No Viral Load=No Transmission? by Laura Whitehorn

In January, the Swiss Federal Commission for HIV said what many HIV-positive people have been saying—or hoping—for a long time: that positive people whose viral load has been consistently undetectable and who don’t have another sexually transmitted infection (STI) are not “sexually infectious.” Bernard Hirschel, MD, says he and others issued the statement to protect people with HIV. Some positive people, he points out, are prosecuted for potentially transmitting HIV even though “no virus [means] no transmission.” So couples in long-term, monogamous relationships may be able to forgo condoms if certain conditions are met.These include: The positive partner sticks to HIV meds and is consistently monitored (twice a year or more), has been undetectable for at least six months, and has no other current STIs (which could cause genital sores, inflammation and an HIV viral-load spike). It’s worth noting that the Swiss statement was based on studies of heterosexual couples. Monogamy is emphasized not only because increasing sex partners increases risk. In one study, the immune systems of long-term positive couples seemed to recognize and protect against their partner’s HIV strain.Some positive people added their own testimonies that undetectable means noninfectious (to see their comments and add your own, search “not sexually infectious” at POZ.com). Also at POZ.com: Dr. Hirschel discusses the issue (search “condom-free sex?”) on video.