Lifelong AIDS Alliance endorses the following statement from the San Francisco AIDS Foundation and the San Francisco Department of Health. We continue to advise the use of condoms to prevent the transmission of HIV in serodiscordant partnerships.

SFAF/SFDPH Statement on the Swiss Natl. AIDS Commission's Report on HIV Transmission

There are nearly 1,000 new HIV infections in San Francisco and an estimated 40,000 to 60,000 new infections nationally every year. The San Francisco AIDS Foundation and San Francisco Department of Public Health urge individuals living with or without HIV infection to continue to use appropriate HIV prevention measures, specifically, to use male latex condoms correctly and consistently during sex. A recent Swiss AIDS Commission report demonstrating that, in some cases, HIV-positive partners did not transmit the virus to their partners in the absence of condoms, is insufficient evidence to abandon safer sex practices for several reasons.

The report reviewed data from four studies conducted among heterosexual couples alone. One, involving 393 serodiscordant couples, found that as long as the HIV-positive partner adhered to a treatment regimen, had an undetectable viral load for at least six months, and did not suffer from any other sexually transmitted infections, the HIV-negative partner did not become infected. But another study that was part of the same report found that 6 out of 43 HIV-negative partners did become infected—a rate of nearly 14%—due to the fact that the HIV-positive partner was not always faithful to a treatment regimen.

Neither the San Francisco AIDS Foundation nor the Department of Health endorses the Swiss AIDS Commission statement, because:

o all of the studies involved heterosexual intercourse and may have little bearing on intercourse among men who have sex with men;

o HIV-positive people with apparently undetectable viral loads can experience occasional spikes in viral load;

o HIV-positive people who carefully follow their treatment regimen may develop viral resistance;

o people with other sexually transmitted infections can be asymptomatic yet still capable of transmitting or contracting HIV; and

o the Swiss report, since it did not use randomized, controlled studies, has not yet verified its causal conclusions.

Even the Swiss commission acknowledges that the data they reviewed do not assume a total absence of risk. In short, HIV-positive people cannot be entirely certain that they meet these criteria or that the criteria themselves are an indication of safety. The San Francisco AIDS Foundation and Department of Public Health advise everyone to continue to use appropriate, evidence-based measures to prevent sexual HIV transmission."