https://amp.theguardian.com/society/2019/may/02/end-to-aids-in-sight-as-huge-study-finds-drugs-stop-hiv-transmission
An end to the Aids epidemic could be in sight after a landmark study found men whose HIV infection was fully suppressed by antiretroviral drugs had no chance of infecting their partner.
The success of the medicine means that if everyone with HIV were fully treated, there would be no further infections.
Among nearly 1,000 male couples across Europe where one partner with HIV was receiving treatment to suppress the virus, there were no cases of transmission of the infection to the HIV-negative partner during sex without a condom. Although 15 men were infected with HIV during the eight-year study, DNA testing proved that was through sex with someone other than their partner who was not on treatment.
“It’s brilliant – fantastic. This very much puts this issue to bed,” said Prof Alison Rodger from University College London, the co-leader of the paper published in the Lancet medical journal. Earlier studies have also shown the treatment protects heterosexual couples where one partner has HIV.
She added: “Our findings provide conclusive evidence for gay men that the risk of HIV transmission with suppressive ART [antiretroviral therapy] is zero. Our findings support the message of the international U=U campaign that an undetectable viral load makes HIV untransmittable.
“This powerful message can help end the HIV pandemic by preventing HIV transmission, and tackling the stigma and discrimination that many people with HIV face.
“Increased efforts must now focus on wider dissemination of this powerful message and ensuring that all HIV-positive people have access to testing, effective treatment, adherence support and linkage to care to help maintain an undetectable viral load.”
In 2017, there were almost 40 million people worldwide living with HIV, of whom 21.7 million were on antiretroviral treatment. An estimated 101,600 people are living with HIV in the UK, and of these, about 7,800 are undiagnosed, so do not know they are HIV positive.
Myron S Cohen of the UNC Institute for Global Health and Infectious Diseases at Chapel Hill in North Carolina, said in a commentary in the Lancet on the study that it should push the world forward on a strategy to test and treat everyone who has HIV. But, he added, maximising the benefits of treatment, particularly for men who have sex with men, has proved difficult.
“It is not always easy for people to get tested for HIV or find access to care; in addition, fear, stigma, homophobia and other adverse social forces continue to compromise HIV treatment,” he said.
“Diagnosis of HIV infection is difficult in the early stages of infection when transmission is very efficient, and this limitation also compromises the treatment as prevention strategy.”
According to the National Aids Trust, 97% of people on HIV treatment in the UK have an undetectable level of the virus, meaning they cannot pass it on. “Hearing this can be enormously empowering and reassuring to people living with HIV,” said Deborah Gold, the trust’s chief executive.
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