Does Antiretroviral Therapy Reduce Risk of HIV Transmission During Condomless Sex?

David Rosenthal, DO, PhD, medical director at the Center for Young Adult, Adolescent and Pediatric HIV Care at Northwell Health, reflects on a JAMA study, which states that use of antiretroviral therapy reduced the risk of HIV transmission during condomless sex.

Interview Transcript (slightly modified for readability)

“I think it’s interesting. I think that it’s an over-simplification [of how] the results can be interpreted. I think what it said is that if you’re taking antiretrovirals, you have a 94% likelihood of not acquiring HIV and there are very few people that actually were taking antiretrovirals that did acquire HIV in those serodiscordant relationships.

I think that it’s important for us to look at studies like that, and I think it’s really important for us to understand [that] there [are] a few things that are involved with [taking] antiretrovirals. One is, are you taking the antiretrovirals as you’re supposed to be taking them? The second thing is, have you skipped doses, and are you resistant? That’s another thing that’s important that the study found; you could be taking your medication but be resistant to the medication, and still transmit HIV.

I think it’s also really important for us to understand [that] if you’re the partner of the person who’s taking antiretroviral medication, you [have to] trust [that] your partner is taking their medication and that’s that one piece that you can do, is you can trust [that] your partner is taking the medication the way they’re supposed to. But what I’m still an advocate of is that if you are that partner of the HIV-positive individual, there’s stuff that you can do to prevent HIV [transmission] for yourself as well. Taking PrEP or medication once a day is one of those things that you can do. That takes the responsibility of the HIV prevention away from just your partner, who definitely needs to be taking their antiretrovirals, and that’s important for his health or her health and your health. But you as the partner of that individual can also take matters into your own hands and do things for HIV prevention like use condoms and take PrEP yourself.”