BHIVA guidelines

British guidelines on the sexual and reproductive health of people with HIV were produced in 2008 by the British HIV Association (BHIVA), the British Association of Sexual Health and HIV (BASHH) and the Faculty of Sexual and Reproductive Health of the Royal College of Obstetricians and Gynaecologists (FSRH).¹ They include some discussion of the issues first raised in the Swiss Statement.

The guidelines acknowledge the “compelling evidence” concerning virally suppressive treatment and vaginal or oral sex, but the authors say they “cannot fully endorse the Swiss consensus statement”.

They raise concerns around gaps in the evidence on anal sex, the potential for individuals to make decisions based on incorrect assumptions, and the fact that studies show that there remains a diminishing, but still significant, chance that HIV-positive people will, at some point in their time on HIV therapy, fail their therapy and thus develop a detectable HIV viral load.² This is a stochastic (inherently unpredictable) event that should be taken into account in discussions with patients.