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“Definition: This statement refers to the use of antiretroviral
therapy (ART) by HIV-positive individuals to reduce the risk of transmission of HIV. There is now conclusive randomized clinical trial evidence, from heterosexual couples where one partner has HIV infection and the other does not, that if the partner who is HIV positive is taking effective ART, transmission of HIV through vaginal sex is significantly reduced (by 96%) [1]. The observed reduction in HIV transmission in a clinical trial setting demonstrates that successful ART use by the person who is HIV positive is as effective as consistent condom use in limiting viral transmission. The risk of a person
living with HIV, who is taking effective ART, passing HIV on to Tanespimycin clinical trial sexual partners through vaginal intercourse is extremely low, provided that the following conditions ZD1839 research buy are fulfilled. There are no other sexually transmitted infections (STIs) in either partner*. The person who is HIV positive has a sustained plasma viral load below 50 HIV-1 RNA copies/mL for more than 6 months and the viral load is below 50 copies/mL on the most recent test. Viral load testing to support the strategic use of ART as prevention should be undertaken regularly (3–4-monthly)‡. The published data are largely from heterosexual couples and there are insufficient data to conclude that successful ART use can provide similar levels of protection in relation
to other sexual practices, including unprotected anal intercourse between men or between men and women. However, it is expert opinion that an extremely low risk of transmission can also be anticipated for these practices, provided that the same conditions stated above are met. With the level of evidence available, it is Thalidomide recommended that health care professionals discuss with all people living with HIV the impact of ART on the risk of viral transmission to sexual partners. For those not yet taking ART and wishing to reduce the risk of transmission, the possibility of starting ART for this purpose should be discussed. Such discussion should establish that there is no evidence of coercion and that the person with HIV infection is fully informed of the need to commit to long-term adherence to ART, frequent STI screening (3–6-monthly dependent on risk)* and regular viral load measurements, and is aware of the potential side effects of therapy. It must be noted that no single prevention method can completely prevent HIV transmission. ART reduces the risk of transmission only of HIV. Irrespective of ART, condoms remain the most effective way to prevent the spread of other STIs.