Swiss Change Safe-Sex Message on HIV
February 01 2008 12:00 AM ET
experts said Thursday that some people with HIV who meet
strict conditions and are under treatment can safely have
unprotected sex with noninfected partners.
astonished AIDS researchers in Europe and North America who
have long argued that safe sex with a condom is the single
most effective way to prevent the spread of the
disease -- apart from abstinence.
''Not only is
(the Swiss proposal) dangerous, it's misleading and it is
not considering the implications of the biological facts
involved with HIV transmission,'' said Jay Levy,
director of the Laboratory for Tumor and AIDS Virus
Research at the University of California, San Francisco.
National AIDS Commission said patients who can satisfy
strict conditions, including successful antiretroviral
treatment to suppress the virus and absence
of any other sexually transmitted diseases, do not
pose a danger to others. The proposal was published this
week in the Bulletin of Swiss Medicine.
scientists took as their starting point a 1999 study by the
U.S. Centers for Disease Control and Prevention, which
showed that transmission depends strongly on the viral
load in the blood.
The other studies
had also found that patients on regular AIDS treatment
did not pass on the virus, and that HIV could not be
detected in their genital fluids.
''Let's be clear,
the decision has to remain with the HIV-negative
partner,'' said Pietro Vernazza, head of infectious diseases
at the cantonal hospital of St. Gallen in Switzerland
and an author of the report.
The studies cited
by the Swiss commission did not themselves definitively
conclude whether people with HIV on antiretroviral treatment
could safely have unprotected sex without passing on
The World Health
Organization said Switzerland would be the first country
in the world to try this approach.
''There is still
some concern that you can never guarantee that somebody
will not be infectious, and the evidence I have to say is
not conclusive,'' said Charlie Gilks, director of AIDS
treatment and prevention at WHO.
''We are not
going to be changing in any way our very clear
recommendations that people on treatment continue to
practice safer sex, including protected sex with a
condom, in any relationship,'' he added.
In any case, of
the millions of people worldwide now receiving HIV
treatment, only a very small number receive medical care
comparable to that in Switzerland, Gilks said. (AP)