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Author Topic: Undetectable Viral Load: As Safe as It Sounds?  (Read 1463 times)

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Offline oksikoko

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Undetectable Viral Load: As Safe as It Sounds?
« on: June 20, 2013, 04:35:04 PM »
Not sure if you all read poz.com or just the forums, but this interview is interesting if you're interested in such things:

Undetectable Viral Load: As Safe as It Sounds?

"Dr. Sonnabend: If in fact an undetectable viral load is being promoted as a new alternative form of safe sex for all, it must be coming from a very small group of people, and I suppose one could speculate on what motivates them—maybe it's just ignorance—if they are making a general recommendation. But I would also agree that there are some circumstances when reliance on a known and established undetectable viral load would be reasonable, although I think these would be relatively uncommon."
Code: [Select]
2013-10-03:                ☣ VL (=) undetectable ☣ CD4 (+) 1105
2013-05-23:                ☣ VL (=) undetectable ☣ CD4 (-) 945
2013-02-25:                ☣ VL (-) undetectable ☣ CD4 (+) 1123
2012-12-16: Enter Stribild
2012-11-20: HIV+           ☣ VL (→) 132,683      ☣ CD4 (→) 920
2012-04-01: HIV-
Dates in this signature file conform to ISO 8601. ;-)

Offline zach

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Re: Undetectable Viral Load: As Safe as It Sounds?
« Reply #1 on: June 20, 2013, 04:51:07 PM »
this isn't a dice roll. sure, undetectable means a lower % of risk of transmission. you may have unprotected sex 1000 times and never transmit. but that one time, its a gift for life. who would really play those odds?

not to mention there are other STDs out there. wear your condoms properly boys and girls. there is nothing fun or casual about AIDS, treat it with the seriousness it warrants.

Offline leatherman

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Re: Undetectable Viral Load: As Safe as It Sounds?
« Reply #2 on: June 20, 2013, 05:23:34 PM »
not to mention there are other STDs out there.
recently, after using up 2 condoms and feeling like I should give it a go for a third time  8) even though I was out of condoms, I learned that UTIs are also a possible consequence of unprotected sex.  :o
leatherman (aka mIkIE)


chart from 1992-2013; updated 2/09/13  Reyataz/Norvir/Truvada

Online Miss Philicia

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Re: Undetectable Viral Load: As Safe as It Sounds?
« Reply #3 on: June 20, 2013, 06:19:13 PM »
I don't have sex.
"I’ve slept with enough men to know that I’m not gay"

Offline buginme2

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Re: Undetectable Viral Load: As Safe as It Sounds?
« Reply #4 on: June 20, 2013, 06:26:27 PM »
You would think they would have edited that article/interview for clarity.  It's not very readable. 

I'm growing tired of the whole anti undetectable talk.  It's ....... quite biased.

Offline oksikoko

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Re: Undetectable Viral Load: As Safe as It Sounds?
« Reply #5 on: June 20, 2013, 09:33:48 PM »
I'm growing tired of the whole anti undetectable talk.  It's ....... quite biased.

You'd be hard-pressed to find proponents of a view who aren't biased toward the opinion that they're correct.

I didn't find it anti-undetectable. Who can deny that undetectable is a great way to be for myriad reasons? There does exist an irrational exuberance among some for the idea that undetectable is as good as cured. I think we can all agree that's not quite true.
Code: [Select]
2013-10-03:                ☣ VL (=) undetectable ☣ CD4 (+) 1105
2013-05-23:                ☣ VL (=) undetectable ☣ CD4 (-) 945
2013-02-25:                ☣ VL (-) undetectable ☣ CD4 (+) 1123
2012-12-16: Enter Stribild
2012-11-20: HIV+           ☣ VL (→) 132,683      ☣ CD4 (→) 920
2012-04-01: HIV-
Dates in this signature file conform to ISO 8601. ;-)

Offline oksikoko

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    • the treatment cascade
Re: Undetectable Viral Load: As Safe as It Sounds?
« Reply #6 on: June 20, 2013, 09:35:55 PM »
I don't have sex.

Isn't that hard on your constitution?
Code: [Select]
2013-10-03:                ☣ VL (=) undetectable ☣ CD4 (+) 1105
2013-05-23:                ☣ VL (=) undetectable ☣ CD4 (-) 945
2013-02-25:                ☣ VL (-) undetectable ☣ CD4 (+) 1123
2012-12-16: Enter Stribild
2012-11-20: HIV+           ☣ VL (→) 132,683      ☣ CD4 (→) 920
2012-04-01: HIV-
Dates in this signature file conform to ISO 8601. ;-)

Offline oksikoko

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    • the treatment cascade
Re: Undetectable Viral Load: As Safe as It Sounds?
« Reply #7 on: June 20, 2013, 09:37:00 PM »
recently, after using up 2 condoms and feeling like I should give it a go for a third time  8) even though I was out of condoms, I learned that UTIs are also a possible consequence of unprotected sex.  :o

:D

That is all.
Code: [Select]
2013-10-03:                ☣ VL (=) undetectable ☣ CD4 (+) 1105
2013-05-23:                ☣ VL (=) undetectable ☣ CD4 (-) 945
2013-02-25:                ☣ VL (-) undetectable ☣ CD4 (+) 1123
2012-12-16: Enter Stribild
2012-11-20: HIV+           ☣ VL (→) 132,683      ☣ CD4 (→) 920
2012-04-01: HIV-
Dates in this signature file conform to ISO 8601. ;-)

Offline jkinatl2

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Re: Undetectable Viral Load: As Safe as It Sounds?
« Reply #8 on: June 20, 2013, 10:13:47 PM »
You would think they would have edited that article/interview for clarity.  It's not very readable. 

I'm growing tired of the whole anti undetectable talk.  It's ....... quite biased.

Agreed. And like I keep saying, it lumps ALL forms of sex under the same umbrella. P in V, P in B, Insertive, receptive. It's the Oral Sex discussion, all over again - with NO quantification other than "don't."

Quote
"Dr. Sonnabend: If in fact an undetectable viral load is being promoted as a new alternative form of safe sex for all, it must be coming from a very small group of people, and I suppose one could speculate on what motivates them—maybe it's just ignorance—if they are making a general recommendation. But I would also agree that there are some circumstances when reliance on a known and established undetectable viral load would be reasonable, although I think these would be relatively uncommon."


Two major things:

This is about gay men, for one.

Because heterosexual serodiscordant couples have conceived children the natural way for over a decade without infection. And that's no "small number" of people, nor are they "ignorant."

Second, what are these "relatively uncommon" conditions? Sounds like someone is covering his ass with a broad brush here - and he seems to have more ass than brush, as he offers NO quantification.

I really hate it when people swoop down and demand we respect their authority, yet give no links, studies, no external quantification. I only know of a single study that mentioned the occasional spike in seminal viral load in otherwise UD partners - and that study failed to determine the nature, quantity, or quality of viral particles in that spike. A spike that, if the positive partner is a female or male bottom, is irrelevant.









« Last Edit: June 20, 2013, 10:30:10 PM by jkinatl2 »
"Many people, especially in the gay community, turn to oral sex as a safer alternative in the age of AIDS. And with HIV rates rising, people need to remember that oral sex is safer sex. It's a reasonable alternative."

-Kimberly Page-Shafer, PhD, MPH

Welcome Thread

Offline newt

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Re: Undetectable Viral Load: As Safe as It Sounds?
« Reply #9 on: June 21, 2013, 04:35:12 AM »
From the summary table of prevention interventions in the British HIV Association/British Association for Sexual Health and HIV position statement on pre-exposure prophylaxis in the UK (see here http://www.bhiva.org/PrEP2012.aspx):

Condoms: risk reduction effect is large 94.2% or greater, high-moderate strength of evidence

ART for HIV-positive partner: risk reduction effect is large, 92–96%, high-moderate strength of evidence depending on risk group

This is for insertive/receptive vaginal/anal sex for men having sex with men/women and women having sex with men

So if condoms work (as Dr Sonnabend says should be the "straightforward and easily understood message that should constantly be heard from research and community leaders"), being on fully suppressive ART works too.

The full and correct rubber message is consistent and correct condom use works to reduce the risk of HIV transmission to a minute level (perhaps even eliminate it).

The full and correct ART message is consistent and correct ART use works to reduce the risk of HIV transmission to a minute level (perhaps even eliminate it).

Small risks are difficult for people to adjudicate on.

What individuals decide may be different in a LTR vs shagging around. There are other reasons to use condoms. Prevention of HIV transmission is not the whole of sex and intimacy.

- matt
"The object is to be a well patient, not a good patient"

Offline oksikoko

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Re: Undetectable Viral Load: As Safe as It Sounds?
« Reply #10 on: June 21, 2013, 05:03:05 AM »
"Condoms are for cowards." -Jerri Blank
Code: [Select]
2013-10-03:                ☣ VL (=) undetectable ☣ CD4 (+) 1105
2013-05-23:                ☣ VL (=) undetectable ☣ CD4 (-) 945
2013-02-25:                ☣ VL (-) undetectable ☣ CD4 (+) 1123
2012-12-16: Enter Stribild
2012-11-20: HIV+           ☣ VL (→) 132,683      ☣ CD4 (→) 920
2012-04-01: HIV-
Dates in this signature file conform to ISO 8601. ;-)

Online Miss Philicia

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Re: Undetectable Viral Load: As Safe as It Sounds?
« Reply #11 on: June 21, 2013, 07:24:16 AM »
Isn't that hard on your constitution?

Not at all -- I watch porn daily and have copious orgasms. My tubes are in excellent condition.

Plus I don't have to deal with freaks in person, of which there are many. And it's condom-free with no other STI's!

Plus with my foot issues and ever increasing arthritis I don't have to contort myself in unusual positions. Obtaining arthritis before the age of 50 is super-duper fab. Thanks, AIDS!
« Last Edit: June 21, 2013, 07:27:31 AM by Miss Philicia »
"I’ve slept with enough men to know that I’m not gay"

 


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