Other statements in response

A number of other bodies and organisations also issued statements in response to the Swiss statement.

In February 2008, the Centers for Disease Control and Prevention in the USA (CDC) issued a brief statement acknowledging the Swiss statement, but noting that the risk of transmission on successful treatment is not zero. The CDC re-emphasised its long-standing advice that people living with HIV who are sexually active should use condoms with all sexual partners.¹

In July 2008, the Australasian Society for HIV Medicine, the Australian Federation of AIDS Organisations, the National Association of People Living with HIV/AIDS, and the National Centre in HIV Epidemiology and Clinical Research issued a joint statement² that said: “by reducing viral load, antiretroviral therapy will also complement the benefits of consistent condom use and effective sexually transmitted infections (STI) detection and treatment, in preventing HIV transmission that may otherwise occur due to condom failure. However, there are no data to suggest that a population HIV-prevention strategy based solely or predominately on the use of ART and associated with a reduction in condom use, will lead to fewer people becoming infected in the Australian and New Zealand populations, especially in the context of rising rates of STI.”

Deutsche AIDS-Hilfe, the largest HIV voluntary-sector organisation in Germany, issued a position paper in April 2009 which broadly echoed the Swiss statement.³ Whereas the Swiss had stated in definitive terms that, in the circumstances listed, people cannot sexually transmit HIV, the German paper describes transmission as “improbable”. Deutsche AIDS-Hilfe says that the transmission risk is comparable to that when using condoms consistently. If an individual combined condom use with controlled viral load, then the transmission risk would be close to zero.

The paper mentions cases where HIV has been detected in semen although it was undetectable in the same person’s blood, and also highlights a case of the German man who transmitted HIV to his regular partner while undetectable on combination therapy.⁴

Nonetheless, Deutsche AIDS-Hilfe argues for a 'realistic' HIV-prevention approach which recognises that individuals do not necessarily aim to completely eliminate all risks, but balance risk reduction against sexual desires.