Estimating the Risk of HIV Transmission from Homosexual Men Receiving Treatment to Their HIV-Uninfected Partners

Published: February 25, 2011

The current study was designed to determine how the risk of transmission from HIV-infected gay men receiving antiretroviral treatment relates to patterns of patient monitoring and condom use.

A stochastic mathematical simulation model was developed of Netherlands men who have sex with men (MSM), defining the parameters of the model using observational cohort data. Included in the model are viral load trends during first-line treatment, patient monitoring and various scenarios for the way in which condom use may depend on recent viral load measurements. Not included was the effect of STDs on HIV transmission.

The results showed that for MSM receiving treatment, the risk of transmitting HIV to their long-term partner is 22 percent (uncertainty interval: 9-37 percent) if condoms are never used. With incomplete condom use (30 percent of sex acts), the risk is reduced to 17 percent (7-29 percent). When men receiving treatment use condoms only six months beyond their last undetectable viral load measurement, the risk is as low as 3 percent (0.2-8 percent). "The risk is further reduced when three months is the time period beyond which condoms are used," the authors wrote.

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