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Treatment Guidelines -including when to start


HIV undetectable does equal uninfectious: the Swiss Statement and the vindication of Pietro Vernazza

Friday, 28 October 2016 Written by // Guest Authors - Revolving Door Categories // Social Media, As Prevention , Treatment Guidelines -including when to start, Research, Health, International , Treatment, Revolving Door, Guest Authors

This is the story of how the Swiss Statement went from policy pariah to documented fact. And it is the story of the vindication of Pietro Vernazza.

HIV undetectable does equal uninfectious: the Swiss Statement and the vindication of Pietro Vernazza

This article by Heather Boerner previously appeared at, here.

On Jan. 30, 2008, Pietro Vernazza, M.D., was on vacation with his wife, Eva, in the Swiss Alps when his phone rang. It rang again when they got back to their hotel room, and then again the next day. The whole week was taken up with one call after another. When he returned home a few days later, he appeared on Swiss national radio. Days after that, he began what turned into a worldwide tour of public health and professional organizations. By October, he was at the U.S. Centers for Disease Control and Prevention (CDC), answering the same questions he'd been answering for nearly a year: What were you thinking? How could you say that? Where's the data?

What he'd said, in a statement in the Bulletin of Swiss Medicine, was this: If you're a person living with HIV on consistent antiretroviral treatment (ART), if your viral load has been undetectable for at least six months, if continuing testing shows that your viral load continues to be undetectable, and if you don't have other sexually transmitted infections (STIs), you don't need to use condoms during sex. You cannot, the statement said, pass on HIV.

This was the Swiss Statement, a public policy salvo lobbed into the heart of the HIV world -- one that prompted a swift and intense backlash. People called it premature. People accused Vernazza of getting ahead of the science. Some demanded he produce data to prove there had been no transmissions. Others simply called him irresponsible. But it's not 2008 anymore.

"The Swiss Statement, when it first came out, I thought it was outrageous," said Seth Kalichman, Ph.D., an HIV researcher at the University of Connecticut. "The Swiss Statement isn't outrageous anymore."

Indeed, nearly nine years later, it's more than a statement. It's a fact, backed up by gold-standard studies released at the Conference on Retroviruses and Opportunistic Infections (CROI) and the International AIDS Conference (IAC).

To read the rest of this article, go to, here.

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