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Partners of people on ART: a New Evaluation of the Risks

Andrew Philips, Alison Rodger and Fiona Lampe

A study in HIV discordant partnerships to estimate the rate of transmission of HIV and to investigate factors associated with condom use.

It is consistently reported that a proportion of people with diagnosed HIV do not always use a condom when having sexual intercourse with partners of negative or unknown HIV status. There are likely to be many reasons for this, and these reasons may have changed over time. It is important to study HIV sero-different partnerships (where one partner is HIV positive and the other HIV negative) that report having unprotected sex to understand the reasons why condoms are not used, and to see what factors are associated with partnerships beginning to adopt consistent condom use.

Increasingly, one reason for not using condoms is likely to be due to the person being on antiretroviral therapy with the plasma viral load being < 50 copies/mL, and statements on the likely reduced infectiousness of people in this situation have been issued. There is increasingly strong evidence that antiretroviral therapy (ART) reduces infectiousness of people with HIV. However, precise estimates of this risk of transmission from unprotected intercourse when the infected person is on ART with a low viral load are not available, particularly for men who have sex with men. It is extremely important that more precise estimates are obtained, both for counselling purposes, and for investigations into the potential prevention effects of a policy of expanding ART coverage to be offered to all people with diagnosed HIV.

The PARTNER study aims to follow sero-different partnerships who initially report recently having had unprotected sexual intercourse. It is an observational study that over two years will follow 1650 such partnerships. The study will include questionnaires on behaviour linked to clinical information on the HIV positive partner.

The aims are to understand:

(i) the risk of HIV transmission to partners, in particular in partnerships that continue not to use condoms consistently and the HIV-positive partner is on therapy with a viral load < 50 copies/mL

(ii) why some partnerships do not use condoms, and to describe the proportion who begin to adopt consistent condom use, and factors associated with this.

For further details see the PARTNER website:

http://www.cphiv.dk/PARTNER/tabid/406/Default.aspx

Page last modified on 15 feb 11 15:29