December #119 : Sex in the Age of Meds - by Stephanie Fairyington

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Table of Contents

On the Cover-Juliano Innocenti

Melting the Winter Blues

Higher Ground

Sex in the Age of Meds

WHY...December 2005

Steps to the Future

The Fright Before Xmas

Striking Oil

A Gift to Yourself

A New Year Bathed in Promise

Weighing CD4 Counts

Trainer's Bench - December 2005

The Legal Eye - December 2005

Sexy Holiday Toys


LeRoy Whitfield 1969-2005

Earthwatch - December 2005

Tripped Up

Buzz - December 2005

Out of the Blues

A Lifeline for All

Yesterday's News

As the Virus Turns

Mentors - December 2005

Mailbox - December 2005

Editor's Letter - December 2005

Most Popular Lessons

The HIV Life Cycle


Herpes Simplex Virus

Syphilis & Neurosyphilis

Treatments for Opportunistic Infections (OIs)

What is AIDS & HIV?

Hepatitis & HIV

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December 2005

Sex in the Age of Meds

by Stephanie Fairyington

Do lower viral loads mean lower risk For HIV?

When Robert Sheriff learned he was positive in 1996, he and his neggie wife, Wilma, dragged a third party into their bedroom: a condom. “[Wearing it] was like trying to make love through a brick wall,” says Sheriff, 44. Six months after he started HIV meds—his viral load having dipped to 13,000—the couple dumped the latex. “We weren’t connecting like we used to,” Sheriff explains. “We’d already gone five years without [condoms] before my diagnosis, and she never tested positive.” Indeed, Wilma, 46, remains negative today. So the Sheriffs weren’t surprised to hear that a Spanish study of straight serodiscordant couples in September’s Journal of AIDS showed that the rate of HIV transmission among participants had fallen 80% since the 1996 debut of HAART cocktails.

 The project recruited 393 mixed-status, heterosexual partners from 1991 to 2003. The couples were categorized by their recruitment time (pre-, early- and late-HAART) and followed until 2003. HIV prevalence fell from 10.3% pre-HAART to 1.9% in late HAART, whether or not the couples had had unprotected sex. Indeed, not a single negative partner of an HIVer on meds was infected. Although the study examined only heterosexuals, lead author Jesus Castilla says the reduced transmission is “applicable to homosexual [populations]” (unprotected anal sex, however, is still considered riskier than vaginal sex).

Castilla warns that this study shouldn’t encourage mixed-status couples to reject condoms. The likelihood of transmission can rise with any number of sexual risk factors, including rough sex and poor med adherence. Robert Remien, a scientist at Columbia University’s HIV Center for Clinical and Behavioral Studies, emphasizes that “transmission is always possible, regardless of viral load” and the presence of HAART. What’s more, condoms protect against other sexually transmitted diseases, which spike HIV risk and endanger immune systems. But the Sheriffs aren’t budging:  “I’m not advocating unprotected sex,” Robert explains. “Wilma and I spent six months apart thinking about the ramifications of this disease in our lives. This is the decision we came to mutually, and it’s the right one for us.”

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