Advice for people stranded because of volcano-related travel ban
A cloud of volcanic ash has caused serious problems for people trying to travel to or within large areas of Europe for several days now. Some people may be experiencing problems because they are not at home and running out of supplies of antiretroviral drugs.
You can find more detailed advice on how to get hold of anti-HIV drugs here, or search for an HIV clinic for help and advice on finding emergency drug supplies here.
HIV treatment as prevention
One of the hottest topics in HIV at the moment is the use of treatment as prevention.
Taking HIV treatment reduces the amount of virus, not only in the blood, but also in sexual fluids. The levels of viral load in blood and genital secretions are related.
Very few HIV transmissions are thought to originate in people who are on HIV treatment and whose blood viral load is undetectable.
Most of the research looking at the link between treatment, viral load and infectiousness has so far been conducted in heterosexual people.
These conditions are:
- The HIV-positive partner has been on stable HIV treatment, with an undetectable viral load, for at least six months.
- They have good adherence to treatment, with no missed, late or incorrectly taken doses.
- They have no other sexually transmitted infections.
The doctors studied the virus in a group of gay men recently infected with HIV to see if it could be placed within clusters of HIV transmissions.
All the men took HIV treatment soon after their infection with HIV, but stopped after a year or so.
The researchers traced six transmission clusters, involving 28 men.
None of the men who transmitted HIV to a sexual partner had an undetectable viral load.
Most of the men those who passed on HIV were in the “chronic” phase of HIV infection, having had HIV for at least one year.
This surprised the researchers. Viral load is highest soon after a person is first infected with HIV, and some researchers have argued that as many as half of all new HIV infections originate in people who have only recently been infected themselves.
In the Swiss research, the viral load in people transmitting the virus ranged from as low as 300 to over 1 million copies/ml.
The researchers think that their findings could have major implications, suggesting that gay men should take early and continuous HIV treatment as a way of reducing transmissions.
However, Swiss HIV doctors have previously pointed out that treatment is not a replacement for safer sex.
The use of treatment as prevention is a highly controversial and rapidly evolving subject. Further developments will be reported in HIV Weekly.