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Human Rights Campaign And The American Medical Association Agree For The First Time In Mainstream News: Hiv Poz-Undetectable Are Not A Threat


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I'm sure most of you know about the PARTNER study that started a few years ago. If you know about it, the results won't be a big surprise for many. However, something HUGE happened and it's been making the news this week (including very mainstream media like TIME, NBC/CBS, Reuters). I didn't see a post about this yet so I thought I'd share this development.

 

The high profile Journal of the American Medical Association recently reviewed new results from the PARTNER study, and for the first time, they not only published but also endorsed the findings and published the entire article for free! If anyone knows the AMA Journal, you know that this is way more than a stamp of approval. The fact that they published it widely "reflects the importance that the results have the widest possible access".

 

A day later, the Human Right Campaign issued a statement to highlight the study. And there are talks for the CDC to update their directives and guidelines about undetectable viral loads, prevention and safe sex. Finally, organizations are already hoping that this publication will give new blood to fight back against HIV stigma and the criminalization of poz partners in unfair legal cases.

 

So with this, here are some of the headlines seen by millions starting this week! I have to admit it's refreshing and encouraging to see how the public opinion may slowly change as more and more of these studies get in the open. Seeing it on FOX News is kinda nice. And I'm sure more will be published on LGBT / medical sites in the coming weeks. It's time to end HIV stigma!

 

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Reuters/NBC: HIV patients with undetectable virus unlikely to infect partner

 

TIME: These Drugs Stop the Spread of HIV Even Without Condoms

 

LA Times: Safe sex without condoms? With drugs keeping HIV in check, infected partners didn't spread virus

 

Human Right Campaign: Findings Show No New Transmissions Between HIV-Negative Partners & People with HIV on Treatment

 

even Fox News: Antiretroviral therapy prevents HIV transmission during unprotected sex

 

and my favorite, from Attitude UK: Gay men, it's time to educate yourselves about what HIV-positive and undetectable means

 

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Finally, here are some interesting explanations about what it all means this week, quickly put together by TheBody. Hope you find these updates interesting!

 

What are the implications of the results?
 

The lack of HIV transmissions should challenge the wrongly held common assumption that there is always a risk just because someone is HIV positive.

 

The results actually go further. The lack of transmission challenges scientists to prove that transmission is actually possible when viral load is undetectable.

 

The PARTNER study -- as with other studies -- suggests that there is likely to be a level of viral load where HIV transmission does not take occur. PARTNER suggests this might be at 50 copies/mL, or at 200 copies/mL or perhaps even higher.

 

 

How will people benefit from these results?
 
HIV positive people can become less anxious and concerned that they are a risk to their partners whenever they have sex. This can still be a worry, even when using condoms.
 
HIV negative people can be less anxious about risk. Even when using condoms, this residual risk can limit full enjoyment of sex.
Less anxiety and fear can help with closer communication and better sex. For many people, a good sex life is an important and essential part of life.
 
Some people might enjoy not using condoms in a way that wasn't possible when they still worried about HIV.
 
Sero-different couples who want to have children can conceive from just having sex without the need for additional PrEP.
 
Reducing fear about HIV transmission might reduce the stigma and rejection HIV positive people encounter when meeting new partners.
 
Legal cases where HIV is used because of a theoretical rather than actual risk will hopefully become more rare. The results might enable some people to launch an appeal.
 
US activist Sean Strub from the SERO project (www.seroproject.com) said in response: "Hundreds of people living with HIV in the U.S. have been charged with criminal offences for the perceived or potential risk of HIV exposure or transmission. Some are serving or have served long prison sentences for spitting, scratching or biting and others for not being able to prove they had disclosed their HIV positive status before having sexual contact (even in the absence of any risk of HIV transmission). HIV criminalisation has created a viral underclass in the law, further burdening a disenfranchised community, putting a disproportionate share of the shared responsibility for preventing sexually-transmitted infections on one party, and discouraging people at risk from getting tested for HIV."
 

 

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Edited by jtonic
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Certainly when the PARTNER study began their definition of undetectable VL was <200, which was the usual treatment definition. As improvements were made to analysis of blood samples, the definition dropped to between 20 and 70 (depending on where you are in the UK), with the commonest threshhold being 50. I don't know if the PARTNER study moved the goalposts in accordance with clinical improvements (I've was on the nevirapine where the protocols were re-written to allow for the use of the newly released protease inhibitors). Whether or not the PARTNER protocols were altered, this, together with the START study (don't wait for CD4 levels to drop: start immediately), are what we've felt in our guts for some time and our feelings are now vindicated.

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