Considers the reliability of viral load as a condition preventing HIV transmission. Found reliability is high with compliance taking medication the most important factor predicting reliability.
Sexual transmission of HIV according to viral load and antiretroviral therapy: systematic review and meta-analysis
Review and meta-analysis of 11 articles found no HIV transmission among heterosexual discordant couples when the positive patient was treated with ART and had a viral load below 400 copies (with data compatible with one transmission per 79 years).
Treating HIV-infected people with antiretrovirals significantly reduces transmission to partners: Findings result from NIH-funded international study
Describes findings of the HPTN 052 study: that early initiation of antiretroviral therapy reduced rates of sexual transmission of HIV-1 and clinical events, indicating both personal and public health benefits from such therapy.
Prevention of HIV-1 Infection with Early Antiretroviral Therapy
Reports findings of OPTN 052 study based in nine countries, which found early initiation of antiretroviral therapy reduced rates of sexual transmission of HIV-1 and clinical events, indicating both personal and public health benefits from such therapy.
Heterosexual HIV-1 infectiousness and antiretroviral use: systematic review of prospective studies of discordant couples
Systemic review and meta-analysis of 50 studies considered HIV transmission risk between heterosexual partners. Found ART substantially reduces HIV infection risk within serodiscordant couples.
Systematic Review of HIV Transmission between Heterosexual Serodiscordant Couples where the HIV-Positive Partner Is Fully Suppressed on Antiretroviral Therapy
Meta-analysis suggests minimal risk of sexual HIV transmission for heterosexual serodiscordant couples when the HIV-positive partner has full viral suppression on cART with caveats regarding information on sexual intercourse type, STIs, and condom use.
The effect of sexually transmitted co-infections on HIV viral load amongst individuals on antiretroviral therapy: a systematic review and meta-analysis
Analyses 14 studies to find evidence about the effects of STI co-infection on transmission from individuals on ART is very limited. Available data suggests the average effect of STI co-infection on HIV viral load in individuals on ART is unlikely to decrease the effectiveness of treatment as prevention. However, limited data precluded ruling out the possibility that particular STIs pose a larger threat.
HIV Transmission in Male Serodiscordant Couples in Australia, Thailand and Brazil
Reports an interim analysis of the relationship between undetectable viral load and HIV transmission in the Opposites Attract observational cohort study of homosexual male serodiscordant couples in Australia. Finds no linked HIV transmissions in 150 ‘couple years of follow up’ among homosexual male serodiscordant couples, despite close to six thousand acts of condomless anal sex.
Sexual activity without condoms and risk of HIV transmission in serodifferent couples when the HIV-positive partner is using suppressive antiretroviral therapy
Reports findings of European prospective, observational (PARTNER) study to evaluate the rate of within-couple HIV transmission (heterosexual and men who have sex with men) during periods of sex without condoms when the HIV-positive partner had HIV-1 RNA load less than 200 copies/mL. Found no transmission after 1.3 years.
High rates of forward transmission events after acute/early HIV-1 infection
Uses a population-based phylogenetic approach to characterize HIV transmission dynamics in Quebec. Found early infection accounts for approximately half of onward transmissions. Suggests therapy at early stages of disease may prevent onward HIV transmission.