Study finds HIV-infected men at risk for spreading HIV despite taking HAART

March 27, 2012, Boston University Medical Center

Researchers from Boston University School of Medicine (BUSM) and Fenway Health have found that highly active antiretroviral therapy (HAART) does not completely suppress HIV in the semen of sexually active HIV-infected men who have sex with men (MSM). The findings, which currently appear on-line in AIDS, could indicate a potential transmission risk in MSM, who are highly susceptible to HIV infection.

Approximately 33.3 million people worldwide are living with HIV/AIDS, and 1.8 million deaths and 2.6 million new infections occur annually. Unprotected intercourse is the most common route through which HIV-1 is transmitted, and of HIV-infected men is an important source of HIV. Whereas the HIV/AIDS epidemic in Sub-Saharan Africa is generalized with approximately equal percentages of infections occurring in men and women, the epidemic in the United States and many other developed countries is concentrated in men who have sex with men. HAART, which is the primary treatment for HIV/AIDS, consists of a combination of potent anti-HIV drugs, which generally suppresses HIV levels in blood and semen, and HIV transmission to sex partners. However, sexually active MSM have a high prevalence of sexually transmitted infections which are a risk factor for .

To determine what percentage of sexually active HIV-infected MSM on HAART have HIV in their semen, the research team, headed by Deborah Anderson, MD, professor of obstetrics and gynecology at BUSM, recruited 101 men from Fenway health, Boston. They measured levels of HIV in blood and semen, and examined the relationship between HIV in semen and other clinical, behavioral and biological variables.

Eighteen percent of the men had HIV in blood despite being on HAART, and half of these men also had HIV in semen. "It has been shown before that HIV levels in peripheral blood are an important predictor of seminal HIV," explained lead author Joseph Politch, PhD, research associate professor in at BUSM.

Of the 83 men with undetectable HIV in blood plasma, 25 percent had HIV in their semen. Detection of HIV in semen was strongly associated with high-risk (unprotected) sex behavior, sexually transmitted infections and genital inflammation.

"Our study provides evidence that genital infections and inflammation are common in HIV-infected MSM that engage in unprotected intercourse, and that these factors can promote HIV in the genital tract of men on suppressive HAART therapy even when HIV is not detectable in blood," said Politch.

Because MSM are more vulnerable to than heterosexual men, this information has potential clinical significance for the HIV epidemic in MSM. "Men who have sex with men who are at risk for transmitting HIV may believe that they have a low risk based on incorrect assumptions that HAART eliminates HIV from semen. Until more information on transmission risk in MSM is available, it would be prudent for sexually active HIV-infected MSM to use condoms and other risk-reduction strategies throughout all stages of HIV disease, regardless of HIV treatment status, and to promote the aggressive diagnosis and treatment of STIs," Politch said. Kenneth Mayer, MD, Director of Research at Fenway Health and a co-investigator on the study added: "We would like to extend this research to study the effects of newer HAART regimens, since newer agents may have different effects on HIV suppression in different compartments in the body, which may have implications for HIV prevention."

Explore further: HIV 'epidemics' emerging in MENA region: study

Related Stories

HIV 'epidemics' emerging in MENA region: study

August 3, 2011
The AIDS virus is spreading like an epidemic in some Middle East and North African countries because of homosexual encounters between men, a study warned on Wednesday.

Higher HIV risk in black gay men linked to partner choice, risk perception

May 2, 2011
Young black men who have sex with men (MSM) get infected with HIV nearly five times more often than MSM from other races, even though they don't have more unprotected sex.

Hepatitis C is transmitted by unprotected sex between HIV-infected men

July 21, 2011
Sexual transmission of hepatitis C virus (HCV) is considered rare. But a new study by researchers at Mount Sinai School of Medicine, working with the Centers for Disease Control and Prevention (CDC), provides substantial ...

Recommended for you

War in Ukraine has escalated HIV spread in the country: study

January 15, 2018
Conflict in Ukraine has increased the risk of HIV outbreaks throughout the country as displaced HIV-infected people move from war-affected regions to areas with higher risk of transmission, according to analysis by scientists.

Researchers offer new model for uncovering true HIV mortality rates in Zambia

January 12, 2018
A new study that seeks to better ascertain HIV mortality rates in Zambia could provide a model for improved national and regional surveillance approaches, and ultimately, more effective HIV treatment strategies.

New drug capsule may allow weekly HIV treatment

January 9, 2018
Researchers at MIT and Brigham and Women's Hospital have developed a capsule that can deliver a week's worth of HIV drugs in a single dose. This advance could make it much easier for patients to adhere to the strict schedule ...

New long-acting, less-toxic HIV drug suppresses virus in humanized mice

January 8, 2018
A team of Yale researchers tested a new chemical compound that suppresses HIV, protects immune cells, and remains effective for weeks with a single dose. In animal experiments, the compound proved to be a promising new candidate ...

Usage remains low for pill that can prevent HIV infection

January 8, 2018
From gritty neighborhoods in New York and Los Angeles to clinics in Kenya and Brazil, health workers are trying to popularize a pill that has proven highly effective in preventing HIV but which—in their view—remains woefully ...

Researchers find clues to AIDS resistance in sooty mangabey genome

January 3, 2018
Peaceful co-existence, rather than war: that's how sooty mangabeys, a monkey species found in West Africa, handle infection by SIV, a relative of HIV, and avoid developing AIDS-like disease.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.