New study: No-one undetectable, gay or heterosexual, transmits HIV in 2 year study

[wood]

http://www.aidsmap.com/No-one-with-an-undetectable-viral-load-gay-or-heterosexual-transmits-HIV-in-first-two-years-of-PARTNER-study/page/2832748/

The second large study to look at whether people with HIV become non-infectious if they are on antiretroviral therapy (ART) has found no cases where someone with a viral load under 200 copies/ml transmitted HIV, either by anal or vaginal sex.

Statistical analysis shows that the maximum likely chance of transmission via anal sex from someone on successful HIV treatment was 1% a year for any anal sex and 4% for anal sex with ejaculation where the HIV-negative partner was receptive; but the true likelihood is probably much nearer to zero than this.

When asked what the study tells us about the chance of someone with an undetectable viral load transmitting HIV, presenter Alison Rodger said: "Our best estimate is it's zero."

This is really great news. For a while now we have known about studies regarding transmission between heterosexual couples with vaginal intercourse, but the we didn't have the data on gay couple and anal intercourse. This looks to prove that treatment is extremely effective in preventing transmission.

What this also means is that public health officials need to make sure people get on treatment immediately, and people get tested often. It really does seem like immediate treatment, and PrEP are much more of an answer to ending the epidemic than condoms and abstinence have been.

[TigerMilner]

I read this today and thought it was great documentation. Thanks for posting.

[Bttm2go]

Great info. Thanks for posting.

[pisces bearcub]

That is great news for those who want to bareback, but aren't chasing. Of course, there are other STIs that you have to watch for, but there is always a risk to everything in life.

[pjaco]

Thanks for the posting. It is interesting and to bear in mind.

[Poz1956]

Lets be careful here. Way too many people will just read the headline, and the quote "Our best estimate is it's zero."

The European based Partner study is following a large number of couples in mixed HIV status relationships. We sometimes get cutesy and call them Magnetic couples, because it's a relationship where one person is HIV Positive and the other is HIV Negative. The medical terms used to describe them are Serodiscordant or Serodivergent. The study includes both gay and straight couples. Before this study there was very little research of HIV in gay relationships or anal sex, and none with enough data to draw statistically significant conclusions. All of the Pozzies in the Partner study have an undetectable viral load.

NONE of the HIV Negative partners contracted HIV from their Poz partner, in the first two years of the study. With an estimated 16,000 gay guy bareback fucks (and 14,000 straight ones), ZERO Negative partners caught HIV from their Positive spouse. Including the straight couples, with a cumulative 894 Years of couple following up, there was not a single transmission from the Poz mate.

Based on the number, and type of sex acts, had the Pozzies not been under treatment, the researches would have expected 86 (30%) of the neg partners to catch HIV.

BUT

Before we celebrate that as a carte blanche in BBing with neg guys, they are about 95% certain -- their "best guess" is we are 0% likely to transmit. They don't have enough data to get that certainty higher, especially for Poz top cum dumping in a Neg bottom. The outside edge of that statistical certainty means, there is a 32% chance of the Neg bottom becoming Poz withing 10 years. They need 450 more European gay serodivergent couples, and study until 2017 to get that certainty higher. They will probably Never be able to say absolutely zero chance.

Here is a link to hear the presentation at CROI 2014, see the slides, and listen to the Q&A afterwards (Conference on Retroviruses and Opportunistic Infections)

There is lots of neat tidbits to pull out of the data. I'm only referring to the gay couples here.

30% of the neg guys only topped. Obviously some are total tops. I'd bet some are seropositioning.

The other 70% got fucked. Obviously some total bottoms and some vers

Only 40% of the bottoms took loads, so 30% were probably practising "Cum on me, not in me"

34% of the couples played with more than just each other, and BB'd with those other guys too. I wonder if that was mostly 3-ways, group parties, or open relationships?

16% of both the Neg and Poz guys got other STI's -- that's almost half of the guys played outside the relationship

The gay guys were followed for a shorter period of time than the straight couples (1.1 years vs 1.5 years) but had a lot more sex than the hetros (16,400 vs 1,400)

Some of the Neg guys did become Poz, but phylogenetic analysis of the virus proved they did not get it from their Poz partner. They caught it from other guys they played with. They're keeping that number under cover until the end of the study.

Interesting data. But it does gives us pozzies hope. And when the study is finished it will give us BIG GUN ammunition to fight back against the Stigma.

There is a certain irony in the fact us undetectable Poz guys, who the neggies are most afraid of, are probably going to turn out to be the ones least likely to infect them! Our status is 100% known verses, all the "think they're neg" guys. Many of them don't test regularly, if ever. Those "Clean U B 2" guys, who aren't so clean, and are newly infected have viral loads in the Millions (Had a recent conversation with a newly diagnosed guys who's VL was 9,700,000 - and that's not unusal.) Those "D & D Free" guys, who really aren't "D Free" and have moved into the chronic phase of infection, have viral loads generally in the 60,000 to 120,000 range. Combined, those two groups of guys who are Poz, but don't know they are Poz, are responsible for over 85% of new transmissions

Compare those viral load numbers to the undetectable Pozzie with a viral load less than 40!

Stop the Stigma!

Edited March 9, 2014 by Poz1956

[Poz1956]

Sorry - Typo and I didn't catch it before the allowed editing time was up.

The straights weren't quite the fuck bunnies we gay guys were, but the typo was an order of magnitude too low.

The gay guys were followed for a shorter period of time than the straight couples (1.1 years vs 1.5 years) but had a lot more sex than the hetros (16,400 vs 14,000)

[JXC]

great post and very interesting article

[Poz1956]

I have to correct myself again. The estimated number of sex acts for the straight Neg males and Ned females was the same. I neglected to add them together.

The straights fooled around an estimated total of 28,000 times. But there were 1.7 times as many straight couples in the study.

So the total estimated number of sex with no transmissions was 44,400. That's one really big bucked of Jiz. Makes Treasure Island's "The 1,000 Load Fuck" look tame by comparison.

Even with that correction, the gay guys played more times per couple than the straight ones.

[Guest pozbtm1967]

Interesting... I posted this article about a week ago... hmm... but, that's ok, the more the information is out, the better it is!