God, AIDS, Africa & HOPE

Reflections / Gedanken

Treatment, Viral Load and (un-)protected sex

Since the early days of treatment there are questions about treatment being a cornerstone of prevention. What does it really mean to be “undetectable” – how much does this translate into being not infectious? Is there a difference between heterosexual and homosexual encounters in this context? Or more precise: Is there a difference when it comes to anal sex versus vaginal intercourse? Is the amount of virus particles in the blood and semen or vaginal fluid the same?  What is the risk by not using a condom, if somebody is on treatment and the viral load is undetectable? What does it mean to have one permanent partner versus several partners? There are so many questions and one hears so many different answers and it seems the debate is ongoing. The Body.com has tried to bring together all the information about these questions and it makes an interesting reading. To read their findings please click here.

Filed under: HIV and AIDS, HIV Prevention, HIV Treatment, Uncategorized, , , , , , , ,

Mortality of people with HIV compared to non-infected peers

The eternal question of people being infected or just getting their positive test result is: How long do I have to live? Does it make sense to continue living as if there is a future ahead? HIV-positive people taking antiretroviral therapy who have an undetectable viral load and a CD4 cell count above 500 cells/mm3 have a mortality risk comparable to that seen in the general population, investigators report in the online edition of AIDS. Researchers looked at mortality rates among participants enrolled in two large, randomized controlled trials – the SMART and ESPRIT studies. “We identified no evidence for a raised risk of death compared with the general population in HIV-infected people on ART with an undetectable viral load, who maintained or had recovery of CD+ T-counts to at least 500 cells/mm3,” write the authors. There have been significant improvements in HIV treatment and care in recent years. Anti-retroviral therapy has become more powerful, less toxic and easier to take. Data from cohort studies suggests that people doing well on treatment – often defined as the maintenance of an undetectable viral load and a CD4 cell count above 500 cells/mm3 – have a life expectancy similar to that of age- and sex-matched HIV-negative individuals.
The whole article which was published via NAM’s aidsmap you can read here.

Filed under: HIV and AIDS, HIV Treatment, Medical and Research, , , , , , , , , , , , , , , , ,

HIV transmission and questions around it…

HIV Particle

HIV Particle (Photo credit: AJC1)

Even in a world where all information about HIV is out in the public there are still questions around transmission and viral load of people living with HIV. Especially when it comes to couples with one being positive and the other negative  these questions arise. In our South African context where there is a whole generation with many people being born and living with the virus, those questions are essential to be asked and answered properly.
Questions like:

* What is exactly viral load and how is it affected by HIV Treatment?
* What is a normal “viral load”?
* What does it mean to have an “undetectable” blood viral load?
* Is the viral load in the blood associated with a person’s risk of transmitting HIV?
* Does HIV treatment reduce the risk of sexual transmission of HIV?
* Is HIV transmission possible when the viral load in the blood is undetectable?
* What is the risk of HIV transmission when the blood viral load is undetectable?
* What does this all mean for people who want to use HIV treatment to prevent HIV transmission

The Body published an article from the Canadian AIDS Treatment Information Exchange Project on all these questions and it is worth reading for those interested. Click here to read the article.

Filed under: HIV and AIDS, HIV Prevention, HIV Treatment, Medical and Research, , , , , , , , , , , ,

Significant Court Case in Canada relating to disclosure

English: Statue of Justicia (Justice), by Walt...The Supreme Court of Canada ruled that people living with HIV do not need to disclose their status to partners before intercourse, provided they have a low viral load and a condom is used. The decision, issued early October, addresses two cases heard by the court in February 2012 regarding a 1998 ruling concluding that people living with HIV who fail to

their HIV status to sex partners can be charged with aggravated sexual assault. Prosecutors from the two provinces where the cases originated, Manitoba and Quebec, petitioned the court to rule that all HIV-positive people should be legally compelled to tell their sex partners, regardless of the risk reduction associated with condom use and effective HIV treatment. The court disagreed with the prosecution. To read more about the case go here.

Filed under: HIV and AIDS, HIV Prevention, Politics and Society, Society and living environment, Uncategorized, , , , , , , , ,

New research supports EKAF statement for MSM

Viral load in the blood and rectal secretions of HIV-positive gay men are highly correlated, according to US research published in the September 1st edition of the Journal of Infectious Diseases. The study also showed that the presence of sexually transmitted infections did not increase rectal viral load. Individuals with a plasma viral load above 1000 copies/ml were significantly more likely to have detectable virus in the rectum.  “Our data add substantially to the few published studies of HIV shedding in rectal secretions of MSM [men who have sex with men],” comment the investigators, “we were able to quantify HIV RNA in rectal secretions, demonstrate the linear correlation between increasing plasma load and rectal viral load and determine a threshold plasma viral load that distinguished detectable from undetectable rectal viral load.” They also believe that their findings have important implications for current debates about the use of HIV treatment as prevention, commenting: “Combination antiretroviral therapy will have a similar effect on reducing HIV transmission in MSM, as seen in studies of heterosexual discordant couples.”
Read more:

English: http://www.aidsmap.com/Plasma-and-rectal-viral-load-correlated-in-HIV-positive-gay-men-supports-use-of-treatment-as-prevention/page/2063383

German: http://news.aids.ch/article.php?subID=12023&key=0&start=0&categorie=Wow!#12023

Filed under: HIV and AIDS, HIV Prevention, HIV Treatment, Medical and Research, , , , , , , , , , ,

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