condomless Sex With Virologically Suppressed HIV-Infected Individuals: How Safe Is It?
JAMA July 12, 2016 V.316 N.2 P.149-151
Eric S. Daar, MD; Katya Corado, MD
Los Angeles Biomedical Research Institute, Division of HIV Medicine, Harbor-UCLA Medical Center, Torrance, California
The use of antiretroviral therapy (ART) across the globe has had a profound influence on the natural history of HIV infection. Although the pandemic continues to spread, one of the greatest advances in prevention since the use of ART in pregnancy to avoid vertical transmission was the recognition that the same treatment prevents horizontal transmission. Many cohorts have suggested this benefit,1,2 findings that in part led to the Swiss Commission statement in 2008 that HIV-infected individuals who have had suppressed plasma HIV RNA load for longer than 6 months and who do not have sexually transmitted infections (STIs) were not sexually infectious.3 Although the statement was controversial at the time, the cohort data were compelling, and there have been very few case reports of an HIV transmission event from a virologically suppressed person and no events identified in a systemic review of patients with suppressed plasma HIV RNA load in cohort studies and randomized controlled trials…