ART reduces the risk of passing on infection

Antiretroviral Therapy (ART) can counteract HIV in infected people so well, in ideal cases, that the virus can no longer be detected in the blood. The virus in other bodily fluids (such as genital fluids) is significantly reduced and the risk of infection for sexual transmission is greatly reduced. ART is an effective preventive measure to fight the epidemic. Studies have shown a drastic reduction of HIV infections in those population groups where the HIV-infected individuals were treated with ART. The rate of new infections was reduced by 80%. So the HIV epidemic in rich industrialised countries could practically be stopped now, if risky behaviours were simultaneously reduced and all HIV-infected people were aware of their infection.

Recommendations for HIV-infected people under effective ART

Yet in individual cases, even with optimal effective therapy (no viruses detectable in the blood), the risk of transmission cannot be completely excluded. In 2008 such an infection was documented in the specialist literature. Unfortunately, there are people who cannot tolerate these drugs because of side effects and others who become resistant to these drugs, so they lose their effectiveness.
The recommendation for HIV-infected people does not change with a successful treatment with ART. The HIV-infected person must inform his/her sexual partner(s) about the HIV infection and use condoms consistently. Even for a couple where both partners are HIV-infected, the recommendation is to use condoms consistently because of the potential risk of transmission of resistant viruses.

ART reduces mother-child transmission

The HIV transmission rate for an HIV-infected mother to her child during pregnancy, birth and lactation is about 30%. With ART treatment and avoiding breast-feeding, the transmission risk can be reduced to under 1%. For this reason, it is a must for mothers-to-be to have themselves tested for HIV, in order to benefit from these measures. Parents should, however, get themselves tested even before conceiving a baby. If one of the parents was HIV-positive, it would be better to reconsider the matter of having a child and to seek advice from a doctor. A child is entitled to parents who strive for his health and also their health.

Post-Exposure Prophylaxis (=PEP)

Antiretroviral drugs are also used as prophylaxis following a risk of infection. These drugs can be taken as soon as possible after an infection risk, ideally after few hours, but at least within 72 hours. ART must be taken for 4 weeks. This way, all viruses should be killed off right at the start, so that they cannot spread into the whole body and settle in.
PEP is used in cases of accidents at work involving medical staff (for example, an injury with an used needle). According to studies, the risk of transmission after injuries with HIV- blood-contaminated syringes or scalpels is reduced by 80%.
Post-exposure prophylaxis is theoretically also available to people who could have been infected during an unprotected sexual contact with an HIV-infected partner. However, still too little is known about the effectiveness of PEP in cases of sexual transmission. Therefore it is not generally suitable as method of preventing transmission during sexual contacts. One useful application of PEP is in rape cases.

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