An HIV cell The New Zealand AIDS Foundation urging caution over a study which has found that an HIV-positive person who takes anti-retroviral drugs after diagnosis, rather than when their health declines, can cut the risk of spreading the virus to uninfected partners by 96 per cent. The United States National Institutes of Health sampled 1,763 heterosexual couples in which one partner was infected by HIV in a trial which was abandoned four years early because it was so successful and has been hailed as “a serious game changer” by Michel Sidibé, Executive Director of UNAIDS. The study began in 2005 at 13 sites across Africa, Asia and the Americas. The trial results exclude gay and bisexual men, who account for more than 75 percent of HIV diagnoses where HIV was contracted in New Zealand. Yet the results are the first from a major randomised clinical trial that show that treating an HIV-infected person can reduce the risk of sexual transmission of HIV to an uninfected heterosexual partner. HIV-positive patients were split into two groups. In one, individuals were immediately given a course of anti-retroviral drugs. The other group only received the treatment when their white blood cell count fell. Both were given counselling on safe sex practices, free condoms and treatment for sexually transmitted infections. Among those immediately starting anti-retroviral therapy there was only one case of transmission between partners. In the other group there were 27 HIV transmissions. NZAF Executive Director Shaun Robinson says "Internationally, 80 per cent of HIV is transmitted sexually, but in New Zealand that figure is much higher so we're very interested in these results. However, to begin treatment for HIV, a person has to have been diagnosed and getting an HIV test is the only way to do that. In New Zealand, a considerable number of people don't get tested for HIV until their infection is very advanced so testing would have to become a much higher priority if there's to be any chance of this approach being effective here." Most HIV testing in New Zealand occurs in GP offices. Since the NZAF introduced rapid testing, a free service that produces a result in ten minutes; there has been a 600 percent increase in the number of people being tested at NZAF regional centres. However, the number of New Zealanders from the communities most at risk of HIV being tested is still low. Asked by GayNZ.com if the study inferences are applicable to gay men the Foundation pointed out that HIV is much more easily transmissable through anal than vaginal sex. "We don’t know yet if the results can be achieved for gay and bisexual men. There is no certainty that the results would be the same for gay and bisexual men for reasons including the different biology of vaginal transmission compared to anal transmission." "We're excited by these results but realistic too," Robinson says. "It's much better not to get HIV at all, and the most effective way to prevent HIV is to use condoms and lube when you're having sex. However, these results suggest that early HIV testing and treatment will strengthen our response to the HIV epidemic."
Credit: GayNZ.com Daily News staff
First published: Friday, 13th May 2011 - 12:37pm