In 2008, a group of Swiss scientists  concluded that people with HIV who are on effective antiretroviral therapy and have an undetectable viral load are sexually non-infectious and can safely practice unprotected sex under certain conditions, a statement that contradicted 20 years of HIV prevention messages. This presentation reflects on the polarised international response to the Swiss statement in the context of interviews with HIV-discordant couples participating in the first qualitative, longitudinal cohort study of people living heterosexually with HIV in Australia .
Findings and discussion: The Straightpoz study found that unprotected sex was common among heterosexual HIV-discordant couples, with many relying on alternative risk-reduction strategies, including an undetectable viral load. However, it was difficult to ascertain to what extent undetectability was a driver of unprotected sex or simply worked to reassure couples that what they were already doing was relatively safe. Indeed, sexual practices appeared far more driven by complex emotions and gender dynamics.
Recommendations: Alongside the scientific controversy over the Swiss statement, there needs to be a debate about its real-life significance and about the ethics and implications of informing HIV-discordant couples about the statement.
References:  Vernazza et al. (2008). HIV-infected persons on effective antiretroviral therapy (and free of other STDs) are sexually non-infectious.
Bulletin des Médecins Suisses, 89, 165–169. http://www.pinktherapy.com/downloadables/1cpc/4threwrite.pdf
 Persson et al. (2009) Men and women living heterosexually with HIV: The Straightpoz study, Volume 2, National Centre in HIV Social Research, UNSW.
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