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Experts Say Positive People on Effective HIV Meds Aren't Sexually Infectious

January 30, 2008

The Swiss Federal Commission for HIV/AIDS has issued the first-ever consensus statement saying that HIV-positive people who are effectively on antiretroviral therapy, and who do not have any other sexually transmitted infections (STIs), cannot transmit HIV during sex, reports Aidsmap.com (aidsmap.com, 1/30).

The statement, issued by four Swiss HIV experts, is published in this week’s Bulletin of Swiss Medicine. According to the announcement, “an HIV-infected person on antiretroviral therapy with completely suppressed viraemia (“effective ART”) is not sexually infectious, i.e. cannot transmit HIV through sexual contact.”

The commission says that this statement is valid so long as the following criteria are met: the person adheres to antiretroviral therapy that is evaluated regularly by his or her physician; the person’s viral load has been suppressed (<40 copies/ml) for a minimum of six months; and the person does not have any other sexually transmitted infections.

The commission’s article in the Bulletin begins by stating that the commission “realizes that medical and biologic data available today do not permit proof that HIV infection during effective antiretroviral therapy is impossible, because the non-occurrence of an improbable event cannot be proven… The situation is analogous to 1986, when the statement ‘HIV cannot be transmitted by kissing’ was publicized. This statement has not been proven, but after 20 years’ experience its accuracy appears highly plausible.”

The commission says it “is not for the time being considering recommendations that HIV-positive individuals start treatment purely for preventative measures.” It also says that it is not advocating a change in current HIV prevention strategies in Switzerland. However, it does state that an HIV-positive person in a stable relationship with a person who does not have HIV, who adheres to their antiretroviral treatment and does not have an STI is “not putting their partner at risk of transmission by sexual contact.”

View CDC's response.