Demetre Daskalakis, MD, is the first public health official in the United States to sign a consensus statement concluding that there is “negligible risk” of HIV transmission when a person living with the virus is taking HIV meds and has maintained a consistently undetectable viral load for at least six months.
Daskalakis is the assistant commissioner for the Bureau of HIV/AIDS Prevention and Control at New York City’s Department of Health and Mental Hygiene. He joins a growing list of global HIV/AIDS experts and researchers who have endorsed the consensus statement, according to Prevention Access Campaign (PAC), which is spearheading the statement as part of its effort to end the dual epidemics of HIV and HIV-related stigma.
“Several strong lines of evidence indicate that consistent viral suppression is truly HIV prevention. Given these empiric findings, New Yorkers living with HIV who take their antiretrovirals consistently and have suppressed viral loads should be confident that their risk of HIV transmission is negligible,” said Daskalakis in a PAC press release. “Being sure about your own health by taking HIV medications means playing and staying sure for your entire community. The challenge is to sustain viral suppression by maintaining a relationship with an HIV health care provider who can support continued and consistent antiretroviral adherence.”
The consensus statement reads as follows:
People living with HIV on [antiretroviral therapy] with an undetectable viral load in their blood have a negligible risk of sexual transmission of HIV. Depending on the drugs employed it may take as long as six months for the viral load to become undetectable. Continued and reliable HIV suppression requires selection of appropriate agents and excellent adherence to treatment. HIV viral suppression should be monitored to assure both personal health and public health benefits.
NOTE: An undetectable HIV viral load only prevents HIV transmission to sexual partners. Condoms also help prevent HIV transmission, as well as other [sexually transmitted infections, or STIs] and pregnancy. The choice of HIV prevention method may be different depending upon a person’s sexual practices, circumstances and relationships. For instance, if someone is having sex with multiple partners or in a non-monogamous relationship, they might consider using condoms to prevent other STIs.
The consensus statement has also been endorsed by leading international researchers in the HIV field, including Myron Cohen, MD; Jens Lundgren, MD, DMSc; Andrew Grulich, PhD; and Pietro Vernazza, MD.
In the press release, Cohen noted: “I’m pleased that Dr. Daskalakis and the NYC Health Department joined the consensus on the dual benefits of early treatment to protect the health of people with HIV and prevent HIV transmission to their sexual partners. We hope that bringing the leading experts together will clear up mixed messages about the subject.”
For more on the topic, read the POZ interview with PAC’s executive director, Bruce Richman, “Does Undetectable Mean Uninfectious? The Challenge of Explaining HIV Study Results.”