July 11, 2008

Unprotected Sex Limits Treatment-as-Prevention Theory, Study Finds

Reported increases in unprotected sexual behaviors and risk taking since the arrival of protease inhibitors in 1996 threatens to eliminate any benefits from such antiretroviral therapy to reduce sexual infectiousness, according to a new study in the journal AIDS, AIDSmap reports (aidsmap.com 7/10).

The impact of antiretroviral therapy on sexual transmission has been the subject of intense debate when some experts—including renowned HIV researcher Dr. Julio Montaner—have said an individual with an undetectable viral load is not infectious. Much of the discussion has centered on increased sexual risk taking canceling out any gains in antiretroviral therapy effect on infectiousness.

The recent AIDS report, which focused on sexual HIV transmission among gay men in the Netherlands, concluded that unprotected behaviors must be reduced to pre-1996 levels for treatment to have an impact on the gay HIV epidemic there.

“On the basis of these model estimates,” the study’s authors wrote, “[antiretroviral therapy] has played an important role in limiting transmission, but that any gains made have been more than offset by increases in the risk behavior rate.”

Search: treatment-as-prevention, Julio Montaner, Netherlands

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Previous Comments:

Buffy Mills, kelowna, 2008-07-17 17:44:48
there is new research that was just presented at the CAHR conference that indicates that low viral load in blood does not mean that there is low viral load in the genital tract. The study actully indicated that there was more virus in the genital tract. Further there is plenty of research indicating that contracting HIV from unprotected sex where a STI is present makes a person more infectious due to increased viral shedding... so what does that mean for this treatment as prevention strategy?

Connie, , 2008-07-15 11:22:32
BUT, has this increased risky behavior rate resulted in transmission? This article seems like a lot of hogwash with no facts, actual human studies (not just models), or anything substantial other than a person or people saying that the use of ART is relating to an increase in risky activity. How can increased risky behavior eliminate ART ability to reduce infectiousness? No amount of sex is going to make treatment less effective. Only resistance can do that.