The Data: Undetectable = Untransmittable in gay men

The Data: Undetectable = Untransmittable in gay men

Data from the Opposites Attract study, presented at IAS 2017, has shown that undetectable does equal untransmittable when it comes to anal sex in gay men.

Over the past few years we’ve seen data coming out of the PARTNER study showing us that people with an undetectable viral load do not pass HIV on to their sexual partners. But one of the criticisms of PARTNER was that it focused too heavily on heterosexual couples – and not men who have sex with men (MSM).

This week at the International AIDS Society (IAS) 2017 conference a team of researchers from Australia, in Bangkok and Rio de Janeiro reported their findings from the Opposites Attract study.

The study, which followed 343 gay couples, where one partner had HIV with an undetectable viral load and the other was HIV negative, recorded ZERO HIV transmissions from partner to partner – with 16,889 recorded instances of condomless anal sex.

There were three recorded HIV infections within the couples the study followed – but these were genetically linked to partners outside their “main relationship” who did not have an undetectable viral load.

Combining the results from the gay couples from PARTNER with these new results from Opposites Attract provides data for over 40,000 incidences of condomless anal sex between ser0-different gay men which re-inforces that the Undetectable = Untransmittable (#UequalsU / U=U) message is for everyone regardless of gender and sexual orientation.

We also now have data to suggest than having a secondary STI does not increase the risk of HIV transmission when the positive parter is undetectable. During the PARTNER study 17.5% of participants had an STI at one point or another during the study, and 6% at any one time in Opposites Attract. Despite this we still saw zero linked transmissions.

Dr Anthony Fauci, director of the IAS National Institute for Allergies and Infectious Diseases, said:

“Scientists never like to use the word “Never” of a possible risk.

“But I think in this case we can say that the risk of transmission from an HIV-positive person who takes treatment and has an undetectable viral load may be so low as to be unmeasurable, and that’s equivalent to saying they are uninfectious. It’s an unusual situation when the overwhelming evidence base in science allows us to be confident that what we are saying is fact.”

Bruce Richman, pioneer of the U=U movement, said:

“This is demolishing HIV stigma and encouraging people to start treatment and bring an end to the epidemic. We need people like UNAIDS, as they did today, to confirm it’s true.”

 

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