The impact of undetectable viral load on HIV in Australia
We’ve known for several years that ‘Undetectable = Untransmittable’ (U=U). If you have had an undetectable viral load for at least six months and you continue to take your treatment as prescribed, there is no risk of passing HIV on during sex.
The scientific evidence proving this was done with thousands of couples in which one partner had HIV and the other did not. Over the course of several studies, they found that there was not a single HIV transmission from an HIV-positive partner who had an undetectable viral load.
It’s logical that this would affect the number of new HIV cases in the wider community, but we haven’t had strong scientific evidence until now. The previous studies focused on couples, not the wider population.
A new analysis looked at the population effect of HIV treatment on new HIV cases among gay and bisexual men in Australia, between 2010 and 2019.
Over this time there was a 27% increase in the proportion of men with an undetectable viral load, which resulted in a 66% reduction in HIV infections. Each 1% increase in the proportion with an undetectable viral load was associated with a 6% reduction in new HIV cases.
This effect was even stronger when PrEP was more widely available, showing the joint effect of HIV treatment and PrEP on the spread of HIV. By 2019, every 1% increase in the proportion of men with an undetectable viral load was linked with a 20% reduction in new HIV cases.
Mpox (monkeypox) and HIV
Mpox (monkeypox) is caused by a virus related to smallpox. It is transmitted during close personal contact, including sex.
In our video, NAM aidsmap's Susan Cole speaks to Professor Yvonne Gilleece, Chair of the British HIV Association (BHIVA), as well as Dr Will Nutland and Dr Matthew Page about the mpox (monkeypox) vaccination for people living with HIV.
You can find out more about mpox and HIV, including transmission, symptoms, prevention, vaccination and treatment of mpox, in our page.
Challenges with mental health and emotional wellbeing are reported by many people living with HIV. There are higher rates of depression and anxiety among people living with HIV than in the general population. Suicidal thoughts and suicide itself are rare, but rates are still much higher among people with HIV than in the general population.
The latest survey to report on this comes from Denmark. The researchers had access to anonymised health records for almost all people in the country, which allowed them to compare almost 6000 people living with HIV with HIV-negative people of the same age and sex.
In the first two years after HIV diagnosis, the risk of suicide was particularly high, with a rate over ten times that of people in the general population. After this particularly vulnerable period had passed, people with HIV still had over three times the risk of suicide.
While those figures may give the impression that suicide is very common, the absolute number of suicides was low – after ten years, 0.7% of people with HIV had died by suicide, compared to 0.2% of people without HIV.
The researchers say that HIV clinics and doctors need to pay more attention to people’s mental health. A page on our website and a video also includes advice on looking after your mental health and emotional wellbeing.
Health & Power
Last week, we broadcast our fourth episode of Health & Power, our series for people of colour focusing on health inequalities.
NAM aidsmap's Susan Cole and Dr Vanessa Apea from Barts Health NHS Trust spoke to Dr Halima Begum, chief executive of Runnymede, the UK's race equality think tank; and Harvey Kennedy-Pitt, chief executive of Black Beetle Health, a public health charity dedicated to promoting health, wellbeing and equality for LGBTQ+ communities of colour.
Pre-eclampsia and high blood pressure during pregnancy
Pre-eclampsia is one of several complications of pregnancy involving high blood pressure. It may happen when there's a problem with the placenta. The placenta passes oxygen, nutrients, and antibodies from the mother’s blood supply to the baby. It’s thought that pre-eclampsia develops when the blood supply to the placenta is not strong enough.
Left untreated, pre-eclampsia can lead to serious complications for both the mother and baby. Early delivery of the baby is often recommended.
A new study has shown that starting HIV treatment before becoming pregnant reduces the risk of pre-eclampsia and other blood pressure disorders during pregnancy. In fact, the South African study showed that women with HIV taking HIV treatment had a lower risk of developing a blood pressure disorder during pregnancy than women without HIV.
The immune system plays a role in the development of blood pressure disorders in pregnancy. This study adds to the evidence that by protecting the immune system and reducing HIV-related inflammation, HIV treatment reduces the risk of these problems.
Eye problems and HIV
HIV can affect your eyesight, but this is much less common than it used to be thanks to effective anti-HIV treatment. Sight problems are more likely to occur in people with very low CD4 counts.
Read about eye problems and HIV in our recently updated page. An audio recording of all the information is also available on the page.
Editors' picks from other sources
BBC EastEnders star James Farrar reveals 'unacceptable' taunting from public amid Zack Hudson's HIV storyline | My London
The star explained how his character's diagnosis is cruelly the brunt of some people's joke.
'A quick death or a slow death': Russian prisoners choose war to get lifesaving drugs | The New York Times
An estimated 20% of Russia prisoner recruits are HIV positive. To some, the Ukrainian front lines seemed less risky than prisons where they said they were denied effective treatments.
Across the generations | National Association of People with HIV Australia
David Menadue found out he was positive in 1984, Beau Newham in 2019. Given they belong to different 'HIV generations', how different were their experiences and how much are they the same? Beau and David got together recently to compare stories.
Daily statin reduces the risk of cardiovascular disease in people living with HIV, large NIH study finds | National Institutes of Health
A clinical trial was stopped early because a daily statin medication was found to reduce the increased risk of cardiovascular disease among people living with HIV in REPRIEVE, the first large-scale clinical study to test a primary cardiovascular prevention strategy in this population.
Patient who achieved HIV remission shares his story | City of Hope press release
Video interview and more information about Paul Edmonds, the 'City of Hope' patient, whose case was first reported in 2022.