The PARTNERS Study. Throw condoms away?

There has been a lot of talk about the PARNTERS Study, which looked at a large number of couples, gay and straight, for several years.    There is some very encouraging news about prevention!   No cases were found in this study where a straight partner seroconverted, and no gay partners seroconverted from their regular partner.   This is great news.


Still, a couple of precautions:

There were new HIV infections in gay men in this study, but all were found to have been the result of sex outside of the primary relationship.     

If the positive partner had a virological failure during the trial, which did happen, that couple was excluded from the analysis.   

Statistically, you can't say this is "zero" transmissions.     The study isn't over, and what can be said so far is that the rate for gay men could be as low as zero, or as high as 4%.  Without drowning in statistics, let me quote another writer:

"A non-technical explanation of these risks, based on the PARTNER results so far, is that the risk of transmission occurring for one couple over ten years (based on having sex 45 times a year) could be as high as 4% for the average participant, and that the risk from anal sex could be as high as 9%. For receptive anal sex this reaches 32% risk over ten years. There is also a 2.5% chance that these risks could be higher."

This is good news, but it does not mean everyone can go to the bathhouses and not care.

1.  Everyone with HIV is not on HAART with undetectable viral loads.  In fact, only about 1/3 of patients are on meds and undetectable.

2.  The most infectious are the newly infected, who don't know their results, still

So, the study documents what we already know:  HIV treatment really does dramatically reduce infections.   How should we apply this to our lives?

After a discussion of status, two adults may decide how best to protect a negative partner from a new HIV infection

In any encounter, someone who wants to remain HIV negative should assume, always, that the person they are going to have sex with is HIV positive and not on treatment until proven otherwise.

What does this change? 

The following link is a good review of the study, and some discussion 


http://i-base.info/htb/24723