HIV transmission among gay partners may be prevented using medication, finds new study

By Dr. Ananya Mandal, MDJul 26 2017

One of the largest studies undertaken has explored the risk of transmitting HIV infection by an HIV infected partner to his non-infected gay partner. Results reveal that HIV positive men who are on medication for HIV that makes their virus load undetectable in blood are not likely to transmit the infection to their non-infected partners.

The study entitled Opposites Attract from Kirby Institute was presented at the IAS Conference on HIV Science in Paris this week. For this study 358 gay couples were studied over a period of four years – 2012-16 and the researchers found couples reporting over 17 thousand acts of anal intercourse without the use of a condom. One of the partners was HIV positive while the other was not. None of the acts of intercourse led to transmission of the HIV infection found the study. The particpants were included from Thailand, Brazil and Australia.

Professor Andrew Grulich from the Kirby Institute and chief investigator of this study said that medications rendered the virus load among the infected partners to be undetectable in blood. Once this is achieved, the risk of transmission can be prevented he explained. According to Grulich, this is the first study of its kind to show that these results hold true in both high and middle income country populations. He said that the team could say “with confidence, that effectively treated HIV blocks transmission in couples of differing HIV status”.

Grulich called this study “revolutionary” for gay men. But he added in the same breath the HIV positive partner should ensure that they are under continuous and regular medical care and do not miss any of their anti-retroviral medications. At any cost, their undetectable viral load should be maintained. Grulich said that there have been smaller studies and incidental reports in the past saying that there is little risk of HIV transmission from an infected partner to a non-infected partner if the viral load is controlled.
Professor Grulich thanked the couples who took part in the study as well as the study partners from Evandro Chagas Clinical Research Institute, Fiocruz in Brazil and the Thai Red Cross in Thailand who made the international representation of participants a reality. The study was mostly funded by National Health and Medical Research Council (NHMRC) and Foundation for AIDS Research (amfAR), ViiV and Gilead.

HIV infection and its transmission

HIV infection is a contagious disease and can be transmitted from person to person and leads to fatal AIDS. AIDS leads to severe depression of the immune system that ultimately causes death.

The virus – HIV, is found in all the body fluids including saliva, nervous system tissue and spinal fluid, blood, semen, pre-seminal fluid (which is the liquid that comes out before ejaculation), vaginal secretions, secretions from the anus or anal lining walls, tears and breast milk. Only blood, semen, and breast milk have been shown to transmit infection to others. The virus does not spread via air like flu.

Methods of HIV transmission include exchange of body fluids. Having unprotected or condom-less vaginal, oral and anal sex especially with high risk groups like those who are injection drug abusers or are likely to have HIV infection may lead to transmission. Sharing needles for injections with other drug users and patients who are likely to be HIV positive, sharing sex toys or tattoo or piecing needles, infection passed from infected mother to the baby before or during birth or through breast milk are all mediums of HIV transmission. Getting blood from an infected individual or organ transplants from an infected person or getting a surgery with contaminated needles and instruments can also lead to HIV transmission.

1. https://www.news-medical.net/health/AIDS-Transmission.aspx
2. https://www.cdc.gov/hiv/basics/transmission.html
3. http://www.nhs.uk/conditions/HIV/Pages/Introduction.aspx
4. https://kirby.unsw.edu.au/news/effective-hiv-treatment-halts-hiv-transmission-among-homosexual-couples-study-finds