AMSTERDAM – After detailing the results of what is likely to be one of the final studies launched to show that effective antiretroviral treatment for HIV renders the virus virtually untransmittable through sex, Dr. Allison Rodger summed up the findings PARTNER 2 here today:
“You would have to have condomless sex for 419 years to have transmission,” she said. “The risk is effectively zero. U equals U.”
While effectively echoing earlier findings from the PARTNER study of both heterosexual and gay couples that had shown virally suppressed people living with HIV do not sexually transmit the virus to their partners (that an undetectable virus equals an untransmittable virus), PARTNER 2 solely followed gay male sero-discordant couples having condomless sex. Partner 2 also further validated findings from Opposites Attract, an Australian study of gay male couples that found nearly 17,000 acts of anal sex without a condom did not lead to a single transmission of the virus from a virally suppressed person to his uninfected partner. The PARTNER 2 study examined outcomes, from 2010 to 2017, including genetic information identifying viral strains, among 922 gay male couples and found zero transmissions following about 75,000 condomless sex acts. All of the infected partners were on treatment that suppressed their viruses. None of the uninfected partners used either pre-exposure prophylaxis antiretroviral drugs — PrEP — or post-exposure prophylaxis — PEP. Of 17 infections that did occur over the course of the study all were proven to be unconnected to the virally suppressed partner in the relationship.
Bruce Richman, founder of the Prevention Access Campaign that has worked to promote the “U = U” message that an undetectable virus is not sexually transmittable — a message that has ramifications for treatment expansion and retention, as well as for HIV-exposure criminal laws — got the chance to ask the last question today. What would Dr. Rodger tell clinicians who still hesitate to tell patients that if they are on effective treatment that suppresses their virus, they do not have to worry about sexually transmitting the virus to others, he asked.
“That the time for excuses is over,” Dr. Rodger said briskly, “It’s very clear the risk for infection is zero.”