Contagiousness in treated HIV-1 infection

Area of Science:

• Infectious Diseases
• Virology
• Public Health

Background:

• Antiretroviral therapy (ART) for HIV-1 significantly reduces illness and death.
• Effective ART lowers HIV infectiousness and disease spread in the community.

Purpose of the Study:

• To assess the contagiousness of HIV-infected individuals on ART.
• To provide guidance from the Swedish Reference Group for Antiviral Therapy (RAV) and the Public Health Agency of Sweden.

Main Methods:

• Review of current scientific knowledge on HIV transmission and ART effectiveness.
• Expert group assessment based on established treatment criteria.

Main Results:

• No risk of HIV transmission during vaginal or anal intercourse if the HIV-infected person meets ART criteria (undetectable viral load, high adherence).
• This holds true even without condom use.
• Other STIs do not increase HIV transmission risk in individuals on effective ART.

Conclusions:

• Effective ART eliminates the risk of sexual HIV transmission.
• While condoms are recommended for STI prevention, they are not necessary to prevent HIV transmission in this context.
• The risk of mother-to-child transmission and transmission in healthcare settings is significantly reduced with effective ART.