SEARCH
= Paid-up subscribersRisk of HIV transmission from MSM undergoing treatment
21 Feb 2011
There is a one in five risk of men who have sex with men (MSM) being treated for HIV passing on the infection to their male partners if they do not use condoms. Using data from a cohort of MSM in the Netherlands, researchers used mathematical modelling to predict the probability that a man will infect his uninfected male partner over the course of first-line antiretroviral treatment. Three clinical situations were used: viral suppression achieved with good adherence to treatment; suppression achieved but adherence poor; suppression not achieved.'There are two very important messages: condoms remain the best way to reduce the risk of HIV transmission but their efficacy is not 100%; and risk of HIV transmission reduces with more frequent monitoring as this guards against risk of viral load increasing since the last measurement, i.e. decisions on condom use can be made based on a recent viral load measurement taken three months before rather than six months or longer. This paper provides a good rationale for any practitioner who sees MSM who are HIV positive and ask about risk of transmission to their uninfected male partners. They should always use a condom regardless of viral load and get the viral load checked regularly at their HIV clinic.'
This article can only be accessed if you are a registered user of thepractitioner.co.uk or a subscriber to The Practitioner.