TREATMENT AS PREVENTION

shield reducing the risk

Reducing the risk of HIV transmission

Antiretroviral therapy (ART) has the potential to lower HIV incidence at the population level and to decrease prevalence by preventing secondary transmission of HIV. In 3 studies, including the PARTNER study, there were no documented cases of transmission between someone who was virally suppressed and their partner who was HIV negative, even after reporting unprotected sex.1-4

Reduce the risk, undetectable = effectively no risk

According to the CDC

Undetectable viral load = effectively no risk of HIV transmission3

The sooner viral suppression is achieved, the shorter the period during which transmission can occur. Modelling studies indicate that incidence and prevalence of HIV on a community or population level might be lowered by expanded use of ART.2

What your patients need to know about treatment as prevention1,3,5

1-6 months is the time required to achieve an undetectable viral load

6 months (from the first undetectable test result) is the time required to maintain an undetectable viral load

If a patient achieves and maintains an undetectable viral load, there is effectively no risk of transmitting HIV

Adapted from NIAID.

So, the idea is that with [the patient’s] antiretroviral regimen and good adherence, they can maintain viral suppression, therefore reducing their risk of transmission."

–Derrick Butler, MD

REFERENCES:

  1. US Department of Health and Human Services. Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in adults and adolescents living with HIV. https://aidsinfo.nih.gov/contentfiles/adultandadolescentgl.pdf. Updated May 30, 2018. Accessed June 4, 2018.
  2. Granich RM, Gilks CF, Dye C, De Cock KM, Williams BG. Universal voluntary HIV testing with immediate antiretroviral therapy as a strategy for elimination of HIV transmission: a mathematical model. Lancet. 2009;373(9657):48-57.
  3. Centers for Disease Control and Prevention. Dear colleague. Information from CDC’s Division of HIV/AIDS Prevention. https://www.cdc.gov/hiv/library/dcl/dcl/092717.html. Accessed April 30, 2018.
  4. Rodger AJ, Cambiano V, Bruun T, et al. Sexual activity without condoms and risk of HIV transmission in serodifferent couples when the HIV-positive partner is using suppressive antiretroviral therapy. JAMA. 2016;316(2):171-181.
  5. Prevention Access Campaign. Consensus statement. Risk of sexual transmission of HIV from a person living with HIV who has an undetectable viral load. Messaging primer & consensus statement. https://www.preventionaccess.org/consensus. Accessed May 1, 2018.