HIV Transmission Risk Small With Antiretroviral Compliance

MONDAY, Nov. 19, 2018 — The risk for sexual transmission of HIV is negligible when an HIV-positive sex partner adheres to antiretroviral therapy and maintains viral suppression, according to research published in the November issue of CMAJ, the journal of the Canadian Medical Association.

Jennifer LeMessurier, M.D., M.P.H., from the University of Ottawa in Canada, and colleagues conducted an overview and systematic review update to examine the risk for sexual transmission of HIV between serodiscordant partners. HIV incidence was calculated per 100 person-years in 12 reviews.

The researchers found that based on one review, HIV transmission risk for condom use without antiretroviral therapy was estimated at 1.14 transmissions/100 person-years (95 percent confidence interval, 0.56 to 2.04). There were 23 transmissions over 10,511 person-years with antiretroviral therapy (0.22 transmissions/100 person-years; 95 percent confidence interval, 0.14 to 0.33) in 11 studies. With antiretroviral therapy and a viral load of less than 200 copies/mL across consecutive measurements four to six months apart, there were no transmissions (0.00 transmissions/100 person-years, regardless of condom use; 95 percent confidence interval, 0.00 to 0.28).

“These findings will support individual patient and clinician decision-making, and will have implications for public health case management and contact tracing,” the authors write. “The Department of Justice Canada used these findings to inform their 2017 report on the justice system’s response to HIV nondisclosure, and they may inform the responses of other justice systems.”

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Posted: November 2018

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