Eight years ago, on January 30th 2008, the Swiss Federal
Commission for AIDS-related Issues (“the Commission”, now the Swiss Federal Commission
for Sexual Health) published a statement which – in the field of human
immunodeficiency virus (HIV) – rapidly received the name “The Swiss statement” [1].
The statement addressed the infectiousness of an HIV-positive person once the
virus was stably suppressed for at least 6 months with antiretroviral therapy
(ART). Despite the lack of results from large randomised studies, the
Commission felt, based on an expert evaluation of HIV transmission risk under
therapy, that the risk of HIV transmission in such a situation was negligible.
The publication was primarily aimed at Swiss physicians,
informing them that it was about time to discuss new data on infectiousness
with patients. Problematic differences in prevention messages were already
being observed by the Commission: some physicians openly discussed the very low
risk of transmission on ART and reassured patients who said they had condomless
sex with their steady partner, whereas others told HIV-positive patients under
therapy that all condomless sex – even with their HIV-positive partner – was
risky.
At the time it was clear that ART did, in fact, reduce the
likelihood of transmission, but the Commission’s estimate on the magnitude of
this risk was neither discussed with patients nor communicated widely. The
Commission summarised the epidemiological and biological knowledge known at the
time and concluded that the risk of transmission in a differing HIV status
partnership where the positive partner was on fully suppressive ART can be
considered negligible. The focus of the paper was on how to communicate this
information with an affected partnership where one partner was HIV positive...
Full article at: http://goo.gl/PXuGHY
By:
- 1Infektiologie/Spitalhygiene, Kantonspital St. Gallen, Switzerland.
- 2Brighton, United Kingdom.
- Swiss Med Wkly. 2016 Jan 29;146:w14246. doi: 10.4414/smw.2016.14246. eCollection 2016.
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