This article by Julie Musonda was originally published in Baseline (Life with HIV and Hepatitis) here.
The debate about the infectiousness of people living with HIV has been raging for a few years now. The first to put their heads above the parapet were the Swiss National AIDS Commission (EKAF) who published The Swiss Statement back in 2008. This highlighted that the risk of HIV infection between sero-discordant, monogamous heterosexuals is negligible if HAART is taken consistently, viral load has been undetectable for at least 6 months, neither partner has any sexually transmitted infections and both partners are counseled and the negative partner is well informed about the risks and provides consent.
Now the debate has taken been propelled further forward with the publication of the HPTN 052 study. This included 1,763 HIV sero-discordant (mainly heterosexual) couples across 13 sites in nine countries in Asia, Africa and the USA. The results published in May last year show that antiretroviral treatment taken early in the course of HIV infection reduces the risk of the sexual transmission of HIV to an uninfected partner by 96%. To put this in perspective; this is greater than the protection afforded by condoms.
The overwhelming majority of positive people will attest that we do not, under any circumstances, want to pass the virus on to anyone else and will do whatever is necessary to prevent the onward transmission of HIV, while at the same time protecting ourselves from acquiring other sexually transmitted infections.
As a positive person it’s not that I want to go out roaming the streets and having unprotected sex with the whole of the local rugby club, as I certainly do not.
But to me, the results of HPTN 052 mean my partner and I have choices; informed choices about the kind of sex we have, choices that we should make as a couple and with the help of the specialist team that take care of me.
So why I ask is the information supplied by the health agencies different in every country in the EEA? The knowledge is shared, the HIV conferences are worldwide and topics such as prevention, treatment and transmission are hotly debated. All I am asking for is a uniform opinion of the risk!
I don’t ever want to pass on HIV. However, If I were single I would like to know that should I meet someone, who I feel is important enough to me to be involved in my life, potentially become a sexual partner, that I can give them clear information for us to make a shared decision that does not leave me worrying myself stupid about accidentally infecting them!
Also, in my view, the ability of HIV discordant couples to conceive naturally is now a distinct reality, not only saving them the heartache and the costs of fertility treatment but also handing them back the pleasure of reproduction!
Maybe, just maybe, the general public will begin to see that HIV is a long-term health condition and not a time bomb of infectiousness and leave us alone to lead our lives without fear of retribution, stigma or discrimination!
After all, I just want to feel ‘normal’!