Undetectable = Untransmittable

[Guinevere]

Unprotected sex can spread more than HIV. Syphilis is making a comeback, especially among gay and bisexual men. There is also HPV, gonorrhea and chlamydia, and more that can be spread by unprotected sex.

I have no doubt that a lot of people would be less careful if they were told they can be protected from HIV without a condom.

Which is maybe why there should be a return to a time when an unmarried couple engaging in unrestrained sex, consensual or not, was not condoned, encouraged, or even considered 'normal' as it is today.  This idea that if you go out with someone more than three times you are (if a male) entitled to sex or (if a female) are expected to give up the goodies is ridiculous and I'd like to know just who decided that this is "the new normal".

Some of you may recall that, back in 2001, Katie Barefoot from the old 'Cafe d'Arte' board and I got together as part of a FtF (no one else showed up, but that's beside the point).  We hit it off, and over the next several years we would meet and spend time together, whether it was at the RenFaire, taking a sunset sightseeing boat ride, attending MiniCon, going out for dinner (or sharing a pizza at the motel while watching movies on TV), or just going out for a walk.  I don't know if these were 'dates' or not (I do know how *I* felt about it, though), but even so I would have no more considered that she 'owed' me a roll in the hay after a certain number of 'encounters' any more than she would have felt obligated to see that I got my ashes hauled for the same reason.

And what the hell is so wrong with such an archaic, almost quaint idea?  As my dad once told me, "If you keep your pecker in your pants, you will save yourself a whole lot of problems" — and for the most part, he was correct.

-"BB"-

There are so many things wrong with this I don't know where to begin. Mostly I just feel sorry for you. Enjoying physical intimacy with another human being is one of the greatest experiences we have, and it is an essential part of our humanity. The notion that some antiquated rule, which was focused on retaining my value as "property" to some male overlord, knows better than I when I should and should not have sex, is simply idiotic.

[RayThom]

... There are so many things wrong with this I don't know where to begin. Mostly I just feel sorry for you. Enjoying physical intimacy with another human being is one of the greatest experiences we have, and it is an essential part of our humanity. The notion that some antiquated rule, which was focused on retaining my value as "property" to some male overlord, knows better than I when I should and should not have sex, is simply idiotic.

Yes, Guin,I agree completely. I was so awkward in my youth it was embarrassing and frustrating in equal measure. I never knew how to react to the sexual vibe at "that moment" and way too often, leave the encounter with my hands in my pockets, massaging my blue balls.

After the "summer of love" I realized I needed to changed my strategy. I dumped my male chauvinistic attitude and started to seek out the young ladies who I felt were way smarter and who were out to break down the archaic sexual barriers that caused so much relationship confusion. Had it not been for these aggressive, liberated, women I may not have gotten laid until I was much older -- praise the Lord.

Within a short time I got comfortable with the shared openness -- regardless how brief the encounter -- and as I got older realized how fortunate I was knowing that my "father's values" were way out of touch in our new, more progressive, society. And to my credit, after I stopped drinking alcohol 36 years ago, this knowledge enhanced my awareness incrementally in all the good ways. Still.

I am so grateful that I had the insight, and change what needed to be done before I became too stoic and too psychologically damaged to fix it. And better still, these lessons learned would prove to be an invaluable asset when I became a father and dad 27 years ago. My daughter and I understand each other completely.

Women rock! Life is good.

[Sue U]

Excellent news, Scooter! But good news never gets nearly as much play in the popular press as does a scare story. And I agree that actively providing accurate information about sexual health is infinitely better than saying nothing or (far worse) obfuscation, no matter how well-intentioned. But even in the 21st Century it is still difficult for many people to talk openly about sex and sexuality, or to be unreservedly sex-positive; fortunately, I see most of the pre-"Sexual Revolution" taboos finally falling away in my children's generation. Lucky them!

Which is maybe why there should be a return to a time when an unmarried couple engaging in unrestrained sex, consensual or not, was not condoned, encouraged, or even considered 'normal' as it is today.  This idea that if you go out with someone more than three times you are (if a male) entitled to sex or (if a female) are expected to give up the goodies is ridiculous and I'd like to know just who decided that this is "the new normal".

***

There are so many things wrong with this I don't know where to begin. Mostly I just feel sorry for you. Enjoying physical intimacy with another human being is one of the greatest experiences we have, and it is an essential part of our humanity. The notion that some antiquated rule, which was focused on retaining my value as "property" to some male overlord, knows better than I when I should and should not have sex, is simply idiotic.

What Guin said.

Also, although I haven't seen any statistics yet, I have a grim suspicion that the burgeoning heroin epidemic will lead to a renewed spike in HIV infections.

[ex-khobar Andy]

What does 'undetectable' mean? If the researchers are unwilling to put 'zero' on that side of the equation, how can they put zero on the other side?

snailgate

In terms of transmission or not it's binary: yes or no, so zero is a permissible result. In terms of detectability, there is a 'detection limit' which is never zero. If say it takes 10 detected virus entities to cause the testing procedure to register a 'hit' then 'undetectable' simply means 'less than ten' which is not zero.

[Scooter]

For The First Time, The CDC Admitted That HIV Can’t Be Transmitted If You’re Undetectable

The Centers for Disease Control has finally admitted what activists and medical experts have been saying for years: People whose HIV loads are undetectable can’t transmit the virus.

It might seem like a given, but as HIV Plus reports, its the first time the august body has made the claim.

In a memo released Wednesday, National Gay Men’s HIV/AIDS Awareness Day, the CDC stated that “when [antiretroviral treatment] results in viral suppression, defined as less than 200 copies/ml or undetectable levels, it prevents sexual HIV transmission.”

“Across three different studies, including thousands of couples and many thousand acts of sex without a condom or pre-exposure prophylaxis (PrEP),” it continues, “no HIV transmissions to an HIV-negative partner were observed when the HIV-positive person was virally suppressed. This means that people who take ART daily as prescribed and achieve and maintain an undetectable viral load have effectively no risk of sexually transmitting the virus to an HIV-negative partner.”

Nearly half of all people with HIV in the U.S. are undetectable, thanks to receiving proper treatment with anti-viral medication.

Bruce Richman*, executive director of UequalsU.org and the Prevention Access Campaign, tells HIVPlus the statement can’t be overestimated. “The CDC’s new and unequivocal language is a result of [the U.S. Department of Health and Human Services’] unprecedented review of transmission risk messaging across departments which will be rolling out core messaging in the coming weeks and months.”

On a less upbeat note, the memo also pointed out that gay and bisexual men are disproportionately affected by the virus, with more than 26,000 being diagnosed with HIV in 2015 alone. That’s two-thirds of all new cases in the U.S.

And Republican threats to the Affordable Care Act; Planned Parenthood; and funding for HIV awareness, treatment and education make our gains even more precarious.

“If Congress repeals the ACA without simultaneously replacing it with programs that ensure comprehensive health coverage for the same if not more individuals… people with HIV and others would lose access to the care and treatment that they rely on to remain healthy,” says Carl Schmid of the AIDS Institute. “People with HIV, who depend on a daily drug regimen, cannot risk losing access to their health coverage, not even for a single day.”

*this guy is a fucking dynamo and a hero of mine, btw - he built U=U into a worldwide movement brick by brick

[BoSoxGal]

[Scooter]

On 25 July 2018, late-breaking results presented at the AIDS 2018 conference in Amsterdam, confirm that having an undetectable viral load is as protective for gay men as it is for heterosexual couples. This will improve the quality of life for HIV positive people and their partners globally.

This is the largest study to look at the risk of HIV transmission when the positive partner in on effective treatment (ART).

The PARTNER2 Study has been following almost 1,000 gay male serodifferent couples from 14 different countries in Europe, where one partner was HIV-infected and on suppressive ART, and the other partner was HIV-negative. The study followed couples from September 2010 to April 2018, over which time couples reported almost 77,000 episodes of condomless anal sex with no linked HIV transmission occurring.

Dr Alison Rodger from UCL, London (lead author on the PARTNER study) explains the study: “The PARTNER2 study was designed to find whether HIV transmission occurs in gay men when viral load was suppressed. Despite these couples having sex without condoms almost 77,000 times we did not find a single case. PARTNER2 data provides robust evidence for gay men that the risk of HIV transmission with suppressive ART is effectively zero, supporting the message of the U=U campaign.”

PARTNER2 was an extension of the earlier PARTNER1 study, which also found zero transmissions in a study population where 65% of couples were heterosexual. Some gay couples in PARTNER2 were also included in the PARTNER 1 results.

The new results provide a similar level of confidence that HIV transmission risk in gay men through condomless sex is effectively zero as PARTNER1 provided for heterosexual couples.

The results underline the importance of earlier diagnosis and treatment.

Professor Jens Lundgren, professor in Infectious Diseases at Rigshospitalet, University of Copenhagen and Co-PI for the PARTNER study, comments “In 2015 we proved that it was better to start HIV treatment as soon as possible. We have now provided the scientific evidence for how effectively treatment prevents further sexual transmission”.

No linked HIV transmissions between serodifferent gay couples in the study

Some of the originally HIV negative men did becomes positive during the study, but by comparing the structure of each virus it was possibile to show that the two infections were different, and to conclude that the new infection was not acquired from the HIV positive partner. This uses a technique called phylogenetic analysis. In the PARTNER2 study, a total of 15 HIV-negative gay men became HIV positive during follow up.

Researchers from the University of Liverpool led by Professor Anna Maria Geretti, undertook the phylogenetic analyses. Professor Geretti comments: “Each individual HIV infection has its own genetic characteristics. Comparing the genomes of different viruses can show how similar or indeed dissimilar one virus is to another. In PARTNER2, the phylogenetic analysis showed that in all cases of new HIV infections occurring during the study, the virus was so different that it must have come from someone other than the HIV-positive partner on suppressive ART.”

Simon Collins, an HIV positive treatment activist at HIV i-Base, London, and one of the community representatives involved in the study said: “PARTNER2 has met the community demand from gay men to have accurate data about our health. There is no evidence that HIV transmission can actually occur when viral load is undetectable. Our data continue to support the international U=U awareness campaign."

The study is supported by grant [grant number DNRF126] from the Danish National Research Foundation