A question about transmission research

[AtomicA]

Hey guys, nothing to report on research but I was hoping someone had some info for me. Has there ever been a large scale study done on the risk of transmission between people with fully controlled, undetectable viral loads and people whose viral loads are not controlled or not well controlled? All I can get from doctors and people I know around the world is anecdotal evidence that it lowers the risk of transmission to be on drugs but I can't find any study that has actually examined that - like looking at long term relationships with sero-discordant couples or something.

I would be very interested in reading a study like that if anyone has seen one

[NYCguy]

Atomic, this has been a hot issue lately.  I don't have time to dredge up all the latest articles, but here is a good one from thebody:

http://www.aidsmap.com/en/news/167784F9-FD3C-4148-8AB3-F669FE941BB3.asp

There been conflicting studies - one European one showed that undetectable means you can't transmit (or so the scientists concluded). This obviously created a storm of controversy.  But I don't think anyone argues that lower vl means lower risk - just doesn't eliminate it.  Also, it seems that undetectable vl doesn't mean undetectable in semen.  However, I think most epidemiologists still believe that the majority of infections are transmitted by people that either don't know they are poz and thus untreated, or those who are not treated for other reasons.  It's tempting to want to believe that we are noninfectious because of treatment - but probably isn't true, or at least not totally.

[NYCguy]

Atomic - I forgot to mention one other thing.  A guy who was in a support group I go to is or was in a study where he was taking extra meds (on top of the standard triple cocktail) in an effort to discover if this would make him 'noninfectious.'   They were going to determine this by measuring body fluid VL with sensitive tests, which of course isn't the best indicator but probably the only way to do it on a small scale.  I thought the whole thing was a bit dubious and that he was exposing himself to additional risk by taking so many pills, but it actually reassured him.  Anyway, I don't know anymore about the study but I can ask him next time I see him.  And thought you might like to know it's going on.