August 5, 2008

Does Undetectable Equal Uninfectious?

Hours before the XVII International AIDS Conference began in Mexico City, A panel of experts engaged in a heated debate over statements made by the Swiss Federal AIDS Commission in January, which affirmed that an undetectable viral load renders an HIV-positive person uninfectious under optimal conditions, Aidsmap.com reports.

“We never thought of it as a statement that was to be delivered worldwide,” says Pietro Vernazza, MD, president of the Swiss Federal AIDS Commission. “It was meant only to be delivered to Swiss physicians to help them discuss sexual risk-taking with their patients and their steady partners.”

According to the article, Dr. Vernazza added that the title of the statement—“HIV-positive people with no other STIs and on effective antiretroviral therapy do not transmit HIV sexually”—was “misleading.” The statement was made primarily to protect positive people in Switzerland, where HIV exposure laws enable the state to prosecute HIV-positive people who had unprotected sex with HIV-negative and fully informed partners. Vernazza affirmed that the statement could be used in court to show that positive people on effective treatment could not expose or transmit the virus.

Vernazza says the statement was made to clear up discrepancies between what some doctors tell their patients privately and what they say in public to eliminate what he calls the “risk of uncontrolled diffusion” of information regarding HIV transmission.

Search: International AIDS Conference, Swiss Federal AIDS Commission, Pietro Vernazza, undetectable, uninfectious

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Previous Comments:

John, Clearlake, 2008-09-30 11:43:38
If 2 HIV poz folks get together, both are long term undetectable and healthy otherwise, how safe are they to NOT use condoms between themselves.

Donald Baxter, Iowa City, Iowa, 2008-09-22 21:58:43
I would be curious to know more about the RI study. Were the women who "shed" HIV measured as undetectable? If so, from where was that virus coming? If there's no detectable virus, how can measurable virus "shed?"

Susan, Boston, MA, 2008-09-17 14:12:41
An update. I see an excellent HIV doctor in Rhode Island whose area of expertise is HIV+ Women's Health Issues and Research. She completed a study a few years ago showing that there at certain times women with HIV "Shed" - are infectious. Every woman is different as to WHEN this happens (say, during a month-long period), and there is no pattern or way of knowing WHEN a woman is "shedding", so that's what's so tricky about being infectious, you can't plan it.

Thomas, , 2008-09-16 14:05:14
This is encouraging for the simple fact that I believe it would help with the HIV/AIDS stigma positive folks face. More studies should be done to absolutely confirm the boast. It should not be seen as license to go out and have unprotected sex. I cannot believe how irresponsible people still are even after having been infected. If we know one thing, it's that the virus is tricky and sneaky. Don't take chances, period. Wear a f#$%ing condum! Protect yourself and your partner.

Thomas, Chelsea, MA, 2008-09-11 15:25:29
It seems logical to me that a person is less infectious if treated close to time of s-conversion,with a solid history of adherence and undetectable V-LOAD However, a person's virus would need to be "undetectable" at the exact time of contact. "Undetectable" is an assumed status it is not known if this status is consistent from one day to the next. The v-load can rise and fall increasing the persons infectiousness. So there is decreased risk in "undetectable" folks in my opinion. tricky

Jim, Van Nuys, 2008-09-03 17:07:09
Come on people. Some of you are saying that this statement is the cause of the rise of HIV+ in some populations. This statement is only a few months old and has a least a scientifically significant researched conclusion. The HIV+ rise in people of color, people less than 30 years of age and people older than 50 years of age has clearly been demonstrated to be a matter of social morays and drug use, long before this article was released.Get a signed legal statement every time you have sex,+ or -.

Tim Sanders, Reno, NV., 2008-09-03 16:49:33
So, in layman's terms, what the EF does this mean. In the state of Nevada, there were just a few years ago, 7 men serving prison time for giving blow jobs to HIV- men being fully informed of the HIV+ person's sero status. The Swiss arguement has been drafted in briefs in an attempt to get these men released. Is it true or is it not true?!!

sexy0d, milwaukee, 2008-08-18 19:28:46
I still think you should still use protection unless your are with your own partner and u both are just hiv poz and no other STI's

warren, vancouver, 2008-08-18 05:26:18
poz is poz.despite people still having safe sex without condoms{see another of those statement said but not believed} no viral load, but measurement standards just changed; spikes in viral loads more common under the new...are you still not a threat...less infectious?, possibly, stupid to risk another persons' wellbeing to find out,insane! will people do it,,,they are and under the guise of the' dr said i was less risk...honest'give me a break! Reality check

François, Montréal, 2008-08-14 20:37:33
I am an MD working with people living with hiv/aids. The statement is true, but no one in Canada or the US wants to take responsibility for it cuz the statement is true ONLY IF the person DOES TAKE his meds regularly, does not forget doses (meaning does not do drugs or ROH), does not have any other STD like genital herpes for example that increases the risk of hiv infection. And the last concern, by lancing a statement like this, we might be encouraging bareback sex.

blacpozgirl, London, 2008-08-14 01:05:51
I seriously believe this statement, I have been with my boyfriend for over 6 years, off and on and though I have been positive all that time he has remained negative, I had always felt he was either extremely lucky or had an immunity...now I feel my undetectable status might be it...

Larry, Santa Fe , NM, 2008-08-12 09:56:33
The statement made by the Swiss Federal AIDS Commission was very irresponsible. Paticularly to a culture were a sound bite or a statement (often taken out of context) is the only news many people receive daily. With HIV infection rates sky rocketing in populations of people of color and youth(misinformation of HIV rooted in denial) this statement is a total disservice and a loaded gun. Thank you Commission for being so resposible!

Hopeful, Houston, 2008-08-10 13:05:54
As someone who's been postive for 8 years, has faithfully taken meds every day, and remained undetectable and very healthy, I am hopeful that some day I will be able to freely engage in unprotected sex with my negative (receptive) partner. More testing is needed, clearly. It would be wonderful to be able to truly feel the connection, rather than feeling that we're in separate rooms.

TroyP, , 2008-08-10 03:23:47
I tested positive for HIV the first time I tested 23 years ago. I have tested "undetectable" for years. I have consensual condom free (bareback) sex often. NONE of my partners have sero converted. Thousands are engaging in condom free sex. We need realistic research and honest information. AND an effective microbicide (substance which kills the virus during intercourse - more safe and effective than condoms). The old Abstinance or Use a Condom, rhetoric is totally missing the real world!

passionatelover39, Houston, TX, 2008-08-08 12:14:19
In what century do the Swiss doctors live in when they said their statement was ment for Swiss doctors and residents only? The internet has been around for a long time and they should know that any statement made can be worldwide in one day. Don't they know the HIV community is very tight knit and any news about HIV goes worldwide in very short order. Doctors should get it together, after all, they tell there kids to not post anything that they don't want the world to see.